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By Cinderella Atenyo
Hundreds of midwives from across Uganda converged in Moroto District on Tuesday 5th 2026 to mark the International Day of the Midwife under the theme “One Million More Midwives.” They issued a passionate call for urgent government recruitment, warning that extreme workloads and critical shortages are driving preventable maternal and newborn deaths, particularly in underserved regions like Karamoja.
Local Crisis in Karamoja: Overwhelmed Facilities and Geographic Barriers
The situation in Karamoja is far more severe than the national average. According to Dr. Stephen Pande, the Senior Executive Consultant at Moroto Regional Referral Hospital, the region’s Maternal Mortality Ratio (MMR) stands at around 700 deaths per 100,000 live births — dramatically higher than the national figure.
He noted that urgent action to recruit more midwives has to be taken seriously, stating that Karamoja needs 1196 midwives, and the regional referral alone needs 80 of them to lower maternal mortality ratio.
Figures from health facilities across the region indicate a bigger gap. For instance, Nadunget Health Centre IV in Moroto was designed for 25 midwives but currently has only 6. Midwives routinely handle more than three deliveries per day, resulting in burnout and forcing many mothers to deliver at home without skilled care.
Mary Nafula from Amudat District Hospital stated that Amudat District requires 78 midwives but operates with just 9, serving not only its local population but also cross-border communities from parts of Kenya and neighboring districts (Nakapiripirit and Nabilatuk).
Christine Lochoro, a midwife at Nadunget Health Centre IV, shared the daily reality: “We are overwhelmed. One midwife ends up handling multiple deliveries in a day, leading to burnout. Some mothers end up delivering at home without any professional assistance.”
Lochoro commended UNFPA for the deliberate efforts of training midwives in Karamoja for the fact that the region has only two nursing schools and access to education remains very limited for the majority who may need to enroll for such courses.
Compounding the problems are vast distances, poor road infrastructure, and limited facilities in this remote pastoral region. Many women walk for hours to reach care, often arriving too late in emergencies. Cultural preferences for home births assisted by traditional attendants, early marriages, and limited male involvement in maternal health further reduce uptake of skilled services. The region has only two nursing schools, severely limiting local training opportunities.
National Context: Progress Amid Persistent Gaps
Nationally, Uganda has made notable progress, reducing the MMR from 336 per 100,000 live births in 2016 to 189 in recent years. However, it remains well above the SDG target of 70. Neonatal mortality has stagnated at around 27 per 1,000 live births.
A single Ugandan midwife handles an average of 500 deliveries annually — nearly triple the WHO-recommended workload. The country urgently needs an estimated 13,000 more midwives for adequate coverage. The government has prioritized health workforce improvements, including better salaries for science-based cadres.
Moroto Woman MP Stella Atyang, who presided over the event, reaffirmed the government’s commitment, announcing plans to allocate 132 billion shillings in the next financial year to hire more midwives. She urged citizens to embrace modern health services to avoid being court under unnecessary emergency situations while under TBA care.
International Context: A Global Call to Action
The 2026 International Day of the Midwife theme “One Million More Midwives” reflects a worldwide shortage of nearly 980,000 midwives across 181 countries, with the largest gaps in Africa. Midwives can provide up to 90% of essential sexual, reproductive, maternal, newborn, and adolescent health (SRMNAH) care. Universal midwifery coverage could avert over 60% of maternal and newborn deaths and stillbirths, saving an estimated 4.3 million lives annually by 2035.
UNFPA Country Representative Ms. Katrine Blokhus emphasized that “Investing in midwives is one of the most cost-effective strategies to accelerate progress towards universal health coverage and ensure every pregnancy is wanted and every childbirth is safe.”
She noted that Uganda’s current MMR achievements are largely thanks to midwives working in lower-level facilities, despite the heavy toll on them.
Potential Impacts of the Crisis on Uganda
If unaddressed, this midwifery crisis could have far-reaching consequences:
Human Cost: Continued high maternal and newborn deaths, especially in regions like Karamoja, perpetuate cycles of poverty, orphanhood, and lost potential.
Economic Impact: Maternal deaths reduce household productivity, increase caregiving burdens, and hinder women’s participation in the workforce. Healthy mothers and children are foundational to economic growth and human capital development.
Demographic and Developmental Setbacks: High mortality slows progress toward SDG 3 (Good Health and Well-being), affects population health metrics, and strains the health system with complications from unskilled deliveries.
Regional Inequity: Persistent gaps in Karamoja risk widening disparities between regions, undermining national unity and development goals.
The convergence in Moroto highlights both the dedication of Uganda’s midwives and the urgent need for scaled investment. Key recommendations include rapid recruitment and deployment (especially with incentives for hard-to-reach areas), expanded training programs, infrastructure improvements (roads, ambulances, maternity units), community engagement to shift cultural norms, and stronger partnerships with development partners.
As Uganda pushes toward its 2030 targets, the message from Moroto is clear: midwives are the backbone of maternal health. Investing in them is not just a health imperative — it is an investment in the nation’s future.
