South Africa: Improve facility management to increase nurse retention

South Africa’s medical infrastructure is relatively well developed, but its maternal mortality rate remains high and numerous studies document poor maternal care. Shortages in nursing staff are a major factor in quality-of-care problems on maternity wards. A Population Council FRONTIERS study of antenatal care in rural clinics in Kwa-Zulu Natal showed that between one-third and one-half of providers interviewed had worked at their clinics for less than a year. In 2004, FRONTIERS followed up on the Kwa-Zulu Natal study to document factors affecting the tenure, motivations, and working conditions of maternal-health nursing staff in three South African provinces. The study covered nurses and advanced midwives. Data were collected through a questionnaire sent to all public hospitals providing maternal-care services, a survey on nurses’ motivation and decision-making, and interviews, as well as site visits to 15 hospitals and 27 clinics. The investigation revealed a variety of problems leading to chronic disempowerment and demotivation of nurses. As noted in this brief, strong management and fully equipped facilities could help redress staff turnover