The Uganda Nurses and Midwives Union, UNMU was established and registered in 2003 to represent the nurses and midwives in Uganda. It is both a professional body as well as a labor organization. As a professional organization, UNMU focuses on ensuring that the profession is practiced at the highest possible standard. As a labor organization, UNMU spearheads efforts geared toward improving the socio-economic welfare of nurses and midwives in the country as a whole. The activities and the functions of UNMU are implemented in accordance with its constitution.
In health care, nurses and midwives play a pivotal role in ensuring that patients get quality care. In Uganda, despite this known fact, nurses and midwives who form the largest portion of the health workforce and thus the backbone of the health care delivery system have continued to suffer numerous constraints that hinder their individual and collective ability to offer quality healthcare to the citizens whenever they need it. In many of the developed countries improvements in the health care system have been precipitated by concomitant improvements in the welfare of nurses and midwives as well as that of other healthcare workers. This means that even in Uganda, issues related to nursing and midwifery desires to be managed cautiously so that the health care can be improved.
One of the strategies is to allow nurses and midwives stronger say and give them more recognition and power in the healthcare arena as well as improve their living and working conditions. It has been shown that these and other reforms serve as effective incentives for improving nurse’s and midwives’ performance. However, although desired, these reforms depend on a body of systematically documented information on the plight of Uganda’s nurses and midwives despite being at the forefront of health service delivery. Such carefully documented information is indispensable for catalyzing and guiding institutional and policy reforms needed to improve the welfare of nurses and midwives in order to achieve the reciprocal effect of improved quality healthcare and health outcomes. Unfortunately, to this date, little of such essential data is available.
In order to help fill this gap, the Uganda National Association for Nurses and Midwives (UNANM) in collaboration with Norwegian Nurses organization (NNO) sponsored a national needs assessment survey on issues concerning nursing and midwifery practice in Uganda. The overall objective of the survey was to identify and describe the perceived needs of nurses and midwives and their national association as relates to their living and working conditions, the work place risk factors experienced as well as the need for institutional capacity building in the national nurses association. In line with the study findings, pertinent recommendations aimed at achieving lasting reforms in the wellbeing and practice of nurses and midwives were advanced.
This study comes at a time when despite the numerous achievements Uganda as a country has experienced in the last two decades, the conditions under which nurses live and work and subsequently their overall performance while delivering healthcare continues to get worse each year. This negative trend is very unfortunate because in the 1990s Uganda succeeded in reversing the deterioration of the health infrastructure that had occurred during the economic and political turmoil of the previous two decades. These changes have seen most health indicators improve significantly, except for life expectancy related to the HIV/AIDS pandemic. Impressively, infant mortality, although still high dropped from 122 to 97 per 1000 live births between 1991 and 1995 and from 97 to 88 between 1995 and 2005. The under-five mortality rate decreased from 203 to 147 per 100,000 live births between 1991 and 2005 and maternal mortality rate reduced from 508 to 505 between 1995 and 2005 (Health Sector Strategic Plan II 2005-2010; Uganda Demographic and Health Survey 1995; National Health Policy 1999).
However, unfortunately, results from the 2000/2001 Uganda Demographic and Health survey suggest that these improvements have not been sustained despite the country’s successes in economic growth, poverty reduction and education. The researchers suggested that one of the main reasons for this stagnation is the poor quality of health services delivered. This study sheds very important light on the dynamics of health care delivery from the perspective of nurses and midwives who form the backbone of the healthcare delivery system (Uganda Demographic and Health survey 2000/2001; Health Sector Strategic Plan II 2005-2010).
These findings are particularly relevant to the line ministries of public service, health, education and finance as they are critical for informing the civil service reforms especially those that relate to strengthening professionalism and improving the welfare of the healthcare workforce especially as regards remuneration and related terms and conditions of service. It is our sincere hope that by offering a new perspective from the nurses and midwives who are truly frontline healthcare givers, this document will make a significant contribution towards enhancing the quality of life and productivity of the population as a result of improvements in healthcare in line with the millennium development goals which are cherished and upheld by the government of Uganda.
UNMU was formed to address the numerous social–economic challenges nurses and midwives were facing across the country. There was need to create a body that would specifically champion their interests, including:
•Terms and conditions of service
•Lack of promotion
•Professional image challenges
•Social economic challenges
•Lack of recognition of professional achievements
The decision to form a union was reached by members of the Uganda National Association of Nurses and Midwives, UNANM during the May 11, 2001 Annual General Meeting, at Duhaga in Hoima District.
The following year, in May, 2002, during the Annual Scientific Conference, Dr. Ogaram, the then Commissioner of Labour, MoGLSD, was invited to present a paper on labour unions held in Arua to create awareness
The nurses and midwives attending this meeting unanimously resolved to form the Uganda Nurses and Midwives Union and tasked the leadership of the association then, to work with MoGLSD to develop the UNMU Constitution.
In November 2002, after finalising the process of developing the UNMU constitution, an interim executive was then elected from among the association members. This election took place at the Queen Elizabeth Nurses Hostel – Mulago at 4:20 pm.
The Interim Executive Committee were charged with the responsibility to:
•sensitize and recruit members into the UNMU
•register UNMU with the MoGLSD
•organize formal elections within a period of two years effective from 22nd Nov 2002 to November 2004.
