New entry rules cause drop in nursing school enrolment

Nursing and midwifery training institutions have raised concerns over the new admission requirements introduced by the Ministry of Education and Sports, which they say are overly restrictive and have triggered a sharp decline in student enrolment.

The revised criteria, which affect certificate and diploma programmes in nursing, midwifery, and other health-related fields, were informed by the new lower secondary curriculum and changes to the Uganda Certificate of Education (UCE) grading system. Under the new curriculum, applicants must score at least a grade C (credit) in science subjects, along with at least a grade D (basic proficiency) in Mathematics and English, to qualify for entry into certificate-level nursing and related programmes. This change has led to a significant drop in enrolment at many institutions.

Students who had already applied or been admitted are now being turned away due to the stricter standards. Mr Maurice Ssekayita, a clinical instructor at St Francis Nursing and Midwifery Training School – Nyenga, said the number of students admitted per intake has plummeted from 120 to between 40 and 50. “We had admitted many students, but now we must refund their money. It’s disastrous. They’re being forced to seek alternative courses outside nursing,” Mr Ssekayita said.

He added that the institution heavily relies on tuition fees, making the enrolment drop a severe financial blow. “The school depends on tuition to operate, including paying tutors. Most of our budget comes from tuition; we have no other source of income. With low enrolment, it’s a serious challenge,” he said.

Private institutions

Private nursing institutions are particularly hard-hit, with many stuck with unverified students unlike their government counterparts. In an April 8, 2025, letter addressed to the Permanent Secretary of the Ministry of Education and Sports, the Uganda Private Health Training Institutions Association (UPHTIA) revealed that more than 2,814 students across various institutions are awaiting verification before the June 2025 examinations.

The new entry requirements affect seven certificate-level programmes: Nursing, Midwifery, Medical Laboratory Science, Pharmacy, Theatre Technology, Environmental Health, and Psychiatric Nursing. They also exclude students who previously qualified under the old O-Level curriculum. Mr Charles Wambi, the public relations officer at Lubega Institute of Nursing and Medical Sciences in Iganga, expressed frustration at the Ministry of Health’s decision to reject students with grades below C in science subjects. “The ministry is disorganised. We’re not satisfied. We’ve raised our concerns, but they don’t seem to care,” Mr Wambi said. “In Busoga, we have more than 10 private nursing schools, yet only one government institution—Jinja School of Nursing and Midwifery.

This shows how private institutions are disproportionately affected. Government must consider us as partners when making policy decisions,” he added. Mr Edson Tumuhimbise, the principal of International Institute of Health Sciences – Jinja, said the policy change caught many students off guard.

“Many students applied without knowing the requirements had changed. This has caused confusion and disappointment. Of those admitted, 40 will be affected by the new rules,” he said. Mr Tumuhimbise emphasised the need for policy harmonisation.

“These policies need to be aligned with students’ learning pathways. The ministry should review the policy to ease the transition into the new curriculum,” he said. Mr Andrew Mugisha, the general secretary of UPHTIA, called for a balanced approach. “There’s a need to maintain education quality while addressing the needs of students and the healthcare sector,” Mr Mugisha said. “A looming nursing shortage threatens Uganda’s healthcare system. The new grading system has made it difficult for institutions to enrol students, worsening the existing shortage,” he added.

210 training institutions

According to Dr Charles Olaro, director general of Health Services, Uganda currently has 210 health training institutions spread across 66 districts. Of these, 66.7 percent are privately owned, 22.4 percent are government-run, and 13.5 percent are faith-based. Ms Agnes Wadda, the principal public relations officer of UHPAB, acknowledged that revising the entry requirements will be difficult since the new law has only just come into force. She said President Museveni assented to the Bill in February 2025, making it law.

The enrolment crisis comes at a critical time for Uganda’s healthcare sector, which is already grappling with a significant workforce shortage. Dr Olaro said the country needs approximately 342,800 health workers to meet its population’s needs. Yet, the current infrastructure can only produce around 154,000, just 44.9 percent of the required workforce.

Key concerns

A looming nursing shortage threatens Uganda’s healthcare system. The new grading system has made it difficult for institutions to enrol students, worsening the existing shortage,” Andrew Mugisha, general secretary of UPHTIA

The requirements

 The new admission requirements stipulate that applicants must:

• Be at least 18 years old

• Demonstrate good physical and mental fitness

• Score at least a grade C in core science subjects

• Score at least a grade D in Mathematics and English

These standards apply to the seven certificate-level programmes, each typically lasting two and a half years. Previously, students only needed passes in five core subjects—Chemistry, Physics, Biology, English, and Mathematics—to gain admission.