Nurses are essential healthcare professionals who provide vital services in hospitals, clinics, and communities. Determining the total number of nurses in a country like Ghana is important for health workforce planning and ensuring adequate capacity to meet population health needs. This article will examine available data to estimate the current total number of nurses actively practicing in Ghana.
Key Statistics on Nurses in Ghana
Total Number of Registered Nurses
According to the latest data from the Nursing and Midwifery Council of Ghana, there were 66,259 registered nurses in the country as of 2018. This includes general nurses, midwives, mental health nurses, and community health nurses. The Nursing and Midwifery Council is responsible for licensing and regulating nursing practice in Ghana.
Nurse to Population Ratio
The World Health Organization recommends a nurse to population ratio of 1 nurse for every 300 people. In Ghana, the ratio is estimated to be around 1 nurse for every 1,200 people. This indicates there is a significant shortage of nurses relative to the population size.
Number of New Nurse Graduates
Ghana produces around 4,000-5,000 new nurse graduates each year from over 60 nursing training institutions. However, not all these new nurses go on to obtain registration and practice in Ghana.
Nurses by Region
The Ashanti region has the highest number of nurses (16,000+), followed by Greater Accra (14,000+) and Eastern Region (8,500+). The Upper West region has the fewest nurses (around 2,000).
Nurses by Sector
The majority of Ghana’s nurses (around 75%) work in the public sector under the Ghana Health Service. The remaining 25% work in private and mission hospitals and clinics.
Factors Affecting Total Number of Practicing Nurses
While there are over 66,000 registered nurses in Ghana, the actual number engaged in active clinical practice is likely lower due to the following factors:
Migration
It is estimated that 10-15% of nurses trained in Ghana migrate to work in other countries like the UK, USA, and other African nations due to better employment prospects. This ‘brain drain’ reduces the number of nurses actively working in the country.
Informal/Unemployed
Some nurses may be unemployed or working informally outside of the health sector due to lack of jobs matching their qualifications and experience.
Retired Nurses
Many older nurses start retiring from active practice from the age of 60 years. Though some may continue working part-time.
Career Change
A small proportion of nurses may change careers into non-nursing fields like administration, teaching, or business.
Temporary Exit
Factors like maternity leave, continuing education, or other personal reasons can lead to temporary exit from the nursing workforce for periods of time.
Estimating Total Number of Practicing Nurses
Given the above considerations, the total number of nurses actively engaged in clinical practice in Ghana is likely to be in the range of 50,000 – 60,000 currently.
This estimate takes into account new graduates joining the workforce annually and accounts for migration, unemployment, retirement, and other factors reducing the nursing labor pool.
While still inadequate for population needs, Ghana is making progress in expanding its nursing workforce. Continued investments in nurse education, employment, and retention initiatives can help boost the total number of practicing nurses in the country.
Geographic Distribution of Nurses in Ghana
The distribution of nurses across different regions and districts of Ghana is uneven, with some areas having adequate numbers and others facing shortfalls. Some patterns in the geographic spread of nurses:
Urban vs Rural Areas
Most nurses are concentrated in urban areas and particularly the big cities like Accra and Kumasi. Rural communities tend to have fewer nurses relative to their populations.
Coastal vs Northern Areas
Coastal areas in the south have higher nurse numbers compared to the north. For instance, Central, Greater Accra and Volta regions have higher nurse-population ratios than Northern, Upper East and Upper West regions.
Affluent vs Deprived Areas
More affluent parts of the country tend to attract and retain more nurses due to availability of better jobs, housing, schools etc. Deprived districts struggle with nurse recruitment and retention.
Public vs Private Facilities
Metropolitan and large hospitals soak up the majority of nurses. Smaller primary health centers and CHPS clinics in rural areas have just 1-2 nurses covering large populations. The private sector employs nurses mainly in urban areas.
Improving the Geographic Distribution of Nurses
To address imbalances in nurse distribution, the following strategies can be helpful:
– Providing increased employment opportunities and recruitment drives targeted at deprived regions and districts.
– Prioritizing nurse deployment to underserved rural and remote areas.
– Offering scholarships and loans tied to working in rural postings for a defined period after graduation.
– Rolling out training programs and schools for nurses in the north rather than just southern cities.
– Building staff housing to accommodate nurses in rural areas.
– Designing financial and non-financial incentives for rural postings like hardship allowances, better remuneration packages etc.
– Developing policies to rotate nurses through different geographic areas during their careers.
– Strengthening HR management to align nurse deployment with health needs.
– Upgrading rural health facilities to retain more nurses.
– Launching campaigns to increase uptake of rural postings as national service.
