What awaits Uganda’s graduate nurse or midwife

Lecture block of a nursing school

Many are attracted to Uganda’s nursing and midwifery profession for a number of reasons – ideological inclinations and economics. An interplay of the two influences Uganda’s present day nurse or midwife – and to some extent the wider medical profession. The perception of a “sure” employment upon completion of one’s training ensures that the economics side stays very much in the mix while considering career choices.

The president’s push for the ‘sciences’ verses the arts – seen in his desire for increased wages for science teachers – makes it even more compelling that one consider the nursing and midwifery profession, among other top contender disciplines. It may not be the pull factors, however, that influence the enrolments, but the push factors as well. The unemployment rate among graduates speaks of a difficult employment terrain that any rational mind will do well to avoid.




Lecture block of a nursing school


But very little is ‘sure.’ When one graduates from one of Uganda’s nursing and midwifery schools, they can expect employment in one of three sectors – the public, the established private sector and the not-so established private sector. If the labour market were a pyramid, the public sector is the apex; the established private in the middle; and the not-so established private sector, the base. A few find their way to the public sector. Most are pre-destined for the not-so established private sector. The public sector is a promised land of sorts for many.

A job there comes with some nice things to have – the prospect of earning a salary while on a government funded study leave, a retirement package, and no to forget the much coveted job security – all of which the middle and base of the pyramid try to match. But the apex can only absorb so many. And indeed as the story goes – not all get to see the promised land. As of this writing, it I this writer’s knowledge that the public sector has, in place, a hiring freeze on new recruits. Only positions rendered vacant are filled with either a redistribution of current staff, or an implementation of surgical hiring.

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The private sector, for all its drawbacks, soon comes into focus. As pointed out earlier, the private sector’s two parts are distinct enough to constitute their own sector. For purposes of clarity, the established private sector sits in the middle between the public sector and another sector – the not-so established private sector. The established private sector in this case being defined as home to employers with large workforces, can afford shift changes for staffs.

It’s not uncommon for them to, however, have a small workforce. They are formally registered entities with some form of organisational structure. Many graduates gravitate to this established private sector. To many, it’s the next best alternative to the public sector. And to some a waiting area before entering the public sector. A substantial number of graduates prefer it to any of the other sectors.

The not-so established private sector is where the majority of graduate nurses and midwives end-up

The not-so established private sector is where the majority of graduate nurses and midwives end-up. This other side to the private sector coin is where most of the clinics, medical centres, drugs shops are found. Entities here are predominantly informal sole proprietorships, and will typically have fewer than five employees. Wages are meagre with payment timelines a factor of the rate of revenue collection from business activity. As such, this sector has the highest labour turn-over rate.

Many employees exist the profession from here perhaps out of burn-out. Entities in this sector are typically a side-income generating business for their owners who are in most cases doctors and clinical officers. In recent times, nurses and midwives have also joined the owners club in the no-so established private sector. It’s worth noting that the fresh out-of-nurse-training-school start here and will typically change employers at least twice in the first few months.

The quality and appeal of the nursing and midwifery field may have improved over the years, going by the number of professionally trained practitioners now compared to a time before. With this increment in qualified professionals, however, has come the side effect of a labour market that is challenging for new entrants, subjecting them to the same labour dynamics that are now common for graduates of other professions.

The ‘sure’ aspect that was once characteristic of the nursing and midwifery profession, and a pull factor for many, is no longer as dominant. Perhaps this lend explanation to the incorporation of entrepreneurship as a course unit at nursing and midwifery training schools. Whatever the realities of the labour market, the novice entrant is well served in being aware of the anatomy of their new assignment – the labour market for the nurse/midwife graduate.


Jurugo D Comboni