EXAMPLE OF A SITUATIONAL ANALYSIS
A SWOT analysis and a review of factors affecting regulation
SWOT ANALYSIS
STRENGTHS: Council strengths
that will enable it to fulfil its mandate
 Gaining more trust from registrants due to
more transparent and better
communication of role of Council
 Autonomous, statutary Council not
dependent on government funding
 Developing new programme, e.g.,
continuing professional development that
will improve nursing/midwifery services
and vsisbility of Council
 Availability of operational plan
 Has own office space
 Has asset – two land sites, vehicle
 Paid staff, including a registrar
 Active members of the board
 Working on developing a computorised
data-base
 Able to balance books
 Through a regional organisation,
particpating in revison of regulatory
framework, and through the International
Council of Nurses has opportunities to
expand international contacts and
resources
 Has recently implemented a system for
Continuing Professional Development
(CPD)
 Receiving technical support and funding
through international development
partners
Section 4: Situational Analysis
WEAKNESSES: Council
weaknesses that will prevent it from
fulfilling its mandate
 Current Law/Act needs updating
 No strategic plan
 No communication plan
 Restricted access to funds results in:
 Lack of physical space to carry out
Council work, including holding meeting
 Inadequate staffing, especially on the
professional side, to enable to Council
to fulfil its mandate due to due funding
restriction
 Difficulty in getting nurses, midwives, and
nursing assistants to re-license
 Does not have a live register
 Paper–based system is cumbersome and
inefficient
 No national scopes, standards, and
competencies identified
 Lack of systems, procedures, policies to
support Council activities, e.g.,
registration, re-licensure, making
complaints, professional discipline, job
descritions, standard setting processes,
etc.
 No system to track registrants
 Lack of written or digital information, e.g.,
how to register, re-license, make a
complaint, professional discipline
 Slow response to complaints
 Ill-prepared members of the governing
board
 No system for orienting and developing
governing board’s members
 Lack of advocay and marketing
strategies/skills
 Poor implementation of governing council
decisions
 Poor commitment to volunteering (for
Council and committee membership)
because of insufficient incentives
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 OPPORTUNITIES: External THREATS: External events
events creating the greatest opportunity for creating the greatest threat for the Council
the Council in the next five years in the next five years

 Increase in registered nurses and  Increasing political influence on

midwives allows better communication of professional regulation—reducing capacity
the importance of rules and regulations to self-regulate
 Learning from other nursing midwifery  Ill-informed public, politicians, and health
councils in the region as well international professionals
bodies open up opprtunties for exchange,  Loss of professional identity, authority if
learning, colloboration with East, Central swallowed by the HPC
and Southern African College of Nursing
 Deteriorating economic situation could
(ECSACON)
jeopardise ability of Council to fulfil
 Assistance from development partners mandate
 Becoming part of the Health Profesions  Rising level of complaints by public on the
Council (HPC) has the potentional to quality of services
increase collaboration, exchange, joint
 CHE accreditation processes may lead to
action among health professionals, and
to closure of schools unable to achieve
achieve greater understanding of each
registration and accreditation criiteria
other’s profession and role in health care
 CHE programme accreditation may not
 Establishment of National Quality Council
deal adquately with the professional
promoting CPD
aspects of nursing and midwifery
 Council of Higher Education (CHE) programmes
implementation of an accreditation
programme has the potential to improve
the quality of education instititions and
programmes
 Rising level of complaints by public on the
quality of services have made officails
more cognisant of this issue

Section 4: Situational Analysis Page 2

MAIN STRENGTHS
 Has a registrar who is a health professional with potential for growth into the role; registrar is
supported by three administrative staff members
 Is progressing well in computerising the registration/licensing database and entry of data
 Has a committed governing council
 Has rented premises and controls its budget
 Is receiving support from international NGOs to strengthen Council organisation and
capacity to carry out its mandate
 Is the most organised and active health professional regulatory body in the country

