KABALE – On Thursday, Uganda joined the rest of the world to commemorate the International Day of Midwives to recognize and honour their efforts towards reduction of maternal, and infant morbidity and mortality.
This year’s national celebrations were held in Kabale District under the theme, “100 Years of Progress” in partnership with the United Nations Population Fund – UNFPA and the government of Sweden and other Development Partners.
Officiating at the event, Vice President Jessica Alupo applauded the midwives for endeavouring to execute even in the difficult working environment.
“Midwives receive new lives into the world and they perform many other roles to the newborns, mother and their families irrespective of at times challenging conditions like shortage of human resource, inadequate of equipment supplies and even conditions like the recent Covid-19 which affected the whole world.”
Represented by the Minister in charge General Duties in the Prime Minister’s Office, Justine Lamumba Kasule, Alupo said that midwives do a fundamental role in ending preventable maternal and newborn morbidities and mortality in achieving sustainable development goal 3, which is to reduce the global maternity maternal mortality ratio less than 70 per 100000 live birth by 2030 and in turn do the same our country, Uganda.
“As a country, we are proud to stand for midwives and their rights, dignity, and health of women and newborns throughout the country. We see this milestone as an opportunity to acknowledge where we have come.”
She, however, challenged every midwife to reflect upon themselves and do self-awarding at the contribution they have made towards saving mothers and their newborns.
Alupo echoed the government’s commitment to ensuring that the midwives are supported to deliver quality midwifery services to all Ugandans by encouraging the enhancement of quality training of midwives, and the implementation of innovative technology.
“…the government is ready to ensure that the skilled attendance to birth is increased and maternal mortality is reduced significantly.”
Mr. Daniel Alemu, UNFPA Deputy Country Representative, said that International Day of the Midwife is a special day for UNFPA because it allows them to pause and reflect on the important work that they do in partnership with health workers.
He said that midwives save lives and are the foot soldiers when it comes to providing skilled and compassionate care for women, newborn infants and families.
Mr. Alemu said the day helps them to think and appreciate the vital role that midwives have played for a very long time and still play not only in ensuring women and their new-borns navigate and childbirth safely, but also receive respectful maternity care that can create a lifetime of good health arid wellbeing,
According to him, each year over 5,000 women in Uganda die due to pregnancy and childbirth-related complications according to UDHS.
“The majority of these deaths are preventable only if enough qualified and adequately resourced midwives were trained and deployed to accompany these women on their journey of giving life.”
“Midwives are skilled to provide up to 90% of the Sexual and Reproductive Health care needed, making them the ideal health professionals to support women and families through this continuum of care,” he added.
Studies show that a 25% increase in coverage of midwife-delivered interventions could avert 40% of maternal and newborn deaths and 26% of stillbirths.
Alemu said, “we would have fewer maternal deaths if Uganda could educate, recruit, and retain its midwives; and regulate their functions to international standards.”
He revealed that due in part to the contribution of midwives, Uganda has managed to reduce maternal by one-third between 2001 and 2016 from 506 deaths per 100,000 live births to 336 deaths per 100,000 live births respectively.
He re-echoed a number of challenges which midwives face in their delivery of services have resurfaced, including heavy workload, inadequate remuneration, lack of accommodation, inadequate equipment and supplies, lack of water, limited opportunities for professional and career growth, among others.
He also revealed that UNFPA in partnership with the Ministry of Health and Ministry of Education and Sports, a lot of work has been accomplished to lay the foundation for competent and well-resourced midwifery in this country.
“With support from the Government of Sweden we have managed between 2010 and 2020 to train over 600 midwives, equipped 20 Midwifery Training schools and supported decentralization of the functions of the Uganda Nurses and Midwives Council to Regional Referral Hospitals. In addition, we have supported midwives to integrate into associations that will help strengthen the midwifery programme as well as improve the overall image of the profession.”
Ms. Annette Evelyn Kanyunyuzi, President National Midwives Association of Uganda (NMAU) said that midwives constitute the largest percentage of frontlines, who meet the needs of mothers and babies.
“Midwives are a significant workforce who do more than deliver babies, a lot of task shifting has occurred and currently midwives’ scope has continued to evolve over the past years. Midwives continue to demonstrate zeal, and passion to deliver respectful, quality maternity service at all levels of health care. We assure you of our strong commitment to Uganda’s pursuit of the achievement of the SDG targets towards t; reduction of maternal, neonatal mortality and morbidity. There is global evidence that with appropriate investment in midwives up to 80% maternal mortality can be averted.”
She said that NMAU strategic directions will focus on strengthening the quality of midwifery services in Uganda, empowering midwives from Public and Private Practice to advocate for and influence the midwifery agenda, engaging the community in advocating for and use of quality midwifery services.
She also tackled the challenges faced with midwives as they execute their duties.
“The recently proposed salary scales are unequitable, falling short of the expanded role and education attainments,” she said.
District Health Officer, Kabale, Alfred Besigensi decried lack of necessary equipment, saying that, “it is very hurting when you are on duty and you lose a baby or a mother you would have saved.”
Among other challenges faced with midwives and other health workers, Mr. Besigensi said is accommodation where most health workers travel long distances to access health facilities.
“This has increased absenteeism and late coming for duty and sometimes we blame them as leaders. So if we can improve the staff accommodation, the conducive environment would be excellent.”
“We are very grateful for salary enhancement. When I joined, a midwife was earning Shs200,000 but now their gross is above Shs1000000, but taxation is too high. Why can’t we exempt these health workers like any other cadre because they are also at war. Even if we increase their salaries with this kind of taxation, we may not see any impact,” he said.
Ms. Tushemerirwe Annah, a midwife and assistant nursing officer Kabale Regional Referral Hospital narrated how she saved a newborn whose mother died after giving birth.
“This man [a one Justus] had a disabled wife admitted in the maternity but she had suffered from Covid, had hypertension, cardiac heart failure. She delivered twin sisters. Unfortunately, the mother and one baby died. This man had no one else to help him raise the left baby. So, I went to the director who gave me a go-ahead to help the man on feeding the baby, hygiene and warmth. I connected him to ‘Good Girl Foundation’ for baby’s milk and the baby who wasn’t weighing more than a kilo started gaining.”
“By the time we discharged them, the baby was well responding and we had taught him what to do. But still, we kept in touch. Every two weeks he comes for review and the ‘Good Girl Foundation’ is still supporting us with the milk.”
On top of earning herself an envelope from the guest of honour, Tushemerirwe was given the scholarship to further her studies for her kind heart.
Ms. Tushemerirwe challenged the community to not only recognize their mistakes but also the good things they do while on duty.
“We do a lot of things as midwives. You know our profession is very challenging and we work on tension. When we do good things you can’t hear them in media for appreciation but one mistake, you will hear the whole community castigating us. For example, you do all possible to save a mother and she unfortunately dies but even if it was inevitable for her to die, the story you hear in the community, midwives neglected the mother, midwives were not cooperative,” she decried.
She also decried low salaries, and shortage of staff, among other limitations.
Madam Vice President said that the government is aware of the current shortage of midwives in the health facilities and assured the midwives that possible measures and being taken to address their challenges.
She lauded the development partners for their tireless efforts in supporting midwives in the provision of sexual and reproductive and maternal-child health services to all Ugandans.