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South Africa needs to appreciate and develop its degree-educated nursing workforce if the country wants to improve the quality of healthcare and make nursing decisions based on evidence and international best practice.

This is the view of the Forum of Nursing Deans in South Africa (FUNDISA) ahead of International Nurses Day, celebrated annually on 12 May, the anniversary of Florence Nightingale's birth. This year’s theme focuses on evidence to inform nursing decisions, a critical and achievable way to improve health system performance.

FUNDISA is calling for South Africa to appreciate and value its degree nurses who form a small but vital component of the nursing profession in South Africa.

“International evidence shows that having a graduate nurse in the nursing care team decreases mortality and failure to rescue patients in hospital, and that investing in a degree-educated nursing workforce can improve quality of care,” said Prof. Leana Uys, chief executive officer of FUNDISA.

Fewer than 20% of the country’s professional nurses are being produced through the four-year degree programmes at universities, despite the international trend towards a Bachelors’ degree as an entry level into nursing, including in Botswana, Mozambique, Malawi and Kenya, according to Prof. Hester Klopper, chairperson of FUNDISA and president-elect of the Sigma Theta Tau International (STTI) nursing honour society.

Degree nurses provide leadership, both clinically and educationally through teaching and research, and boost the country’s health sciences research capacity. Through research, nurses can review nursing practice and gather evidence to challenge inefficiencies and poor quality in nursing practice, and in financially constrained times, to use resources as efficiently as possible.

Stressing the importance of degree nurses, Prof. Uys commented that South African research shows that they are generally better equipped at solving problems, work unsupervised, are quicker at taking on more responsibility and demanding roles, and are generally equally committed to nursing as a vocation as their diploma counterparts, preferring to stay in nursing and clinically-orientated posts.

Educating nurses through university was also cheaper than for diploma students. A costing analysis of college subsidies versus the degree subsidy (through the Department of Higher Education) showed the budget per diploma student was double that of university nursing students. Official figures from the South African Nursing Council indicate that 590 nurses graduated from South African universities in 2011, compared to 2376 nursing diploma students.

“In comparison to diploma nurses, degree nurses pay their own education fees and seldom earn salaries, easing the burden on the Department of Health which trains diploma nurses while paying them a salary. The B. Nursing degree is an arduous, comprehensive degree, and students are required to accumulate the same amount of clinical practice hours as diploma students in order to register as professional nurses,” said Prof. Uys.

“Degree nurses are important for developing the leadership cadre of the profession. With nursing becoming increasingly complex, South Africa needs a substantial number of specialist nurses to practice, most of whom are degree nurses who are theoretically better prepared and interested in real nursing care,” she said. 

Illustrating the important leadership contribution of degree programmes, Prof. Uys said Nelson Mandela Metropolitan University (NMMU) in Port Elizabeth had made great strides with donor funding to upgrade the level of education being provided at the Eastern Cape’s Lilitha Nursing College. Without the nursing school at NMMU with its experienced under graduate programmes, there would not have been the in-country capacity to upgrade and strengthen the college. FUNDISA is undertaking a similar programme in KwaZulu-Natal with three university-based nursing schools in that province.

“There is definitely a need for both degree and diploma nurses; we are not saying we should exclusively have degree nurses. But the 20% currently being produced appear to be undervalued and are very important for the profession. To reduce the number of degree nurses or do away with them when there is a nursing shortage is nonsensical, particularly when the universities have capacity for world-class training and can support colleges. With too few matriculants passing with a university entrance, diploma nurses will still be a critical component of the nursing profession for many years,” concluded Prof. Uys.


Further information/Interview: Prof. Leana Uys, CEO: FUNDISA: (012) 333 1415; 082 825 1651;

Regional interviews can be done with the following FUNDISA members:

  • Eastern Cape: Prof. Dalena van Rooyen, Head: Nursing Science, NMMU: (041) 504 2960/2122;
  • Free State: Prof. Magda Mulder, Head: Nursing Science, University of the Free State: (051) 401 2246;;
  • Gauteng: Prof. Mavis Mulaudzi, Head: Nursing Science, University of Pretoria: (012) 354 2125;
  • KwaZulu-Natal: Prof. Nokuthula Sibiya, Head: Nursing Science, Durban University of Technology:(031) 373 2606;
  • Limpopo: Prof. Lizzy Netshikweta, Head of Department of Advanced Nursing Science, University of Venda: (015) 962 8239; 072 493 3694;
  • Western Cape: Prof. Hester Klopper, Dean: Faculty of Community and Health Sciences, University of the Western Cape: 082 787 5407;

For further information on International Nurses’ Day, visit