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Nurses – The Backbone Of SA’s Healthcare System

  • 5 min read

Nurses have emerged as heroes in the fight against Covid-19. The grit, quick decision-making and compassion required to take care of patients in the face of a terrifying global pandemic has been highlighted in media stories the world over1

Notably, last year was a significant year for nurses. In addition to the year being the 200th anniversary of Florence Nightingale’s birth, and the World Health Organisation declaring 2020 the International Year of the Nurse and Midwife, COVID-19 shed light on the crucial role of nurses in the face of extreme medical crises2.

As the world observes International Nurses Day on 12 May 2021, the International Council of Nurses (ICN) has given the event the theme of A Vision for Future Healthcare3. The organisation says COVID-19 exposed weaknesses in global healthcare systems around the world compelling nurses to work under enormous pressure, and having to draw on their reserves of commitment and courage to do their jobs3.

While the COVID-19 pandemic presented several challenges to the entire healthcare sector, nurses, in particular, were hard hit. These included the short supply of personal protective equipment (PPE), tedious 12-hour long shifts, not being able to see family, and more importantly, the inability to mourn the loss of those close to them, including colleagues4. Moreover, the pandemic and influx of ill patients meant higher levels of stress and an added sense of fear, greatly impacting their ability to work to the best of their abilities5.

This is further exacerbated with a shortage of nurses6. In South Africa, for example, there are a mere 1.3 nurses and midwives for every 1,000 people, well below the global average of 3.8 per 1,000 people7. COVID-19 has made the situation worse, with nurses having to address the needs of an influx of even more patients8, albeit already understaffed9.

With more than 66% of South Africans living in urban areas and cities10, the remaining 34% of the population in rural areas rely heavily on nurses as their first point of contact and care11. Rural healthcare facilities are often understaffed and patients face difficulties such as transportation issues and vast distances to travel, amongst others, all of which impact them in accessing these facilities12

These challenges, combined with the need to reach far-reaching communities, and address the basic human right of suitable primary healthcare, has driven pharmaceutical companies such as Pfizer, to invest in and support ventures such as Unjani Clinic. Boasting a network of 81 black female professional nurse-owned clinics, the initiative provides quality, affordable and accessible primary healthcare to underserved communities in South Africa13.

Each time a new facility is opened, the professional nurse is empowered to not only own the clinic but to employ two members of staff. To date, the facilities have conducted as many as 1,684,230 consultations. Coupled with the fact that as much as 84% of the South African population are dependent on an already overburdened public healthcare system, Unjani Clinics will have a resounding impact on communities in the country13.

Nurses do more than just care for patients, they advocate for health, educate, innovate and provide ongoing assessments for patients’ health14. Nurses save lives14, and as the largest profession in the sector, they will play a vital planning role for the future of the South African healthcare system3.


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4. Harrisberg K. The daily battle of rural nurses on South Africa’s COVID-19 frontline [Internet]. Reuters. 2020 [cited 2021 Apr 22]. Available from:

5. Tshikalange S. “Nurses have seen the worst — please protect yourself from the coronavirus” [Internet]. TimesLIVE. 2020 [cited 2021 Apr 22]. Available from:

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12. Katzen LS, Tomlinson M, Christodoulou J, Laurenzi C, le Roux I, Baker V, et al. Home visits by community health workers in rural South Africa have a limited, but important impact on maternal and child health in the first two years of life. BMC Health Serv Res. 2020 Jun 29;20(1):1–10.

13. home – Unjani Clinic [Internet]. [cited 2021 Apr 22]. Available from:

14. Nursing in today’s society [Internet]. [cited 2021 Apr 22]. Available from: