Edition October 2026

Before she became a nationally recognised nursing leader, researcher and regulator, Professor Ntombifikile Gloria Mtshali, learned the realities of healthcare not from boardrooms or policy documents, but from the frontlines of rural South Africa.

It is a world nestled where nurses could mean one young professional carrying the weight of an entire hospital.

It was in those demanding early years that Mtshali’s leadership philosophy took root. Her career has since taken her from rural wards in KwaZulu-Natal to university lecture halls, international development projects and the highest levels of nursing regulation in South Africa.

Today, Mtshali is the Chief Executive Officer and Registrar of the South African Nursing Council (SANC), a role she transitioned into in 2023 after a distinguished academic career that included serving as head of the University of KwaZulu-Natal’s (UKZN) School of Nursing. Across every chapter of her journey, one purpose has remained constant: strengthening nursing education, developing health professionals and improving healthcare systems.

Mtshali began her nursing career in 1986. Her early experience included Ekombe Hospital in Nkandla, northern KwaZulu-Natal, where she confronted nursing shortages that would shape her understanding of healthcare inequality.

“I was still new and when we came in, we were only two. We had to be in charge of wards and even manage the hospital,” she recalled. 

Those immense early responsibilities unearthed niggling challenges facing rural healthcare, igniting a lifelong commitment to finding solutions.

That experience established the question guiding her career: how can South Africa educate and retain nurses equipped to serve communities where the need is greatest?

“We always complain about the shortage of nurses in the city, but if you go to the remote areas, you actually experience what shortage means,” she lamented.

Expanding access to healthcare 

Rather than simply highlighting the problem, Mtshali chose to contribute to building systems capable of addressing it. After years in clinical practice, she moved into nursing education, resigning from her hospital post to complete a master’s degree at UKZN. She accepted a contract lecturing position at roughly half her previous salary, driven by a belief that education could transform the profession.

“I was passionate about teaching because of where I came from, I wanted to conduct research that would make a difference and assist in improving how we teach.”

Her research focused on widening access to nursing education, particularly for students from rural and previously disadvantaged communities. She questioned whether traditional admission pathways reflected the realities of learners from under-resourced backgrounds.

“How do we craft our programmes and have programmes accredited according to the needs of the different areas?” she asked, adding that there is a need for strong academic or comprehensive support for  students from rural and remote areas.

Flying the South African flag high

Mtshali's commitment to impactful research earned her international recognition. In 2024, ScholarGPS named her a Top Scholar, placing her among the top 0.5% of scholars globally in nurse education. She was recognised for both her lifetime contribution and her work during the preceding five years.

The recognition came as a surprise to her. 

“They do the work without you knowing about it. You are not even aware, and then they say, ‘we have identified you and we are recognising you.’”

Mtshali said the award was not only personal recognition, but also a reflection of the growing global profile of South African nursing scholarship.

“Most of the people who have been awarded these are from developed countries,” she said. “For South Africa to be recognised in such spaces means a lot. It profiles nursing education and nurse educator research in South Africa.”Her influence has extended beyond South Africa’s borders. Mtshali contributed to nursing education initiatives in Rwanda after the 1994 genocide and supported specialist education in Seychelles and Lesotho.

Heading the profession 

When Mtshali became SANC CEO, she entered a new environment – one where regulation, governance and public accountability became central to her leadership role. She believes that leadership is about applying principles whereever one goes. 

“The challenge was the culture within the organisation because it is different. It is very structured and bureaucratic,” she explained.

Her response was to understand the system, identify obstacles and focus on practical improvements. One of the most urgent priorities was digitisation.

“When I came in, the biggest challenge was that we were doing things manually,” she reflected. 

The Council had relied heavily on paper-based processes, physical receipts and long queues. Institutions submitted accreditation applications manually, while nurses often travelled long distances to resolve registration and licensing matters.

Under her leadership, the Council appointed a digitisation service provider, established a steering committee and began moving accreditation, finance, supply chain and licensing processes online. Institutions can now submit programmes electronically and  practising certificates can now be generated and sent digitally.

Empowering workers

Mtshali acknowledges that digital transformation also requires careful management of its impact on staff.

“Some people become redundant in other positions. The solution  is to reskill them and move them to other positions where they can add value,” said Mtshali.

Mtshali has also prioritised reducing accreditation backlogs and improving turnaround times through additional capacity, quicker recruitment and clearer processes.

Strengthening public healthcare

For Mtshali, strengthening nursing education and regulation is inseparable from strengthening public healthcare. Nurses remain the backbone of service delivery.

“Nurses are the majority of health workers. They are at the first point of entry when a person needs medical attention or health support, and when patients exit the system, it is nurses.”

That responsibility requires competence, ethical conduct and professionalism. It also requires a regulator willing to act when public trust is compromised.

“The professionalism that we exhibit when we care for patient improves how they view the profession. If unprofessional conduct is reported, the regulatory body has to take action, and the public needs to see that action,” explained the CEO.

From rural hospitals to lecture halls, international partnerships and national regulation, Mtshali’s career has been defined by one belief: leadership must create meaningful change. ❖