Health 20 June 2026 Daily Monitor (Uganda)
Apuce Health Centre II: A Single Midwife Battles Overload in Rural Uganda
Apuce Health Centre II, serving 800 patients monthly in Lira District, has struggled with severe understaffing for over a decade, with a recent intervention finally bringing a much-needed midwife and electricity. Source: https://www.monitor.co.ug/uganda/news/national/one-midwife-for-800-patients-the-bitter-sweet-triumph-of-apuce-health-centre-ii-5503138
Apuce Health Centre II, located in Ayami Sub-county, Lira District, stands as a critical healthcare provider for a remote community, handling an estimated 750 to 800 patients each month. Despite offering essential services ranging from HIV testing and TB treatment to antenatal care and family planning, the facility has been plagued by a chronic shortage of staff.
For more than ten years, Apuce Health Centre II operated with a skeletal team of only six individuals, including three technical staff: an assistant nursing officer, a health assistant, and a single midwife. This severely limited their capacity, particularly in crucial areas like maternal care. There were periods where the facility lacked any midwife at all, forcing pregnant mothers to travel long distances or seek assistance from traditional birth attendants, raising concerns about maternal and child health outcomes.
The turning point for Apuce Health Centre II came in early 2024 through the implementation of the Community Score Card (CSC), a participatory social accountability tool. This initiative highlighted the critical service gaps, including the absence of a dedicated midwife. The advocacy efforts stemming from the CSC assessment, supported by the CASCADE project, finally prompted the district health office to deploy Ms. Judith Ajwang as an enrolled midwife to the facility in September 2024.
Since her arrival, Ms. Ajwang has seen a significant increase in antenatal care registrations, exceeding her targets. The efforts of the CSC also led to the sub-county connecting the facility to electricity, improving safety and enabling services during nighttime hours. However, challenges persist. Ms. Ajwang often finds herself working alone, performing duties meant for a larger team. While the facility is adopting digital record-keeping, experts caution that technology cannot substitute for adequate human resources.