OPINION : Why Undermining Nurses and Midwives in Salary Enhancements Will Pose a Detrimental Catastrophe to Uganda's Health System

OPINION : Why Undermining Nurses and Midwives in Salary Enhancements Will Pose a Detrimental Catastrophe to Uganda's Health System

Uganda's health system has always grappled with a number of endless salary crises, with the Ministry of Health perpetually feeding the disgruntled health workers on endless hope, but the actualisation of this hope wallowing in vain. Over the years, health workers have staged numerous strikes to have their salaries enhanced and as well have the salary disparities solved. Where as government has scaled up efforts in improving health workers' salaries, the disparities continue to bite a Ugandan nurse.

Considering the current alleged enhancement framework as published in national media previously, Ministry of Health and Ministry of Public Service seem to prioritize medical doctors, dental surgeons and Pharmacists while undermining nurses' and midwives' magnitude of work. Regarding this framework, these who are under a U4 salary scale will have their emolument raise from Ush. 3m to 5m while graduate nurses remain  unrecognised officially by Uganda's Ministry of Public Service despite a Bachelor of Nursing programme being in existence for close to 30 years. As doctors, pharmacists and dental surgeons will have their enhancement by 66.6%, a diploma nurse will have only 40% enhancement. Besides, the U4 salary scale for nursing is weaker than the U4 scale for other medical professionals, another point of contention. This creates perceptions of worthlessness among the nurses, inducing demotivation and consequently resulting into poor job performance.

Severally, Nurses have always been considered second class health workers while other designations in the field enjoy their attributed dignity. Recently, following a nationwide industrial action by medical interns, the President made a directive to have every group of interns be paid half of the proposed salary enhancement of their seniors as per the signed 2018 Collective Bargaining Agreement (CBA) between the Government of Uganda and the different Public Service Labour Unions. This implied that Intern Doctors and Pharmacists, Nurses and Midwives were to be paid 2.5m and 2.4m respectively in fulfilment of the presidential directive. However, the Ministry of Health and Ministry of Public Service chose to effect payments of 2.5m for Intern doctors, 2m for Intern Pharmacists and 1.5m for Intern Nurses and Midwives. This emerged as another case of degradation of Nurses and Midwives.

It is worthy noting that Nurses and Midwives form the backbone of healthcare delivery in Uganda, constituting about 72% of Uganda's Public Healthcare workforce. They are usually the first contact for the patients and consequently the front liners in times of health catastrophes such as the recent COVID-19 pandemic. Nurses and Midwives spend the most time with the patients, doing all the smart and dirty work for the well-being of humanity.

Undermining their services as justified by the previous alleged meagre salary increment strikes a demoralisation signal. This will breed harmful interventions such as industrial actions resulting into a number of avoidable deaths in hospital.

A strike or industrial action by nurses and midwives will imply that the health service work force will go down by about 72%. With the records officers already on strike and the looming industrial action by allied health professionals, this will be tragic in Uganda's Health System.

Cognizant of the CBA aforementioned, clause 2.3. states that there shall be no discrimination in pay and other terms and conditions of services and that where they exist, the parties shall work towards its  elimination. Therefore, for purposes of equity, adequacy, fairness, sustainability, proffessionalism and performance orientation, there is a need of the Health Ministry, Ministry of Public Service and Ministry of Finance, Planning and Economic development to revisit the agreement herein , allocate funds and statisfactorily enhance Health workers salaries instead of hurling endless empty speech across many fora. Short of this, we all shall soon witness a detrimental catastrophe, ramifying across Uganda's Health System. Government ought to intervene and save the innocent citizens from this health sector accident waiting to happen


MAYANJA Edrine Isaac

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