MAIN WEAKNESS
 Current Acts need updating
 Poor organisational structure, policies, and practices
 Governing council requires considerable capacity building to understand roles and
responsibilities in order to make sound regulatory policies.
 Register and re-licensure held by Council does not capture all nurses and midwives currently
working in country, and consequently the information on the nursing/midwifery workforce
is unreliable
 Apart from the registrar, the absence of health professional staff to coordinated and follow up
on committee work severely limits work in areas such as standard setting, accreditation of
education programmes, and professional discipline
 Financial base is insufficient and unreliable to allow expansion and more efficient services
 Poor communication with the professions it regulates, government, and society about
Council’s role in contributing to public safety

MAIN OPPORTUNITIES
 Increasing quality as seen by creation of the a national accreditation agency for higher
education
 Greater government and international concern with respect to professional regulation
 Regional networks focusing on regulation provides opportunities for sharing and learning
from others with similar problems.

MAIN THREATS
 Loss of hard earned independence and autonomy of nursing and midwifery, and potentially
revenue, if replace by Health Professions Council
 Apathy and lack of trust from the professionals it regulates and society in general
 Insufficient professional staff will inhibit the ability of the Council to provide leadership and
advance the professions through standards setting, activities related to quality, such as
accreditation, education programmes, and CPD activities, and providing the necessary
policies and guidance as practice and education changes

Section 4: Situational Analysis Page 3

FACTORS AFFECTING REGULATION
Key Factors Significant Events/Trends Regulatory Implications
Quality and Extension of primary health care services  Is the scope of practice identified and officially recognised; otherwise
goals of  Substitution of lower-level cadre due to staff shortage practice of the lower-level cadre may be illegal?
services  Inadequate supervision  If scope of practice lies outside that of the current legal scope of
 Available supervisors overloaded with respect to what is practice, what mechanisms can be used to ensure that the health
expected in the way of supervision especially in remote, worker is practising legally?
inaccessible areas  Who is accountable—the new cadre or the supervisor?
 Is this cadre to be regulated and by whom?
Accessibility New cadre of community health worker to be introduced  Who sets the scope of practice and decides on the job description?
and costs of  Inadequate discussion of the nature and role of the new cadre  Are the community health workers to be regulated through statutory
services with other health care providers working in the practice setting means?
 Scope of practice not defined  Who decides on the education/training needs and monitors the
 No job descriptions quality of the training programmes?
 Skill-mix decisions need to be made
 Education/training needs are unclear and under-resourced
Public policy Privatisation of health services gathering momentum  Do regulatory requirements apply equally to the private sector?
 Unclear how far regulatory requirements apply to the private  How will staff in the private sector be tracked and have their
sector credentials checked?
 No system for identifying staff who are hired and for checking  Will there be a system to check the quality of clinical settings in the
their credentials private sector that are being used by students?
 Potential of having access to great variety of clinical settings
and higher quality services
Goals of the All graduate professionals  Who will be responsible for accrediting programmes being given by
profession  Output of programmes is small the universities?
 Employers not satisfied with clinical competency levels of new  How will the professional regulatory body ensure that profession-
graduates specific standards are included in accreditation standards for
 Internship programmes to raise competency levels are university?
expensive to implement and difficult to oversee  If internship programmes to raise competency levels are in place,
who will set competencies required for success and at what point will
a license be issued?
Other health Shortage of physicians  Is task shifting taking place without proper authority or training?
workers  Task shifting taking place without proper authority or training  If there is a trend to develop advanced practice roles, are the
 Driver for developing advanced practice roles developers aware of the regulatory issues that are involved with role
expansion?

Page 4 Section 4: Situational Analysis

 Key Factors Significant Events/Trends Regulatory Implications
Status and Career ladder to be introduced  Do human resources planners collaborate with regulators in issues
welfare of  Potential to increase retention if practitioners have routes to related to scopes of practice, education and training, safe skill-mix,
practitioners advance professionally and accountability structures?
 Human resources planning needs to take account of career
ladders in workforce planning

Page 5 Section 4: Situational Analysis