Qualified health personnel in Colombia have seen the impact on their working conditions increase during the pandemic generated by covid-19. Nursing, medical and practical nursing professionals show steady increases in hours worked per week. Without the possibility of rest, there is an insufficient human resource to cover the high number of patients.
This is the conclusion of a study by the Universidad del Rosario and the Corporation for the Development of Social Security (Codess), according to which Nursing and medical personnel have been the fundamental axis of the management of the pandemic in the field of patient health carewhich around generally low income conditions and types of hiring through service provision, temporary or associated work cooperatives, the health emergency has led them to further aggravate their inadequate working conditions.
The results of the consultation “Concrete alternatives for social protection and formalization of work for skilled informal workers in the field of health in the face of the impacts of the covid-19 pandemic from the perspective of decent work”, reveal that ‘Between 2018 and 2021 They presented constant increases in the hours worked per week, both for nursing and medical personnel, said Iván Jaramillo Jassir, a researcher at the Labor Observatory of the Universidad del Rosario.
“We can say that the supply of staff is insufficient for the sector, which is reflected in the average number of patients treated in a single working day: 25 patients per day for each nurse, nurses being the ones who assist in mean a greater number of patients,” said Iván Jaramillo Jassir.
In the case of medical personnel, men see more patients each working day, with an average of 23 per day. Substantial difference with what is proposed by the OECD which recommends between 12 and 15 appointments per day for health personnel in general.
The Dane’s large integrated household survey indicates that in 2021, 80% of employed nurses were women. Likewise, Between 2020 and 2021, the staff employed increased significantly in response to the pandemic (4.5% nursing staff and 16.6% medical staff)without having managed to reach sufficient levels to cover the needs required by covid-19.
In this regard, the professor of economics at the Universidad del Rosario Darwin Cortés, indicated that the study identified that the sector has low informality, defined as affiliation to social security. In 2021, the informality rate was around 7.4% for nurses and 5.6% for doctors. Within this population, there is a large proportion of self-employed (35%), which may be a possible evidence of inadequate employment conditions in relation to decent work.
The researcher of the Labor Observatory of the Universidad del Rosario Diana Londoño explained that the analysis showed that the average income of those employed in the sector exceeds the minimum required to access the social protection floor and periodic economic benefits – BEPS. Nursing staff earn an average monthly per capita income of between 2 million pesos and $2.8 million, while medical staff manage to reach and exceed $6 million per month. Men have higher average incomes than women, identifying gender wage gaps in the country.
At the regional level, there are significant differences in the number of people employed and in the real income of these workers. In Bogotá, a considerable drop in the real salary of nursing personnel has been observed since 2019, while Cartagena is one of the cities that has presented the largest drop in salary for medical personnel.Londono commented.
A comprehensive policy that formalizes the occupation of health professionals must address issues related to poor labor market fit, shortage of trained health care personnel, inappropriate types of hiring, the low mobility that occurs between the population trained in nursing schools in large cities and their labor migration to remote areas of the country that do not have enough health personnel.
The study team developed an index of precarious work, in terms of occupation, which includes information relating to decent work. It has been found that nursing staff are more likely to be in precarious conditions than medical staff. This index took into account the duration of an employment contract, the deadlines for terminating employment contracts and hiring deadlines, the size of the employing company, salary levels, the place where work activities are exercised and working hours.
Support for trained caregivers
The Universidad del Rosario and Codess (Society for the Development of Social Security) conducted a survey that identified the type of support received by trained healthcare personnel: 56% have endowments to do their job, 27% have psychological support and only 10% have rest facilities. In terms of economic benefits, 60% receive paid leave, 40% have access to health insurance, 33% receive transport assistance and only 7% receive food assistance.
The firm issues a series of recommendations focused on improving working conditions within the framework of decent and dignified work, aiming at a transition towards the formalization of the work of all nursing and medical personnel; promote the mobility of nursing staff to areas that need it; have adequate spaces and rest times for nursing staff; establish a salary system that recognizes training and experience, seeking gender equity and minimizing exposure to risks due to work-related causes in all areas, among the main ones.
For Codess expert research adviser John Marulanda, the study is important in three ways: first, because it deepens and establishes the real situation of labor informality among skilled carers. Second, it identifies gaps and inequalities in wages and working conditions by gender and profession of health workers that are unfair and avoidable. And thirdly, because it defines specific recommendations for decent work in the sector, as well as the criteria and the basis for the objective of a new model of health focused on the most basic level.
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