How close Uganda’s workforce gap in real time

______________

OPINION

By Irene Atuhairwe

In 2024, Mbale Regional Referral Hospital was facing a maternal health crisis. More women were coming in for maternal care, but the hospital didn't have enough capacity to manage so many complicated births. Delays in getting mothers to the right specialists, overcrowded wards, and overwhelmed staff meant that, tragically, mothers were dying. The maternal mortality rate stood at 1,117 per 100,000 live births. This isn’t just a number; every death means a family losing a mother and a child becoming an orphan.

 Working closely with Seed Global Health, the hospital implemented a series of targeted interventions: hands-on emergency practice sessions for health workers, enhanced mentorship for pre-service and in-service staff, improved communication between referring facilities and the regional hospital by providing phones with airtime and ensuring they were always staffed, and the provision of essential equipment, among others.

The result and impact of these interventions were visible: in 2025, maternal mortality was reduced by almost half (47%). What this shows is simple: when health workers are skilled, supported, and motivated, mothers and babies survive. But this sadly isn’t the reality across Uganda.

As of December 2024, only 31% of approved health service positions had been filled, according to the Ministry of Public Service.  A vacancy rate of 69% isn't just a number; it is a mother in labour without a skilled midwife, or a premature baby without the care of a trained specialist. These gaps leave mothers and babies vulnerable when they need care the most.

Overcrowded maternity wards, delayed referrals, exhausted midwives, and preventable deaths of mothers and newborns, especially in underserved regions, are not uncommon in our facilities. Notably, limited funding for the health budget, combined with inadequate planning and recruitment, continues to constrain the ability of the public service to recruit health workers at the scale and speed required.  As a result, qualified and eager health professionals remain unemployed or unable to fully use their skills, while health facilities operate below staffing capacity.

These staffing shortages, coupled with inadequate infrastructure, essential equipment and medications, lead to unnecessary deaths and suffering, especially for women and newborns in hard-to-reach areas. These challenges come at a critical time when Uganda needs to speed up progress toward universal health coverage. Without urgent action, workforce gaps will continue to limit access to quality care. To address staffing shortages, Seed continues to work with the Ministry of Health and the Ministry of Public Service to ensure adequate staffing structures are created, including specialist positions, such as emergency medicine doctors, neonatologists, and neonatal nurses, among others, ensuring qualified graduates can deliver care where it is needed most. 

To close the vacancy rates sustainably, we must ensure there are employment places matched to newly graduating health workers. This ensures the health system is ready to absorb trained health workers, including specialists, nurses, and midwives. Alignment requires funded positions, an adequate facility-level wage bill, and fast-tracked, transparent recruitment processes.

Additionally, to address budgetary constraints, Uganda could adopt a phased recruitment approach, beginning with the most understaffed services, to further accelerate impact. Development partners could offer temporary funding support while government resources are mobilised, maintaining continuity without compromising national ownership.

Ultimately, staffing hospitals alone will not resolve health inequities. Workforce recruitment must be paired with minimum system-readiness investments, functional referral pathways, reliable ambulance networks and services, and essential emergency equipment. This helps staffing gains translate into lives saved and better outcomes for patients.

However, there is progress, and we should be encouraged by recent developments from the Government of Uganda. In December 2025, at the Universal Health Coverage High-Level Forum in Tokyo, the government launched its National Health Compact (2026–2030), developed with Seed’s support. The Compact outlines reforms to strengthen primary health care, improve health financing, and enhance coordination across government. It targets increasing access to essential health services from 49% to 58%, raising the national health budget from 5.6% to 9% by 2030, and expanding Health Centre III coverage from 74% to 85%.

Importantly, the Compact calls on all partners, government institutions, multilateral donors, and NGOs, to align behind one national plan and one budget, ending fragmented funding approaches and ensuring investments directly advance Uganda’s health priorities. This will benefit Ugandan citizens across the board.

One of the Compact’s key priorities is expanding and strengthening the health workforce. As Minister of Health, Dr Jane Ruth Aceng noted, the Compact represents “a direct action that will halve vacancy rates, strengthen our primary health care system, and ultimately save thousands of lives from preventable deaths.”

Under the leadership of the Ministry of Health, Seed remains a committed partner in translating national policies into practice by embedding educators and specialists inside public hospitals and training institutions so that improvements in clinical skills, supervision, and systems translate into better patient outcomes as the workforce grows. Through partnerships with universities and national and regional hospitals, we are supporting workforce, service delivery, and systems transformation to reduce preventable maternal and newborn deaths.

To sustainably improve maternal and newborn health outcomes in Uganda, we must be serious about strengthening our human resources for health. This calls for more intentional, government-led action and collaboration across sectors.

This is only possible with coordinated, nationally driven endeavours that place health workers at the centre of reform. By investing in a skilled, equitably distributed, and well-supported workforce, we can accelerate gains in maternal and newborn survival and build a resilient health system for the future.

With strong leadership, shared responsibility, and sustained commitment, we will secure better outcomes for every mother and every newborn in Uganda.

The writer is the Country Director, Seed Global Health, Uganda