Improving Midwifery Care in Ugandan Public Hospitals: The Midwives’ Perspective

Abstract

Background: A serious shortage of nurses and midwives in public hospitals has been reported in Uganda. In addition, over 80% of the nurses and midwives working in public hospitals have been found to have job stress and only 17% to be satisfied on the job. Stress and lack of job satisfaction affect quality of nursing and midwifery care and puts patients’ lives at risk. This is coupled with rampant public outcry about the deteriorating nursing and midwifery care in Ugandan public hospitals. Objective: To explore factors that result in poor quality of midwifery care and strategies to improve this care from the perspective of the midwives. Method: It was a qualitative exploratory design. Participants were midwives and their supervisors working in four Regional Referral hospitals in Uganda. Data was collected by FGDs and KIIs. Content analysis was used to analyze the transcribed data from the voice recordings. Results: Four major themes emerged from the study. They were organizational (poor work environment and lack of materials/equipment), professional (midwives’ attitudes, lack of supervision), public/consumer issues (interference) and policy issues (remuneration, promotion and retirement). Conclusions and implications for Practice: Midwives love their work but they need support to provide quality care. Continuous neglect of midwives’ serious concerns will lead to more shortages as more dissatisfied midwives leave service