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Midwives in remote Ugandan villages demand better welfare
Health workers march on the streets of Soroti District as they commemorate International Day of the Midwife 2023. PHOTO/ KARIM MUYOBO
What you need to know:
- Uganda has an estimated nurses and midwives’ coverage of about 17 midwives per 10,000 people and World Health Organization (WHO) estimates that at least 71 nurses and midwives per 10,000 people are needed to achieve at least 80 percent of the Universal Health Coverage targets.
Midwives in Soroti health centres have asked the government to focus on facilitating midwives in remote areas who work under more challenging circumstances to help mothers deliver safely.
Uganda has an estimated nurses and midwives’ coverage of about 17 midwives per 10,000 people and World Health Organization (WHO) estimates that at least 71 nurses and midwives per 10,000 people are needed to achieve at least 80 percent of the Universal Health Coverage targets.
Speaking to this publication, Ms Annet Evelyne Kanyonyozi, the president of the National Midwives Association of Uganda said there is a need for equitable distribution of midwives in the country to match their workload.
“Up to day, midwives in Uganda, deliver 350 to 500 mothers as opposed to the 175 mothers as recommended by WHO and this compromises quality of services delivered,” Ms Kanyonyozi said.
According to the National Midwives Association, 75 percent of the deaths occur in the facilities due to lack of relevant skills by the midwives despite the timely turn up of the clients.
The 2022 Ministry of Health annual report indicated that Uganda loses 1,226 mothers in health facilities.
While commemorating the International Day of Midwife in Soroti, Dr Mary Otieno, the United Nations Population Fund (UNFPA), country representative warned of the consequences of not having enough skilled midwives and the required supplies.
“Evidence shows that universal access to midwives offers the best and most cost-efficient solution to end preventable maternal deaths. By closing the deficit in the number of midwives, we could prevent two out of three maternal and newborn deaths,” Dr Otieno noted.
She also urged the government to invest in capacity building of the midwifery workforce to ensure that more mothers and babies survive.
“Midwives are often the only healthcare workers serving people in hard to reach places and evidence shows that competent midwives can provide 90 per cent of maternal health care,” she argued.
“Yet because they are in short supply there is a deficit in access to this care. The evidence further indicates that health workforce data systems, primary health care, especially in underserved areas and effective regulatory frameworks are key to building a robust work force. Relatedly, Midwife-led care models improve health outcomes, increase patient satisfaction and reduce costs,” she said.
Dr. Otieno noted that although they recognize the improvements over the years, the death of about 100 mothers per month of those that come to the health facility is still unacceptably high.
It's from this background that Ms Kanyonyozi asked the government to invest in supporting midwives in remote areas of Uganda.
Ms Agnes Chandia, the Commissioner, Nursing and Midwifery noted that midwifery remains key in maternal child health services, arguing that it leads to the rudeness of the “tired” members, a common habit amongst midwives..
“Not only that, [but] inadequate equipment supplies and commodities…let’s look at that so that it can make my midwives functional and to deliver and do what we require from them,” she said.
What the government says
State Minister for Health, Ms Anifa Kawooya revealed that midwives provide approximately 80 percent of the healthcare in the country. According to her, the government will ensure and improve their welfare and also continue enhancing their salaries.
“I have taken note of every remark that has been made here. Ministry of Health is working with a wide range of stakeholders to transform the country’s nursing and midwifery professions as a major strategy to improve the health of all populations,” she said.
