Nursing Leadership in Epidemic Control: Lessons from South Africa's HIV Service Scale-Up

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 • Role of nursing in: • 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.

5. Nursing Education Institutions Selection Criteria Mpumalanga College of Nursing Northern Campus of FSSON Prince Mshiyeni Campus of KZNCN Support to implement New Specialist Nurse Qualification Support to implement New Professional Nurse Qualification Support to implement New Staff 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

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

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

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