1. The Role of the Nursing Leaders in Epidemic Control: Lessons learned from HIV service scale up in South Africa
Dr JN Makhanya PhD
Chief Nursing Officer, National Ministry of Health
Republic of South Africa

2. Nursing in South Africa: Introduction
SA national health system
Public, Private and NGO sectors
Stewardship role (National Ministry)
Nurse-based services across the 3 sectors
Regulated health sciences education & training
Statutory health councils: SANC
Nursing
Policy management through Chief Nursing Office (recent)
Review of the national role of the CNO in HIV policy formation, legislation and regulation of nursing practice

3. Role of Nursing in HIV Epidemic Control
Education and Training
Policy formulation & implementation
Administration
Practice
Thematic involvement
Leadership
Scientific activities
Community initiatives

4. Nursing Education & Training
Role of the two Ministries – Education and health.
Health sector a major employer for nurses
South Africa has a quadruple burden of disease compared to other countries
Has adopted Re- engineered of PHC as an approach to service delivery
South Africa's nurse-based healthcare system requires nurses to have the competence and expertise to manage the country's burden of disease and meet South Africa's healthcare needs.
Important to note that even though there are many changes in the nursing education & training landscape, many institutions are still applying the bedside teaching methods
Exposure to different settings remains a critical aspect of nurse training especially at public nursing colleges
Advances in SA nursing are also influenced by the strong research element arising out of nursing departments at higher education institutions
Integration of HIV & AIDS education into nurse training has to be balanced with other serious public health concerns like the rise in lifestyle driven conditions like obesity, diabetes etc

5. Nursing Education Institutions
Selection Criteria
Northern Campus of FSSON
Mpumalanga College of Nursing
Prince Mshiyeni Campus of KZNCN
Support to implement New Professional Nurse Qualification
Support to implement New Staff Nurse Qualification
Support to implement New Specialist Nurse Qualification
Focal areas
Institutional programme submission to HEQC
Academic staff development
Pre-service curriculum development & implementation
Clinical education strengthened through the preceptor programme
Outcomes:
Improved institutional and academic capacity
Improved quality of nursing education
Appropriately educated & trained competent nurses/ midwives are produced
Impact
Improved health outcomes for populations in low resourced settings and across the life span

6. Policy Formulation & Implementation
CNO recently established and located at national Ministry of Health
Role:
Policy formulation,
Harmonisation of nursing services
Influence on pre-service education
Liaison with international bodies on nursing
Statutory regulation of nursing
Education & training
Scopes of practice
Practitioner conduct
Coordination role of CNO critical for advancement of nursing policy
CNO has major implications for all aspects of nursing – practice, education & training, leadership, policy & regulation, resourcing and social relevance

7. Service / Practice Established role in public health programmes
Removal of constraints in prescribing (HRH shortages)
Specific role in HIV & AIDS epidemic
Counselling and testing
Awareness campaigns
Initiation of treatment
HIV & TB
NIMART
Necessitated by scale of epidemic
Limited to professional nurse & midwife
Forced a change in the scopes of practice
Role of nursing and its leadership not a major problem in SA despite historical challenges – made it possible due to leadership roles in managing public health programmes and many aspects of acute / chronic care within health facilities
Venturing into non-profession specific areas almost always nurse-led e.g. infection control
HIV epidemic required mass scale response – nursing became obvious choice of profession to spearhead the fight
Impact on society and the profession itself

8. Conclusion conclusion NURSES LEADING THE WAY TO 90 90 90
SUSTAINABLE DEVELOPMENT GOALS
Access
Equity
Rights
NURSES LEADING THE WAY TO
UNIVERSAL HEALTH COVERAGE

9. THANK YOU