The Interim Leadership of UNMU
Name of Executive
Ms. Catherine Iwollu
Mr. Masereka Zakayo Black
Ms. Nassuuna Edith
Deputy General Secretary
Mr. Peligrino Mbabazi
Ms. Ursula Kizza
Vice National Treasurer
Ms. Atim Joyce Lucy
Secretary for Health and Safety
Mr. Bateganya Patrick
Secretary for Gender
Ms. Acheng Florence
Mr. Mufumba Emmanuel
Secretary for Research and Ethics
Ms. Mutabazi Jemimah
Representative to NOTU
Ms. Otule J. Florence
EXTRAORDINARY CONGRESS MEETING AT IVY’S HOTEL IN FEBRUARY 2009
Resolutions of the Extra-Ordinary Interim Executive Meeting
Hence the Interim Chairperson and the rest of the executive committee members utilising the UNMU constitutional provision, decided to solve the problem by holding an Extra-Ordinary Executive Committee meeting in which the following resolutions were made:
• Ms. Nassuna Edith, Interim General Secretary was relieved of her duties pending approval of the UNMU Congress.
• Ms. Acheng Florence, Interim Secretary for Gender be relieved of her duties because she had become an SPNO and this would create conflict of interest.
• Mr. Bateganya Patrick was elected as Care-Taker General Secretary.
• An Extra-ordinary Congress was to be called to elect substantive officials of UNMU within four weeks as per the UNMU Constitution.
• All stake holders were to be informed of these new developments in UNMU.
In May 2007, during the AGM in Nambole Stadium, Kampala, the nurses and midwives once again expressed the need to belong to one body instead of two with overlapping roles.
The nurses and midwives thus resolved to have one organization that would address their issues instead of belonging to both the association and the union.
A task force (comprising Mr. Bateganya Patrick, Ms. Ursula Kizza, and Ms. Rwabahima Florence) was elected to work with the interim executive of the nurses union to ensure that UNANM and UNMU merged into one organization.
However, unfortunately, no positive results were shown as the then General Secretary of the nurses union refused to collaborate with the members of the task force.
In July 2007, to verify the aspiration of the nurses and midwives to form one strong organization,
UNANM commissioned a study supported by NORAD through the Norwegian Nurses organization (NNO) that covered eastern, central and western Uganda.
The findings of the survey indicated that the majority of nurses and midwives (over 80%) preferred to have one strong legal body instead of two similar organizations.
The survey also highlighted several challenges Nurses and Midwives face that would be best addressed by a labour union specifically formed to address their concerns.
In May 2008, the findings of the study were presented to the UNANM AGM in Lira district andthereafter, the nurses present were asked to advice how the executive would proceed with the transformation process.
This was after ninety five (95%) percent of the Nurses and Midwives present voting in favour of transforming UNANM into UNMU, based on the following resolutions:
The UNANM leadership and the interim union leadership were tasked to work with ministry of labour to ensure a smooth transformation process from UNANM to UNMU
The old constitution of the nurses and midwives union (August 2003) needed to be reviewed to cater for the needs and interest of retired nurses, nursing assistants and special interest groups such as the Uganda police, not included in previous constitution.
The then UNANM executive was mandated to form a joint executive committee with the interim UNMU executive for a period of five years. During this period, the joint committee would then accomplish transformation process and strengthen UNMU.
It is important to note that, following the AGM in Lira, (May 2008), MsNassuna, still declined to work with other members of the interim executive as well as with the leadership of UNANM as mandated by the nurses and midwives in 2007 and 2008 in Nambole and Lira respectively.
Following the Extra-ordinary meeting of the Interim Executive committee, an Extra Ordinary Delegates Congress was called by Ms. Catherine Iwollu, the Interim Chairperson of UNMU at IVYS Hotel on 14th Feb. 2009 in Wakaliga- Kampala.
In this Extra Ordinary Delegates Congress, the resolutions of the Extra-ordinary meeting of the Interim Executive Committee were presented, adopted, discussed and approved.
The congress was attended by 135 persons, of whom 95 were delegates (paid up members) while 40 were observers (nonpaid up members and non-nurses). The observers were from Ministry of Health and the Director of Labour, MoGLSD presided over this elections.
Among others activities of the Extra Ordinary Delegates Congress, was election of substantive office bearers as per the UNMU Constitution.
In this delegates’ congress, the following persons were elected:
Name of Executive
Ms Janet D. Obuni
Ms Florence Rwabahima
Mr Patrick Bateganya
Vice General Secretary
Mr Black Masereka
Ms Atim Lucy Joyce
Secretary for Health and Safety
Ms Theopista Kabalisa
Secretary for Education
Mr Gerald Amandu Matua
Secretary for Gender
Mr Cherop Justus
Representative to Labour Centre
Ms Catherine Iwollu
In May 2009, as was requested by the nurses and midwives during the AGM in Lira in May 2008, the aforementioned substantive executive of the Uganda nurses and midwives union was officially presented to the Annual General Meeting that was held in Masaka at the Golf Lane Hotel.
The following resolutions were made as mandated by the constitution of the nurses’ association:
• Uganda National Association for Nurses and Midwives was dissolved
• All assets and liabilities of UNANM were transferred to UNMU and its board of trustees
• All nurses and midwives were asked to become members of the UNMU.
• The executive informs relevant authorities of UNMU’s role as the sole representative of nurses and midwives in Uganda in professional and socio-economic matters. .