18.2 Learnerships

To address the shortage of qualified nurses in the Western Cape Province, particularly in the Boland-Overberg Region, representatives from a number of district level hospitals, including the regional hospital Eben Dönges, met with the Health and Welfare Sector Education and Training Authority (HWSETA) and the Department of Education (DoE) and established the 18.2 Learnership Project in 1997.  The 18.2 Leadership Project was created as an induction, education, and employment system for nursing that admitted only the best and brightest applicants from the Boland-Overberg Region. The inductees were placed into programmes designed to educate the participants in the field of Auxiliary Nursing.  In addition to a campaign aimed at attracting individuals from the community at large, the programme also employs a policy of in-house promotion which rewards current hospital staff through advancing current levels of employment.  

In an effort to generate employment in underutilised segments of the population stipulations were put into place concerning the demographics of the region.  Social impetus required that 85% of the total number of participants in the programme had to be black, 54% of that number women, and additionally 4% were required to be disabled.  Advertisements for open positions in the programme were placed in towns, community centres and libraries.  Originally, the minimum requirement to enter the programme was a Grade 10 pass, but because of the level of competition the requirements have been raised to a Grade 12 pass, and the ability to read and write in two official languages. The programme drew 7 000 applicants in the initial stage which implied that each district hospital had to create a short-list of possible candidates.  Once this was completed, potential beneficiaries were interviewed by a panel comprised of hospital staff and community representatives.

Successful candidates are admitted to a one-year accredited course, which includes theoretical and practical training. The Human Resource Team from the Eben Dönges Hospital provides the theoretical training while the practical training is conducted at the district hospital level and also in Paarl Hospital.  Upon completion of the 1 year programme participants are required to successfully pass the South African Nursing Council (SANC) final exam before they are eligible to apply to the Hospital Authority for a position as an Enrolled Nurse.  After an additional 2 years of formal training, and subsequent exams, participants are then capable of becoming Registered Nurses. 

Innovation

Addressing the low skill base in nursing in the Boland-Overberg area, and meeting the critical shortage of health care personnel through a rigorous in-house training programme is innovative.  Also, the "step-ladder" approach to training, offered to current employees who wish to advance in their careers, creates a working culture that rewards hard work and ambition with upward mobility through advancing employees' skills.

Effectiveness

Since the inception of the project, 90 community members have completed the learnerships and are employed by the Western Cape Department of Health. 40 hospital cleaners have had their skills upgraded to auxiliary nurses. 36 nurses have completed an additional year of training, while 32 have completed an additional two years of training.

Poverty Impact

All learners selected for training were previously unemployed, with the majority of them coming from disadvantaged backgrounds. Completion of the 1 year process resulted in the average salary of R41 946 per annum.

Sustainability

Funding is secured from the HWSETA and with the critical shortage of health personnel, it seems likely that the project will be funded for at least the next three years. The Hospital Facilitation Board administers the funds received from the HWSETA according to the Public Finance Management Act.

Replication

The nursing programme can be replicated in any hospital with an enthusiastic and dedicated staff. 

Partnerships

• Health and Welfare SETA
• Provincial Department of Health
• Provincial Department of Education