Last Tuesday was International Day of the Midwife. Uganda is commended for increasing the number of midwives because right now 60% of new mothers are attended to by a skilled person, up from 40% five years ago.
The challenge is, estimates show that about 20 women die everyday due to maternal health issues. As we celebrate the contributions made by Uganda’s super midwife, who delivers up to 500 babies, 200% more than the internationally-recommended 175 per year, it is disappointing to learn that nearly one million mama kits have been abandoned at the National Medical Stores (NMS).
The mama kit is a packet that contains materials and resources a pregnant woman needs for safe delivery. Daily Monitor reported last week that two consignments of mama kits lying idle at NMS cost about Shs 1.7bn.
NMS is complaining that the kits are taking up valuable space and mothers unions are concerned that in the past, expired kits were destroyed. Yet these kits are in short supply at many health centres, midwives are overworked and new mothers are still dying.
Perhaps there is need for more ‘thinking’ in the health sector. In a two full-page spread advert in the very week of the international midwives day and in the week it was reported that thousands of kits were idle, the district service commissions of Uganda were seeking several medical personnel for health centre III and IVs!
The commissions are looking at big numbers; 25 midwives at the level of nursing officer are required nationwide. Among others, Kasese district alone needs 58 enrolled nurses and 121 medical officers. Butaleja needs 45 enrolled nurses, Lyantonde needs 27 and Kisoro 22! Overall, over 1,000 skilled medical posts must be filled!
Seeing such a big number of vacancies all over the country means that there is a big deficiency in service provision. Of course all of us complain about poor health services most of the time and we envy those that can afford private clinics or hospitals plus the few who are able to go abroad.
Consequently, it behoves policymakers and managers in the health sector to ensure that mama kits are not left idle or even destroyed by NMS after expiry. As a country, we must also accept shame that NMS regularly destroys drugs yet we are so needy in this sector!
As if that was not bad enough, government is promoting a project to export about 250 medical personnel to Trinidad and Tobago!
As my friend Dr Chris Baryomunsi used to say before he became a minister of health, it is okay if medical workers seek to find greener pastures even abroad. However, a government that is acutely short of staff has no business involving itself in draining out scarce resources for the benefit of a foreign country.
Health ministry officers have justified this absurd venture by claiming that we have a lot of medical staff who are under-employed but need greater exposure and that it would build good relations with Trinidad and Tobago.
All these claims are suspect, and perhaps Trinidad and Tobago medical workers are the ones that should come here for good exposure. Indeed, the proposed workers to be exported are needed more here in Uganda as reported in The Independent of May 7, 2015.
Among the medical personnel in line to be exported include 15 of Uganda’s 91 registered internal medicine specialists, 4 of the 11 registered psychiatrists, 20 of the 28 radiologists, 15 of 92 pediatricians, 15 of the 126 gynecologists, 4 of 15 pathologists, four of the 6 urologists, and 4 of the 25 ophthalmologists, among others.
Trinidad and Tobago will also take one of Uganda’s only three neurosurgeons. It is interesting that last week 30 civil society organisations published an open letter to the speaker of parliament on the 2015 budget allocations for the health sector via a newspaper advert.
Apparently there is no provision for greater pay for health workers in the new budget. This group would like the speaker and parliament to compel government to include monies for ‘retention, motivation and wages of medical staff in public health facilities’ in the budget.
If medical workers are better paid, there is a possibility that Uganda will meet her long-term ambition of providing one doctor for every 12,000 patients in 2015! The WHO standard for Africa is 10,000 per doctor.
The open letter to Speaker Rebecca Kadaga presents figures from Uganda Medical and Dental Practitioners Council showing that in 2013, of the registered 4,200 physicians, only 1,200 are in active clinical medicine practice. Some 2,000 left the country perhaps without government assistance!