Uganda short of 3000 midwives

“I was inspired into midwifery when my cousin sister lost her first child during child delivery, she labored for so long and no one was there to help her. When she got pregnant again, I helped her deliver but got stranded when I had to get rid of the placenta. I had never delivered a mother before, but I was determined to save my cousin’s baby. These were the words of Joyce, a young Karamojong woman now training in Mid-wifery.

My inspiration came from a personal bad experience with a mid-wife, when I gave birth and out of carelessness, my baby dropped down and died. The mid-wife had been extremely rude to me. said Apio another young trainee.

These and many more, were some of the testimonies of dedicated 130 beneficiaries of a two year scholarship program by UNFPA, who attended a recent symposium in Moroto that saw 90 midwives Commissioned and have so far be recruited by the Ministry of Health to ensure sufficient human resources for maternal health. Special emphasis is on the Karamoja region because it has lagged behind in access to skilled attendance.

I had to escape from school to go and do the interview for this scholarship. I couldn’t have asked for anything better. Helping mothers deliver gives me joy. Joyce says this with so much satisfaction.

Some of the midwives attending the symposium in Moroto. Photo by Echwalu Edward

Some of the midwives at the symposium in Moroto. Photo by Echwalu Edward

According the 2009 State of Midwifery Training Assessment Report by UNFPA Uganda, the gap in the number of filled midwife positions has decreased from 1,961 to 1,043 as stated in the Human Resource for Health Audit Report of 2012. This decrease was registered despite a massive recruitment effort by the government. However, the staffing norm does not reflect the actual need of the increasing Uganda population.

According to the World Health Organisation (WHO), a mid-wife is supposed to conduct not more than 175 deliveries annually. However, due to a shortfall in mid wife numbers, it is estimated that a midwife supports between 350 to 500 deliveries a year. This is overwhelming, yet Dr. Tumwesigye the minster of Health confirmed that Uganda needs 3,000 more midwives to meet the required minimum staffing norms.

The World Midwifery Report of 2014 indicates that access to skilled birth attendance will mitigate child birth-related complications up to 87%. Practice has also shown that availability of a midwife at a health facility will increase utilization of skilled services and that facility-based deliveries in health facilities in Karamoja region such as Panyangara HC III in Kotido district and Rupa HC II in Moroto, have shown dramatic increases in utilization of delivery services when midwives are posted.

The United Nations Population Fund (UNFPA) with support from the Swedish International Development Agency (SIDA) is supporting the Ministry of Health to recruit 130 midwives to fill the human resource gap for maternal health. Under this arrangement, UNFPA will support for up to two years, midwives who will have been recruited in the health system with the understanding that the government will take over to ensure sufficient human resources for maternal health. Because every life saved is a generation birthed.