Uganda: Review Nurses, Midwives Act

Globally, the nursing profession is in a crisis as the shortage of nurses and midwives escalates each year. But this has even worsened with the outbreak of Covid-19.

However, the general public expects to be cared for by competent nurses and midwives through delivery of optimal care. Each country has professional regulatory bodies that set and regulate standards for training and practice.

In Uganda, the Uganda Nurses and Midwives Council (UNMC) is mandated with regulating and setting standards for the nursing and midwifery profession.

UNMC is also supposed to protect the public from any unsafe nursing and midwifery practices and ensure quality of the services provided while fostering the development of the profession.

One way to do this is to ensure a current scope of practice for the different categories of nurses and midwives in place commensurates with the current developments and trends in the profession.

This scope of practice is in tandem with the Uganda Nursing and Midwifery Act which unfortunately was last updated in 1996. This means that despite guidelines issued by the International Council for Nurses (ICN) and International Confederation of Midwives (ICM) to member countries, Uganda still lags behind. This deprives Ugandans the opportunity to tap into the unique skills and abilities of nurses and midwives who have been highly trained to meet the ever changing population needs.

Currently, Uganda has trained and licensed nurses and midwives at various levels ranging from certificate, diploma, bachelors, masters and even PhDs.

As of March 31, Uganda has 681,527 registered nurses and 39,071 midwives. A lack of an updated scope of practice means that these nurses and midwives trained at bachelor’s level and above cannot practice to their full potential.

With the current human resource challenges in the country and nurses and midwives forming the largest proportion of the healthcare workforce, nurses and midwives are the most represented cadre of health workers at all levels of health care. They are responsible for more than 80 per cent of health outcomes within the nation.

Lately, there has been a shift in tasks with nurses and midwives taking up roles that were initially for doctors.

In Uganda, lower health centres are purely managed by certificate and diploma nurses. They are the ones responsible for assessment of patients including history taking, physical examination, investigation and treatment.