The Ministry of Health plans to multiply the healthcare workforce by fourfold within the next four years. The move is intended to address a shortage of nurses and midwives across the country.

Theophile Dushime, the Chief Technical Advisor at the Ministry of Health, told The New Times that only one skilled professional is currently serving 1,000 people yet there is need for at least five professionals per 1,000 people.

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"We need more doctors, nurses, and midwives. Regarding nurses, currently, we have a quarter of the required nurses needed in the country. We are devising strategies to increase those who go to university, the number of lecturers, facilities, and laboratories in health care,” he said.

He added that the target will be achieved by increasing the number of students who graduate in medicine, nursing courses, and midwives courses from 2,000 to 8,000 every year.

"The number of intakes should be increased in a short period given that 90 per cent of diseases are treated at health centres and health posts yet doctors, nurses, and midwives are few at these facilities,” he said.

There are 1,247 health posts, 512 health centres, 40 district hospitals, four provincial hospitals, and eight referral hospitals across the country.

Nurses and midwives union weigh in

The president of the Rwanda Nurses and Midwives Union (RNMU), Andre Gitembagara, said that in order to be able to increase the healthcare workforce by admitting many students to the university, the government should consider "incentives to retain nurses and midwives in the profession as more continue to migrate to Canada and UK for jobs due to poor salaries and working conditions.”

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"The nurses and midwives are still getting a meagre salary yet they work excessive hours. By addressing these issues, it will attract younger people to pursue these professions at university,” he said.

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Nurses’ salaries range between Rwf120,000 and Rwf200,000.

In addition to that, more than 70 per cent of them work for more than 60 hours a week yet Rwanda revised the law related to working hours per week from 45 to 40 in order to enable employees to fulfill other obligations.

Due to such challenges, Gitembagara said that some nurses and midwives leave the sector and join entrepreneurship.

"There was a target of having a ratio of one nurse per 1,071 people by 2024 but in 2021 our evaluation realized that there was one nurse per 1,270 people. The situation is worse for midwives. For instance, you can find one midwife in a health centre serving 15,000 people,” he said.

Capacity building

Meanwhile, he said that they have embarked on training new young female nurses and midwives in terms of leadership skills and motivating young people to join the profession as they make a big part of the healthcare workforce.

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"We started with 100 young female nurses and midwives because once they are well equipped with leadership skills, they will carry out advocacy so that policies that are favorable to nurses and midwives are adopted in the next five years.

They must be in leadership positions at all levels. Women and Men empowered through the program will become future leaders in the public and private sectors,” he said.

There are currently about 15,000 nurses and midwives across the country and only 10,000 are members of the union.

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"Universities should also reduce tuition fees to attract more young people in the profession. For instance, a bachelor's degree in nursing at University of Rwanda requires between Rwf12 million and Rwf15 million in four years,” he said.

Sylvie Igihozo, a nurse at CHUB, said: "Due to the shortage of workforce, we do a tiresome job. If the government looks at what can help increase the number and increase salaries, it could be a motivation to others who want to join the profession.”