An Overview of Nursing Services in Uganda

1. An Overview of Nursing Services in Uganda Uganda UK Alliance by Enid Mwebaza Assistant Commissioner health Services -Nursing Ministry of Health 12th February 2013

2. Focus of this presentation • Brief background of the Nursing profession in Uganda • The situation analysis • Critical gaps in the nursing profession • Future plans for Uganda UK Alliance

3. Background of nursing profession in Uganda • (1914- 1918) The first healing and training centre • 1919 Midwifery training under the Uganda Medical Services at Mengo. • 1930 Nurses training at Enrolled level • 1956 April 12th The Uganda Nurses and Midwives` Council was formed

4. 1952 Mulago hospital opened. 1961 Registered General Nursing 1967 Midwifery Course Background 2

5. Background 3 • To date the total of practicing nurses in the public facilities : - No of nurses  - 6724 - No of Midwives - 4656 • Serving a population of about 34m • Very few highly specialized nurses

6. Situation analysis • Nursing Department heads the largest health workforce (more than 60%) in the health sector. • Nurses deliver 90% of the health services in the country covering curative, preventive and rehabilitative services. • Strengthened nursing leadership with clear and specific policy guidelines in line with the implementation of Ministry of Health Strategic Plan.

7. SITUATION ANALYSIS 2 Mission • To promote a health workforce that is appropriately skilled, well balanced, distributed, committed and performing efficiently and effectively in order to provide quality health care of individuals, families and communities in Uganda Mandate • To strengthen nursing standards and maintain quality nursing services in the country, in accordance with the National Health Policy

8. SITUATION ANALYSIS Delivering on health priorities: Maternal Mortality • Persistently high maternal mortality ratio of 438 per 100,000 (UDHS 2011) • Estimated 26% of preventable maternal deaths caused by unsafe abortion • Increasing access to post-abortion care by training more midwives and ensuring implementation of the current legal framework on abortion would save thousands of lives of pregnant women

9. Situation analysis 3 Health advocacy and Uganda’s Parliament • Successful advocacy effort by Parliament and Civil Society to secure increased investment in health workforce • FY2012-2013 allocation to health workforce increased as a result of advocacy demanding for an additional 6,172 professional health workers to be deployed at HCIII/IVs • More than doubling of the wages of medical doctors at HCIVs

10. Critical gaps to be addressed in the nursing profession • Nursing Education and career building • Nursing Practice • Nursing Leadership/advocacy • Social Positioning of Nursing profession -Balancing of Nurses’ Association and Nurses’ Union • Nursing Regulation, and standards • Resources for Nursing • Nursing Research • Nursing Policy

11. Critical gaps in the nursing profession 2 • The country is experiencing a sharp decline in the standards and quality of nurses - a need for specialized nurses at various levels - insufficient in quality and quantity - Training of many nursing cadres at various levels - Training is not well coordinated between MoH and Ministry of Education

12. Critical gaps in the nursing profession 3 2. Strengthening of the Nursing practice • Improvement in Service delivery- setting of standards • Quality of service – evidence based care • Human resource issues (attraction and retention) Improved working environment - Ensuring patient safety • Streamlining ‘Scope of practice’ • Harmonization and accreditation of CPDs programmes -

13. Critical gaps in the nursing profession 4 3. Development of a strategic direction for nursing and midwifery services: - Lack of succession planning - role models for nursing - senior nurses that young ones can look up to and learn from - enabling environment for nursing leaders in delivering meaningful change - developing structures supportive of nursing leadership

14. Critical gaps in the nursing profession 5 4. To address issues of Social Positioning of the Nursing profession- Nurses not satisfied with the public image • The profession is not well positioned to attract the best candidates for training as future professionals • Balancing the functions of a Nurses’ Association and Nurses’ Union as required by the international bodies (ICN, ICM, ILO)

15. Future plans for Uganda UK Alliance • To address the challenges that have been highlighted as a potential threat for the nursing profession • Through mentorship, exchange programmes, the nursing department in particular, will have an opportunity to implement the National Health Policy within the context of globalisation, liberalisation, and macroeconomic policy setting. • To build consensus among stakeholders with regard to the strategic direction, products and services required to develop the nursing and midwifery services in Uganda.

16. Future plans 2 • Creation of visible nursing services at institutional levels and in the primary health care sector responsible for managing, developing and implementing quality nursing services • Strengthenedand improved the capabilities of nurses through structured, sustainable continuing education programmes and research. • Improvedcoordination between the Ministry of Health and the Ministry of Education to reduce the gaps between education and clinical service.

17. FUTURE PLANS 3 • Strengthened key leadership in the Nursing Profession through initiation of this Alliance: • - Office of Commissioner Nursing • - Officer of the Registrar • - Office of Nurses Association • - Principal Tutors – Ministry of Education and Sports • - Regional leaders by implementing twinning arrangements both nationally and internationally

18. acknowledgements • Thanks to Uganda UK Health Alliance and its Director, Maura Buchanan • UHSM Academy for supporting my visit to UK • To all UK volunteers who give of their time and expertise to support our efforts.