The importance of investing in Skilled Health Workers: Lessons from Uganda’s Maternal Emergency Implementation

During a session held at Africa Health Agenda International Conference in Kigali, Rwanda, on 4th March 2025, Martin Msukwa, Chief Program and Innovation Officer at Seed Global Health, delivered a critical message: “Investing in skilled health workers is key to saving lives.” [EM1] Over more than a decade, Seed Global Health has trained more than 45,000 doctors, nurses, and midwives, across 7 countries, impacting the lives of 76 million people across seven countries. However, Msukwa cautioned that strained health systems and funding uncertainties pose serious threats to this progress.

The role of human resources in health systems is vital. In many countries, a significant portion of total health expenditure is allocated to health workers. For healthcare systems to deliver cost-effective interventions, these workers must possess the appropriate skills, competencies, and motivation. 

“We have made significant strides in the health systems of Uganda, with improvements compared to 20 years ago. However, challenges persist, with some regions operating at only 40% of the required health workforce capacity. Since 2019, the Ministry of Health Uganda, in partnership with Seed Global Health, has focused on addressing these gaps. So far, we have trained 25 emergency physicians, a significant improvement from none five years ago. Additionally, 13,000 health workers have been trained to attend to emergencies, as these cannot wait.” Irene Atuhairwe, Country Director, Seed Global Health, Uganda

Investing in the health workforce not only enhances population health but also drives economic development. A healthy population increases productivity, with healthy children more likely to attend school and receive better education, and healthy adults contributing actively to the economy. Additionally, healthier populations attract foreign investment, and countries with a higher worker-to-dependent ratio can harness the benefits of the demographic dividend.

“A study conducted by Seed Global Health in collaboration with the Ministry of Health Uganda on Health Systems Strengthening, involving 74 health facilities of all levels, revealed a 50% decline in emergency-related death rates, demonstrating the impact of investing in skilled health workers. The study also highlighted human resource gaps, with facilities lacking emergency physicians, too few trained health workers, and frequent medical stockouts.” Dr. Andrew Twineamatsiko, Program Manager, Seed Global Health, Uganda.

In Uganda, the impact of these investments is clear. According to the 2022 Demographic and Health Survey, Uganda’s maternal mortality rate has decreased to 189 deaths per 100,000 live births, a 44% decline from the 2016 rate of 336 deaths per 100,000 live births. This progress is attributed to the role of frontline health workers – midwives, nurses, and doctors who serve as the first point of care for maternal services and ensure safe pregnancies. Countries with higher rates of births attended by skilled health professionals tend to have significantly lower maternal death rates.

“During the last COVID-19 outbreak between 2019 and 2022, Uganda controlled the outbreak within 69 days, the fastest period ever recorded by the World Health Organization.” Dr. John Baptist Waniaye, Emergency Medical Services Commissioner, Ministry of Health, Uganda.

Ensuring that trained and equipped health workers are always within reach is essential to reducing maternal and child mortality. This is also critical to achieving national health goals, universal health coverage, and health-related Sustainable Development Goals.

Uganda is making strides in improving its health workforce. By 2022, the country had 210 health training institutions across 66 districts, with an estimated 158,932 health workers. Between the 2018/2019 and 2022/2023 financial years, Uganda’s public health sector wage bill increased by 15%, signaling a strong commitment to fair remuneration for health workers. Despite these gains, a significant global shortage of health workers persists, with Africa projected to face a shortfall of 6.1 million by 2030.

Investing in the health workforce requires a coordinated, whole-of-society approach, involving collaboration between government ministries, development partners, and the private sector. Uganda is on the right path to achieving UHC by 2030, having made significant investments in health infrastructure, improved health worker remuneration, and increased training for healthcare professionals.

Amref Health Africa is committed to empowering Health Facility Managers with the skills and knowledge needed to effectively manage and lead their facilities. This is in recognition that the future of healthcare rests in the hands of these managers, and providing them with autonomy is key to improving healthcare. To date, Amref Health Africa in Kenya has collaborated with the Council of Governors and County Governments to train 613 healthcare workers, drawn from dispensaries, health centers, sub-counties, and county hospitals across seven counties. This model is not any different from that of Uganda, as it investing in the capacity building of health care workers, to ensure that healthcare systems are strengthened.

Author: Rose Betty Mukii, Monitoring, Evaluation and Learning Officer at Amref Health Africa

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