Qualified health care personnel in Colombia have seen the impact on their working conditions accentuated during the pandemic generated by covid-19. Professionals in nursing, medicine and nursing assistants present constant increases in the hours worked per week. Without the possibility of rest, there is a human resource that is insufficient 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 for managing the pandemic from the area of health care to patientswho around generally low-income conditions and types of hiring through the provision of services, temporary or associated work cooperatives, the health emergency has led them to further deepen their inadequate working conditions.
The results of the consultancy “Concrete alternatives for social protection and labor formalization for qualified informal workers in the area of health care in the face of the impacts of the covid-19 pandemic in the perspective of decent work”, reveal that between 2018 and 2021 They have 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 affirm that there is an insufficient supply of personnel for the sector, which is reflected in the average number of patients treated in the same working day: 25 patients a day for each nursing person, with women nurses being the ones who attend in average a greater number of patients”, highlighted Iván Jaramillo Jassir.
In the case of medical staff, men see more patients each working day, with an average of 23 a day. Substantial difference with what is proposed by the OECD, which recommends between 12 to 15 appointments per day for personnel in the health area in general.
The Great Integrated Household Survey of the Dane indicates that by 2021, 80% of employed nursing staff were women. Likewise, Between 2020 and 2021, the employed personnel increased significantly in response to the pandemic (4.5% nursing personnel and 16.6% medicine personnel)without having managed to reach sufficient levels to cover the requirements demanded 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. By 2021, the informality rate was around 7.4% for nursing staff and 5.6% for doctors. Within this population there is a large proportion of self-employed workers (35%), which may be possible evidence of inadequate employment conditions in relation to decent work.
The researcher from 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 the Periodic Economic Benefits – BEPS. Nursing staff earn monthly per capita income on average between 2 million pesos and $2.8 million, while medical staff manage to reach and exceed $6 million per month. Men have higher average earnings than women, identifying gender wage gaps in the country.
At the regional level, there are significant differences in the number of employed persons and in the real income for these workers. In Bogotá, a considerable decrease in the real salary of nursing personnel has been observed since 2019, while Cartagena is one of the cities that has presented the greatest reduction in salary for medical personnel.Londono commented.
A comprehensive policy that formalizes the occupation of health care professionals must take into account issues that are related to poor matching in the labor market, the shortage of trained personnel for health care, inadequate types of hiring, low mobility that occurs between the population that is trained in nursing schools in large cities and their labor migration to distant areas of the country that do not have enough health personnel.
The study team developed an Index of Labor Precariousness, in terms of occupation, which includes information related to decent work. It was found that nursing staff are more likely to be in precarious conditions than medical staff. This index took into account the tenure of a labor contract, the termination times of the labor contracts and the hiring times, the size of the employing company, the salary levels, the place where the work activities are carried out and the working hours.
Support for trained health care personnel
The Universidad del Rosario and Codess (Corporation for the development of Social Security) conducted a survey that identified the type of support received by staff trained in health care: 56% have endowments to do their work, 27% have with psychological support and only 10% have facilities to rest. In terms of economic benefits, 60% receive paid vacations, 40% have access to health insurance, 33% receive transportation support, and only 7% receive food support.
The consultancy makes a series of recommendations focused on improving working conditions within the framework of decent and dignified work, seeking a transition towards the labor formalization of all nursing and medical personnel; promote the mobility of nursing personnel to territories that require it; have adequate rest spaces and times for the nursing staff; establish a salary scheme 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 advisor John Marulanda, the study is important in three aspects: first, because it deepens and establishes the real situation on labor informality in qualified health caretakers. Second, it determines gaps and inequities in wages and working conditions by gender and occupation in health workers, which are unfair and avoidable. And third, because it defines specific recommendations for decent work in the sector, as well as the criteria and basis for the objective of a new health model focused on the most basic level.
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