Nurse Categories and Roles in Ghana
There are different categories and designations of nurses in Ghana aligned to their qualifications and job roles:
Registered General Nurse
– Have diploma in general nursing from accredited institution
– Provide broad-based care in hospitals and clinics
– Can progress to specialist areas like midwifery, critical care etc. with additional training
Registered Mental Health Nurse
– Diploma in psychiatric/mental health nursing
– Provide care to clients with mental health conditions and psychiatric disorders.
– Work in psychiatric hospitals, units, and mental health outpatient facilities.
Community Health Nurse
– Diploma in Community Health Nursing
– Care for individuals, families and communities through health promotion, preventive care, treatment and rehabilitation.
– Support public health programs at community and primary care level.
Registered Midwife
– Diploma in Midwifery
– Provide care and support to women during pregnancy, labor and the postpartum period.
– Work in antenatal clinics, labor wards, postnatal units and related areas.
Nurse Educator/Tutor
– Teach nursing students in training colleges/universities
– Minimum bachelor’s degree in nursing; master’s preferred
Nurse Administrator/Manager
– Take on leadership, management and administrative roles
– Require experience and/or postgraduate qualifications in nursing, health management etc.
Clinical Nurse Specialist
– Undertake advanced training in specialized areas like critical care, neonatology, wound care etc.
– Provide expert nursing care in their specialty area.
Nurse Practitioner
– Have advanced clinical training at Master’s degree level
– Can take on roles like diagnosing patients, prescribing medications etc.
– Relatively new role in Ghana – still evolving.
Enrolled Nurse
– Have certificate training in nursing
– Provide basic nursing care under supervision of registered nurses.
– Being phased out in favor of increasing RNs.
Nursing Education Pathways in Ghana
There are clear pathways for nursing education and training in Ghana:
Certificate
– 2-year enrolled nursing program (being phased out)
– Award is a certificate in nursing
Diploma
– 3-year diploma in general nursing or specialized branches like mental health, community health etc.
– Entry requires senior high school certificate
– Offered at public nursing training colleges or private institutions
Bachelor’s Degree
– 4-year BSc Nursing program
– Entry requires diploma in nursing or equivalent qualification
– Offered at universities
Master’s Degree
– 2-year duration
– Entry requires Bachelor’s degree in nursing
– Specializations like clinical nursing, public health nursing, nursing education etc.
Doctorate
– Highest nursing qualification
– Needed for roles in research and academia
– 6-year duration after Bachelor’s degree
Post-basic specialist courses are also available in areas like critical care, neonatology etc. Continuing professional development is required for renewal of nursing licenses.
Challenges Facing the Nursing Profession in Ghana
While Ghana has made strides in strengthening its nursing workforce, some key challenges still hamper the profession:
Staff Shortages
– Current nurse-population ratio still lags behind WHO standards, leading to high workload.
Poor Working Conditions
– Issues like low salaries, lack of accommodation, and shortage of supplies negatively impact nurses.
Limited Higher Education
– Nurses with advanced qualifications are few, hampering specialist care provision.
Insufficient CPD Opportunities
– Continuing education programs for nurses to advance expertise are still limited.
Lack of Retention Strategies
– High attrition as nurses migrate or leave the profession due to lack of growth prospects.
Resource Constraints
– Funding constraints inhibit expansion of nursing capacity.
Addressing these challenges can help unlock the full potential of Ghana’s nurses.
Growth Prospects for Nursing in Ghana
The future for nursing in Ghana looks promising, with policies and strategies underway to facilitate growth:
Increased Training and Education
More nurses are being trained, and higher education pathways are now open through bachelors and masters nursing programs.
Expanded Career Options
Specialist and advanced roles like nurse practitioners and clinical specialists are beginning to emerge.
Better Salaries and Working Conditions
Though still insufficient, there have been some improvements in nurse pay and workspace resources.
More Opportunities for CPD
Access to continuing professional development is being strengthened through courses, workshops and in-service training.
Alternative Employment Models
Options like public-private partnerships, part-time work, and outsourcing provide nurses alternative work arrangements.
Investment in Human Resources
Nurses are increasingly seen as a key part of the health workforce needed to achieve universal health coverage.
Positive Image of Nursing
Traditional misconceptions of nursing being unrespectable are changing through media campaigns on the value of nursing.
Overall, nursing in Ghana looks well placed to grow in capacity and capabilities to better serve the expanding healthcare needs. The coming decade is likely to see enhanced status, standards, and significance of nurses in the country.
Conclusion
In conclusion, while exact counts are difficult, the total number of practicing nurses in Ghana currently stands at an estimated 50,000 to 60,000. Major gains have been made in expanding the nursing workforce over the past decade. However, distribution imbalances persist, with shortages of nurses in rural and deprived districts. Ongoing investments, improved policies, and strategic human resource planning will be key to further strengthening the nursing profession and harnessing its full potential to advance population health outcomes. The coming years are likely to see positive developments in nursing education, career pathways, working environments and stature that can accelerate Ghana’s progress toward universal health coverage.