Ugandan midwife Budesta Amongin (L) attends to expectant mothers at Kobwin health centre III in Ngora District on May 16, 2025. PHOTO/YAHUDU KITUNZI
In a remote village in Ngora District, eastern Uganda, Kobwin Health Centre III serves as a vital lifeline for expectant mothers. At its centre is nurse Budesta Amongin—the facility’s sole midwife—who delivers up to 40 babies each month under challenging conditions.
At the facility, she is the only midwife in the maternity ward, providing lifesaving care to hundreds of women and children monthly. At just 37 years old, Ms Amongin shoulders the weight of an entire maternity unit.
“You see me here—I don’t rest. Mothers come at any time, day or night,” Ms Amongin said at the weekend. “I am the only midwife at this facility. Every month, I deliver more than 40 mothers, handle 190 antenatal cases, 70 family planning clients, and 60 postnatal mothers. I also manage over 40 cases of urinary tract infections, immunise about 150 children, and treat 20 outpatients every week,” she added. Uganda has approximately 17 midwives per 10,000 people.
The World Health Organisation (WHO) estimates that at least 71 nurses and midwives per 10,000 people are necessary to achieve at least 80 percent of universal health coverage. When faced with complicated deliveries, Ms Amongin refers patients to Ngora Health Centre IV for specialised management. It is a facility she knows well—she worked there before being transferred to Kobwin Health Centre III on January 21.
She began her career at Agu Health Centre III after being recruited in 2016 by the Ngora District Local Government. Due to the demands of her work, Ms Amongin has had to enrol her two children, aged 8 and 12, in boarding school. “This work has caused serious domestic issues.
My husband complains that I don’t give him enough time, and it’s true. I often don’t cook or do any housework because I am always working. I love my job, and I love my family—but I am failing to balance the two duties,” she said.
Despite the challenges, Ms Amongin remains passionate about her work and urges health workers to stay committed to saving lives. “I completed my diploma in 2019, but I have never been promoted. I am a registered midwife, and I believe it’s time I am considered for growth,” she said.
Ms Amongin’s story reveals the sacrifices health workers in Uganda make daily—often working alone, under-resourced, and underappreciated, yet deeply committed to the people they serve. While larger hospitals may have teams of midwives and doctors, Kobwin Health Centre III is severely understaffed, with a single midwife handling maternal care for the entire community.
“From monitoring labour to overseeing delivery and providing postpartum care, I handle it all,” she said. Amongin’s story also depicts the systemic deficiencies in Uganda’s healthcare system.
Many health centres, particularly in rural areas, are overwhelmed by the increasing demand for services but struggle with shortages of qualified medical staff and essential resources. Mr Job Okello, a resident and opinion leader in Ngora District, said the government must address staffing shortages, improve resources, and establish infrastructure that enables health workers to deliver quality care. “This reveals a worsening crisis in Uganda’s healthcare system that requires urgent attention,” he said.
Inspection
During an inspection of health centres in the district last month, officials from the Health Monitoring Unit (HMU) were impressed by Ms Amongin’s dedication to Kobwin Health Centre III. The HMU team spent three weeks in the Teso region conducting unannounced spot checks and detailed investigations across various health facilities, aiming to ensure accountability in the delivery of public health services.
The investigation uncovered issues such as absenteeism, extortion, corruption, drug theft, and incomplete infrastructure. The HMU team urged the district leadership to formally recognise Ms Amongin’s service. The Chief Administrative Officer (CAO), Mr Francis Opolot, pledged that the district would honour Ms Amongin for her exceptional commitment. “I want to take a moment to recognise and commend Nurse Amongin’s exceptional dedication.
Despite working under challenging conditions and often being the only health worker on duty, she continues to provide quality care,” Mr Opolot said. The Ngora Deputy Resident District Commissioner (RDC), Ms Jacinta Ayo, sais, said while some health workers may come across as rude, Ms Amongin is consistently respectful and kind.
Ms Ruth Abiro, who was assisted by Ms Amongin during a recent night-time delivery, praised the midwife’s dedication. “She works tirelessly, often on her own, but still manages to care for everyone with kindness and dedication. She never complains like others in other facilities,” she said.
Maternal deaths
According to the National Midwives Association, 75 percent of maternal deaths in facilities are attributed to a lack of relevant skills among midwives, despite mothers arriving in time for care.
The 2023 Ministry of Health Annual Report indicated a rise in maternal deaths from 1,226 in 2022 to 1,276 in 2023, with severe bleeding and high blood pressure being the leading causes. Data from the Ministry of Health further reveals that the patient-midwife ratio is 7:2, while the bed-midwife ratio is 5:1. Midwives reported a 20 per cent workload excess due to a five-person shortfall.
