Government, development partners pledge continued support to Midwifery in Uganda

By Umar Weswala:

A procession of Midwives around Soroti City

The government of Uganda together with the Swedish government and the United Nations Population Fund (UNFPA) have made further commitments towards improving the state of Midwifery in Uganda.

The commitments were made on 5^th May 2023 during the national commemoration of this year’s International Day of the Midwife at Soroti sports ground in Soroti City.

The event brought together midwives and other stakeholders from all over Uganda under the theme: Together again: from evidence to reality.

Speaking on behalf government, the State Minister of Health in charge of general duties Hon. Anifa Kawooya lauded midwives for saving the lives of mothers and new-born babies even under difficult circumstances. Minister Kawooya was standing in for the Vice President Jessica Alupo.

She said that investing in and empowering midwives is key to the government of Uganda’s efforts towards meeting the national and global targets of universal health coverage.

Minister Kawooya speaking at the Midwifery commemoration
event in Soroti City

“We do appreciate that despite all that you go through for example, the World Health Organisation (WHO) standards of the midwife ratio to the mothers is 1:1000, as a country we are still far; we are at 1:5000, very below what is required but we are hopeful that we shall reach there” the Minister said.

According to the Minister, the ministry of health is working with a wide range of stakeholders to transform the country’s nursing and midwifery profession as a major strategy to improve the health of the whole population.

One of the issues that keep coming up in the midwifery service is poor welfare.

In addition to appreciating their dedication to service under difficult working conditions, the minister made a promise to the midwives.

“We promise, as we continue, our basket enlarging, we shall continue looking into the welfare of the midwives and the nurses because you are the first center of approach”.

The promise did not provide a quick solution to their grievances but it gave them hope that the government is aware of their poor welfare and is willing to address it.

Minister Kawooya (R) recognizes a midwife with a
certificate

The minister expressed gratitude to UNFPA and the Swedish government for what she described as their contribution to the enhancement, strengthening of the health system in Uganda, noting that; “cooperation and partnership strengthens our daily working”.

With support from the government of Sweden, UNFPA Uganda office supported the development, launching and dissemination of the Scope of Practice for Nurses and Midwives; a tool that ensures quality service delivery.

This is in addition to the Midwives training and bonding program that saw over 500 midwives trained and deployed to underserved facilities across Uganda, as well as the tracking the distribution and deployment of midwives across the country through the Geographic Information System.

These developments were made possible with support from the Swedish government and UNFPA Uganda.

Speaking on behalf of UNFPA, the Country Representative Dr. Mary Otieno described midwives as foot soldiers who provide skilled and compassionate care for women, new-born babies and their families.

UNFPA Country Rep. Mary Otieno 
delivering her remarks

Evidence shows that universal access to midwives offers the best and most cost-effective solution to end preventable maternal deaths.

“By closing the deficit in the number of midwives, we could prevent two thirds of maternal and new-born babies” Dr. Otieno said.

In a world where a woman or girl dies every two minutes due to pregnancy or child birth related causes, the UNFPA representative said the International Day of the Midwife avails all stakeholders an opportunity to pause and reflect on the important work that midwives do and why they must be supported.

She assured midwives in Uganda that they can count on the UNFPA support in delivering a Uganda where every pregnancy is wanted and every child birth is safe so that no woman dies while giving birth.

The Ambassador of Sweden in Uganda Maria Hakansson said Uganda had seen great improvements in many health indicators over years and that some of these are directly related to the work of midwives.

She singled out maternal mortality and child mortality which have reduced over years, as well as increased antenatal visits and deliveries at health facilities with the assistance of skilled health workers.

She commended the government of Uganda for showing commitment to promoting gender equality and access to health services for all and for standing with midwives on their day.

A group photo of the Minister (C) with some of the
stakeholders present

She however said Uganda is not there yet when it comes to midwifery service in particular and access to health for all.

“To be able to achieve the global Sustainable Development Goals that Uganda has signed up for, to address teenage pregnancies in the country, and for the midwives to achieve their full potential, we would like to see the government scaling up investments in education, training and deploying more midwives into health workforce as well as remaining committed to the right to health for all” the Envoy said.

Swedish Envoy Maria Hakansson
delivering her remarks

Like the UNFPA representative, Ambassador Hakansson assured Ugandan midwives that they can count on support from Team Europe especially in the areas of training and recruitment of more midwives in areas where they are needed most.

The Commissioner Nursing and Midwifery at the Ministry of Health Sr. Agnes Chandia Baku said midwives play a very significant role in Uganda’s maternal health service delivery. Together with the nurses, midwives constitute 72% of the health sector workforce in Uganda and contributed almost half of the key performance indicators.

Despite their key contributions, the Commissioner expressed concern over the existing staffing norms which she said do not give the serving midwives time for self-care.

She was however relieved to learn the good news from Dr. Olaro Charles, the Director Health Services, Clinical at the Ministry of Health.

While speaking at the same event, Dr. Olaro revealed that the ministry has is going to deploy more midwives at Health Centers III and IV.

“Previously at Health Center III, there were only two midwives, but we have reviewed this now and there are going to be nine midwives.

Commissioner Nursing and Midwifery
Sr. Agnes Chandia Baku (R)

At the Health Center IV, we had three midwives but this number has now been increased to 18 midwives”.

Uganda has an estimated nurses and midwives’ coverage of about 17 midwives per 10,000 people. The WHO estimates that at least 71 nurses and midwives per 10,000 are needed to achieve at least 80% of the Universal Health Coverage targets.

Investing in training and recruiting enough skilled midwives and required supplies is therefore a matter of urgency for Uganda.

Around the globe, in countries that invest in a capable workforce, more mothers and babies survive and thrive.