South Africa has been faced with a critical shortage of nurses, which has been worsening over the years, resulting in a number of challenges in providing quality healthcare.

According to data from the South African Nursing Council (SANC), the total number of nurses in both the private and public sectors has increased from 123 755 nurses in 1998 to 271 047 nurses in 2022, which is a 199.6% increase. While this increase is commendable, we cannot overlook the fact that the nurse-to-patient ratio still remains high, with 224 patients per nurse in 2022.This has far-reaching implications for patient care, including excessive workloads for nurses, heightened stress levels, extended waiting times and insufficient attention to individual patient needs.

The nurse shortage crisis

The nurse shortage crisis in South Africa can be attributed to several factors. Firstly, the increasing healthcare demands of an increasing population, coupled with the burden of infectious diseases such as HIV/AIDS, have stretched the healthcare system to its limits. Another contributing factor is the limited capacity of the private sector to train nurses to their full potential due to existing regulations. Additionally, low retention rates due to poor working conditions, especially in the public sector, and relatively low salaries have driven nurses to pursue alternative careers, or to seek employment opportunities abroad in countries such as Australia and the United Kingdom.

Concerns with the National Health Insurance (NHI) implementation

The approval of the NHI Bill by Parliament’s Portfolio Committee on Health is very concerning, especially with regards to its likely devastating impact on healthcare professionals, including nurses. One of the major concerns is the potential brain drain of healthcare professionals, including nurses, as better opportunities and working conditions in European countries may tempt them to leave the country. The loss of skilled nurses through brain drain will further worsen the shortage and destroy efforts to improve patient care.

Addressing the nurse shortage

To address the nurse shortage crisis in South Africa, it is critical to improve the working conditions of nurses. Healthcare facilities must prioritize the well-being of nurses by providing competitive salaries, manageable workloads, and opportunities for career growth and professional development. By creating a supportive work environment, South Africa can retain more nurses and prevent them from leaving the country to seek opportunities abroad.

Additionally, it is important for the government to grant permission to private hospitals to participate fully in nurse training programmes. Richard Friedland, the CEO of Netcare, recently highlighted the fact that this organization has the capability to train over 3 500 nurses annually. However, the government has only accredited it to train approximately 10% of that number, resulting in a surplus of nursing college capacity within the company. The private sector can play a major role in resolving the nurse shortage crisis, contributing towards increasing the number of trained nurses. 

Furthermore, partnerships between the government, healthcare institutions, and nursing organisations can help identify and implement strategies to alleviate the shortage. This can include targeted recruitment drives, mentorship programmes, and initiatives to enhance job satisfaction and work-life balance for nurses.

The nurse shortage crisis in South Africa demands immediate attention. By improving working conditions and implementing targeted retention strategies, South Africa can begin to address the shortage and improve the quality of healthcare. However, concerns surrounding the potential impact of NHI implementation on healthcare professionals cannot be taken lightly. It is important to strike a balance between expanding healthcare access and ensuring the retention of skilled professionals. By addressing these issues, South Africa can work towards an effective healthcare system that meets the needs of its citizens while retaining its healthcare workforce.


Tawanda is a research analyst for the Centre For Risk Analysis (CRA). He is primarily involved in writing chapters for the Socio-Economic Survey of South Africa, a reference guide on major trends in various social and economic fields. Tawanda’s other responsibilities include writing opinion pieces, assisting in research projects and reports and liaising with the media. Tawanda holds an Honours in Business Management from the University of Limpopo and is currently studying towards his Masters in Business Management.