Midwife shortage continues to plague Uganda

KAMPALA, Uganda

A shortage of midwives at public hospitals continues to be reported in Uganda, and the results are too often tragic.

A lack of skilled midwifery care puts the lives of expectant mothers and their newborns at risk, warned the latest report as the world observes the International Day of the Midwife on May 5.

A report by the National Library of Medicine titled Improving Midwifery Care in Ugandan Public Hospitals: The Midwives' Perspective notes that over 80% of the nurses and midwives working in public hospitals have been found to experience job stress and only 17% are satisfied with the job.

Stress and the lack of job satisfaction affect the quality of nursing and midwifery care and put patients' lives at risk, the report notes.

This is coupled with a rampant public outcry over the deteriorating nursing and midwifery care at Ugandan public hospitals.

The chronic under-investment in midwifery highlights how the needs of women and the skills of a mostly female workforce are often neglected by policymakers and health systems.

It is believed that midwives who are educated and regulated by international standards are able to provide 87% of the essential care needed by women and their newborns.

Policy

Pediatric specialist Dr. Fatuma Nakintu told Anadolu Agency that low- and middle-income countries, where growth in the number of nurses is barely keeping pace with population growth, are suffering the most acute shortages.

“The government should support midwives through recruiting highly trained midwives into the mainstream public service system, to strengthen nurse leadership and ensure that nurses have an influential role in forming health policy and decision-making, to contribute to the effectiveness of health and social care systems,” she said.

Shukura Nebaza, a midwife, told Anadolu Agency that midwives are central to primary health care and are often the first and sometimes the only health professional that people see and the quality of their initial assessment, care and treatment is vital.

"Good health is the foundation of a country's human capital, and no country can afford low-quality or unsafe health care. Midwives are part of their local community and can deliver effective interventions to meet the needs of patients in their localities,” she said.

For all countries to reach Sustainable Development Goal 3 on health and well-being, the World Health Organization (WHO) estimates that the world will need an additional 9 million nurses and midwives by the year 2030.

The global midwifery workforce now stands at 1.9 million, about two thirds of what is needed, according to the State of the World’s Midwifery 2021 report.

Universal coverage

According to the Health Ministry, Uganda needs an estimated 1,400 midwives to ensure universal coverage of maternity care. On average, a midwife in Uganda conducts 500 deliveries annually compared to the 175 recommended by the WHO.

Nakintu added that achieving health for all will depend on there being sufficient numbers of well-trained and educated, regulated, and well supported nurses and midwives who receive pay and recognition commensurate with the services and quality of care that they provide.

“Investing in nurses and midwives is good value for money,” she said.

The State of the World’s Midwifery 2021 report concluded that investments in education and job creation in the health and social sectors result in a triple return of improved health outcomes, global health security, and inclusive economic growth.

Dr. Jane Ruth Aceng, Uganda’s health minister, said the country is moving toward achieving universal health coverage, which is the cornerstone for the attainment of Sustainable Development Goal 3 on the global development agenda.

“The country has a robust health sector development plan that seeks to, among other goals, accelerate movement towards universal health coverage with essential health and related services needed for the promotion of a healthy and productive life,” said Aceng.

“There is a political commitment, strong partnerships, a vibrant private sector, and communities that are determined to ensure they get what they want,” she added.