Saturday, May 5, 2012


Uganda Government should consider higher salary and better working conditions for Health workers as their right
A midwife helps a woman to deliver. HomeNewsNational National Midwives demand higher salary and better working conditions Share Bookmark Print Email Rating A midwife helps a woman to deliver. A midwife helps a woman to deliver. FILE PHOTO By Agatha Ayebazibwe (email the author) Posted Saturday, May 5 2012 at 00:00 In Summary Uganda currently has 2,500 midwives in public facilities and 800 in the private health facilities accounting for nearly 40 per cent workforce while leaving a gap of 60 per cent. About 1.5 million mothers give birth every year and only 38 per cent of them deliver by a skilled birth attendant. As Uganda joins the rest of the world to celebrate midwives week, the women who play a big role in ensuring safety of mothers and babies during birth remain unappreciated, according to the Assistant Commissioner for nursing at the Ministry of Health. Dr Enid Mwebaze said at a press conference in Kampala on Thursday that midwives in Uganda continue to be subjected to poor working conditions despite the fact that they work under unbearable conditions. “More than 50 per cent of the midwives in Uganda are stationed at rural health centres which do not even have accommodation, running water and power. It becomes very difficult to attract and retain them in such health centres when they are paid less than 100 dollars with no allowances,” she said. According to the Assistant Commissioner, certificate midwives, who form the biggest percentage of the workforce in midwifery in Uganda earn Shs270,000, a figure which she says is very demoralising, especially in retaining the health workers in rural areas where their services are most required. For that, midwives want their salaries given a double increment or allowances in form of accommodation and other social incentives that will attract them to the lower health centres. Ms Gorret Musoke, the president of the Private Midwives Association of Uganda, said: “When a woman dies in labour, the public is quick to judge the midwife in-charge at the time but when a midwife gets hurt or infections on duty the same people will remain silent and the case goes unnoticed.” The United Nations Population Fund Executive Director, Dr Babatunde Osotemehin, in his joint message with the international confederation of midwives, called for urgent investment in midwifery if countries are going to meet the Millennium Development Goal aimed at reducing child and maternal deaths. WHY UGANDA DOCTORS PREFER TO WORK ABROAD Publish Date: Mar 16, 2008 By Robert Bukenya I write in response to an article by the Gulu LC5 chairman, Norbert Mao, published in The New Vision of March 11 titled: “Where is the sh8b for the referral hospitals? Mao was right that our healthcare is in shambles. Becoming a health care practitioner To become a doctor, one has to study for five years at university and take another year for internship (practical training). Pharmacists, nurses and radiographers need to study for four years. These are highly didactic courses with tight schedules that require students to attend class morning to evening throughout the week, get practical experience by visiting the wards and have elective practical training. Medical courses are expensive in terms of tuition and stationery. Privately-sponsored students pay over sh1m per semester for five years, making the courses a no-go area for students from poor families. Challenges to the healthcare system Some of the challenges facing the healthcare system in Uganda include lack of drugs and other resources in the hospitals, poor working conditions and high patient loads. We should be thankful to the health workers who choose to practice in the public sector since the private sector pays better. Entry level graduate doctors and pharmacists in the public sector are on salary scale U4 where they earn a gross pay of sh700,000 per month or a net pay of sh500,000 (plus the risks to one’s life). In the US, a doctor earns over $100 (about sh170,000) per hour. This translates to sh1.3m per day (eight hours), sh27m for 20 days and sh40m for 30 days. To make matters worse, health workers receive their pay late but they are expected to serve (and risk their lives) patients when they have no money to buy food for their families, pay monthly bills and school fees for their children. This is why health workers in government hospitals show up for a few days in a month. Lack of drugs in hospitals is partly as a result of theft of drugs from hospital premises but stealing is not the root cause of the problem. It stems from delayed payments to health workers and corruption. As long as corrupt officials are rewarded with promotions or left free, which promotes a culture looking at people who steal public funds as being smart, we shall keep dancing around the same drum. For example, ministers who were censured by Parliament were later re-appointed to more critical ministries. It is no wonder that the health care system is in shambles. Today, the Government sponsors people to be treated for malaria abroad. If a national referral hospital cannot treat malaria, what will it treat? Mulago Hospital is for the poor. The rich go to Kadic, International Hospital of Kampala, Nsambya, Rubaga and the private wing of Mulago as the last resort if they cannot afford to get treatment overseas. The life of a poor Ugandan seems to count less on the government’s priority list, while MPs simply sit and wake up to vote. Every year, the Ministry of Health complains of under funding. Is the number of tax payers reducing every year? The way forward Our education system needs a revamp, especially now that the Government is emphasizing science courses. In the US, it is almost impossible to pay for one’s education. You need to take either a federal or a bank loan. Students in Uganda do not do courses of their preference. Many graduates have opted for courses because they did not qualify for government sponsorship to their desired courses. They could not afford private sponsorship on the desired courses and settled for cheaper courses. This costs the country skilled labour in critical areas. MPs should have zero tolerance for corruption. They should pass strict laws to punish corrupt officials, including confiscating their properties to recover the money lost. The health care system should be overhauled, health workers facilitated, and drugs and supplies stocked. The education system should be modified. The Government sponsorship scheme should be replaced with government loans. Students should sign contracts with the Government in order to qualify for sponsorship. Students could pay back by working in a health centre agreed upon at the time of signing the agreement. The university authorities can be instructed not to release any government sponsored student's transcript without the approval of the government. This would, therefore, go a long way in improving the health sector. The writer is a Ugandan healthcare practitioner based in Massachusetts, Boston in the US

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