Moroto, Uganda | URN | Karamoja sub-region requires at least 1,196 additional midwives to address critical maternal health gaps and reduce its high maternal mortality ratio, health officials have revealed. The call was made on Tuesday in Moroto District during national celebrations to mark the International Day of the Midwife, held under the theme “One Million More Midwives.”
Officials say the region continues to face a severe shortage of skilled birth attendants, poor access to health facilities, and difficult terrain, all of which have contributed to one of the highest maternal mortality rates in the country. According to Dr. Stephen Pande, a Senior Consultant at Moroto Regional Referral Hospital, Karamoja’s maternal mortality ratio stands at about 700 deaths per 100,000 live births, compared to the national average of 189 deaths per 100,000 live births. Uganda’s target is to reduce maternal mortality to 70 deaths per 100,000 live births.
“While the country needs to reduce maternal mortality by 66 percent to hit the target, Karamoja needs to reduce it by 90 percent. That means we need extra miles and affirmative action to get more midwives,” Pande said. He stressed that the region urgently requires affirmative action in the recruitment and deployment of midwives to improve maternal healthcare outcomes.
The shortage comes at a time when the entire Karamoja sub-region, made up of nine districts, has only four Health Centre IV facilities, while at least 22 sub-counties have no health facility at all. Moroto District Health Officer Dr. James Lemukol said the lack of health infrastructure has left many mothers without access to quality maternal and reproductive health services.
“This has created a huge gap in access to quality health services and specialized midwifery care. It calls for urgent action by the Ministry of Health,” Lemukol said. He praised midwives for continuing to serve communities under difficult circumstances, including insecurity, poor roads, and limited medical supplies. Lemukol noted that despite the challenges, midwives continue to save lives and ensure safer childbirth experiences for mothers and newborns.
Health workers in the region also say understaffing is putting enormous pressure on the few available midwives. Susan Niyigena, a Senior Nursing Officer at Moroto Regional Referral Hospital, said many midwives suffer physical strain due to long working hours and difficult working conditions.
“Sometimes this exposes us to health challenges like headaches and back pain. We also lack consumables, yet we deal with blood directly,” she said. Niyigena added that referrals from lower health facilities are often delayed because floods and poor roads cut off access to the regional hospital.
“You find an emergency coming from a lower facility, but accessing the regional hospital is very hard because rivers cut off roads in the rainy season, and it’s extremely hot during droughts,” she explained. The National Midwives Association of Uganda says efforts are underway to strengthen maternal healthcare services nationwide.
According to the association’s President, Annette Kanyunyuzi, partnerships with UNHCR have enabled the introduction of medicines to prevent postpartum hemorrhage in districts including Isingiro, Yumbe, and Madi-Okollo. She said over 500 health workers have already been trained, while more than 2,000 mothers have benefited from the interventions.
Meanwhile, the Acting Commissioner for Nursing and Midwifery at the Ministry of Health, Evelyn Kyomugisha, said the government is working to mobilize funds to recruit more midwives across the country. Kyomugisha added that the Ministry plans to deploy community health workers in every parish by 2030 to support maternal health services and strengthen early disease detection.
“We are trying everything possible to raise funds for recruitment, with more concentration on midwifery,” Kyomugisha said. She urged midwives to continue offering quality services to encourage more women to seek skilled care during childbirth.
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