SOROTI – Midwives in Uganda have decried too much workload which they say has compromised the quality of the services they give.
Midwives in the country had on Friday, May 5 gathered in Soroti to commemorate their day which is celebrated internationally.
The 2023 International Day of the Midwife, was commemorated under the theme “Together again: from evidence to reality”.
Ms. Annet Evelyne Kanyonyozi, the president of the National Midwives Association of Uganda noted that 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 to be delivered as recommended by World Health Organization,” she said, adding, “and it’s because of that the quality is compromised.”
Kanyonyozi also revealed that up to 75% of the deaths occur in the facilities due to lucky of relevant skills by the midwives despite the timely turn up of the clients.
She urged the government to support them to undertake courses for specialization to meet the challenge.
“We pray that we can be able to have the skills to match the complexities that are arising out of the various complications, for instance, the condition such as preeclampsia, postpartum hemorrhage, and many more.”
“We cannot do that well unless we are equipped with the necessary skills not only their skills,” Kanyonyozi noted.
The midwives also asked the government for an enabling environment including modern technology.
Ms. Agnes Chandia – Commissioner, Nursing and Midwifery noted that midwifery remains key in maternal child health services.
She commended them for remaining committed to serving even when they have no necessary equipment.
She also reechoed the issue of staffing, noting 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.”
Chandia also tackled the challenge of the skill gaps especially in the area of technology in regards to reproductive health.
“Many times we have upgraded technology and programs without realizing the skills amongst the people who are supposed to deliver this.”
On her part, Dr. Mary Otieno, United Nations Population Fund (UNFPA), country Representative noted that Uganda has an estimated nurses and midwives’ coverage of about 17 midwives per 10,000 people.
World Health Organisation – WHO estimates that at least 71 nurses and midwives per 10,000 people are needed to achieve at least 80% of the Universal Health Coverage targets.
Dr. Otieno 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 2/3 of maternal and newborn deaths.”
According to the 2022 Ministry of Health annual maternal deaths report, Uganda lost 1,226 mothers in health facilities.
Dr. Otieno says that while 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.
She called for investment in capacity building of the midwifery workforce to ensure that more mothers and babies survive and thrive.
“Midwives are often the only healthcare workers serving people in hard-to-reach places in line with the theme of 2023 Together again: from evidence to reality’. evidence shows that competent midwives can provide 90 per cent of maternal health care, 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 robust work force Relatedly, Midwife-led care models improve health outcomes, increase patient satisfaction and reduce costs,” she said.
To move from evidence to realty, Dr. Otieno, amongst others, called for the recruitment of more midwives, supporting the existing midwives to offer quality care, equipping the health facilities with essential medicines and supplies to minimize stock-outs and improving the infrastructure so that there is no shortage of basic supplies like water, and electricity as well as quality space that offers privacy to the mothers.
Swedish Envoy in Uganda, Amb. Maria Håkansson also commended midwives for the key role they play in ensuring sexual reproductive health and rights and maternal and newborn health care of high quality.
She says that midwives support and promote healthy families, empower women and couples to choose whether when and how often to have children.
“Midwives are central for empowerment and we know that empowered women contribute greatly to economic prosperity, sustainable growth and development of the nation and it’s therefore so important that women and men have the same power to shape society, but of course, mostly their own lives.”
She noted that although Uganda has seen great improvements in many health indicators over the years, there were negative consequences of the COVID-19 pandemic that challenged some of these positive trends resulting in; increased numbers of unwanted pregnancies, teenage pregnancies unsafe abortions and limitations in access to sexual reproductive health and rights services and inflammation.
Ambassador called for an increase in support and counseling regarding sexual reproductive health and rights to empower teenage adolescent girls to take informed decisions to reduce the risks of becoming pregnant at an early age or getting infected with HIV.
“Equally important is that the same information is provided to teenage and adolescent boys access to modern contraceptives for everyone. That is sexually acting is key since childbearing at an early age does not only have socio-economic consequences, it can cause lifelong physical damage and even death.”
Guest of Honour, the State Minister of Health-General Duties, Anifa Kawooya Bangirana revealed that midwives provide approximately 80% of the health care in the country.
She pledged that the government will ensure and look for how to improve their welfare and also continue enhancing their salaries.
“I have taken note of every remark that has been saved here. They are going to our drawing table,” she pledged.
“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 population,” she added.
