NML-ISSUE 1

Vol I | Issue I April 24, 2020

THE NURSE AND MIDWIFE LEADERS’ COVID-19 THINK TANK Nurses and Midwives are the backbone of every healthcare system and the WHO has called on

Call to all countries to invest in nurses and midwives as part of their commitment to health for all” Action (WHO, 2020).

WE SALUTE THE UGANDA NURSES & MIDWIVES We the Nurses and Midwives Leaders’ Think Tank wish to express our thanks and gratitude to the Nurses and Midwives of Uganda for their sacrifices, zeal, resilience, hard work and major contributions they have made as frontline providers in the fight against COVID-19 so far, and the continued provision of health care services.

Your contribution to the Health System in Uganda is enormous and should not be underestimated.

As your leaders, we pledge to continuously advocate and support you as you serve this nation.

The goal of the Nurse and Midwife Leaders’ Think Tank is to amplify advocacy for all Nurses and Midwives in Uganda. We aspire to achieve the following objectives:

● To advocate for and support Nurses and Midwives across the country during the COVID-19 pandemic and beyond. This includes advocating for equity in compensation and facilitation related to frontline health workers during the pandemic. ● To work together with the National Task Force (NTF) to ensure inclusion and contribution of Nurses and Midwives in the planning processes of the National Response to COVID-19.

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The courageous work of nurses and other healthcare workers in face of coronavirus does honour

ICN 2020 to the Year of the Nurse and Midwife (YONM) 2020 and the 200th anniversary of Florence Nightingale’s birth. Florence would be proud of you.

WHO IS IN THE THINK TANK? The Think Tank initiative was formed as a response to the COVID-19 pandemic. It comprises of Nurse and Midwife Leaders from the following institutions: o Ministry of Health, Department of Nursing o Ministry of Education and Sports o Uganda Nurses and Midwives Council o Uganda Nurses and Midwives Examination Board o Uganda Nurses and Midwives Union o Professional associations like Critical Care Nursing Association of Uganda, Association of Graduate Nurses and Midwives, Nurses and Midwives Society o Nurses and Midwives in the Private Sector o Leaders from Training Institutions and Academia o Nurse leaders from respective National and Regional Referral Hospitals among others

ISSUES AT HAND During this period, the Think Tank was tasked to address the following issues relating to COVID19: 1. Representation of Nurses and Midwives at the Ministry of health level as well as the interministerial task force. Leadership is critically important during a pandemic’s management.

The magnitude of challenge nurses and midwives face amidst the pandemic underscores the urgency of nurses to be fully and deliberately involved in all strategic measures taken by any government.

2. Increase access to adequate PPE for Nurses, Midwives and other frontline health workers.

Nurses and Midwives are uniquely placed as they spend a significant amount of time with patients. This puts them at a higher risk of acquiring the infection.

3. Adequate training on: Management of COVID-19 suspected or confirmed Cases; Appropriate use of COVID-19 specific PPEs.; Mitigation, Preparedness and Response to a pandemic 4. Logistics and Resources including: Transportation and Accommodation.

5. Provision of psychosocial support to nurses, midwives and other frontline health workers.

Studies indicate that there is a significant amount of mental health distress associated with pandemics.

6. Appropriate compensation and facilitation for healthcare works involved in COVID-19 patient care as well as considerations for the Welfare of their families.

7. Increase testing for frontline health workers for COVID-19 8. Appreciation for the nurses and midwives’ continuing contribution to health for all by the Government of Uganda.

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PROGRESS REALISED SO FAR ●

The Think tank has fundraised 19,700,000/= Uganda shillings towards supporting Nurses and Midwives at the front line. This will contribute to the purchase of PPE for the Nurses and Midwives. We encourage those who can, to contribute to this fund through Emily Bako +256 (0) 772-692-777, MoH, Department of Nursing.

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A meeting with the Permanent Secretary, Ministry of Health, Dr Diana Atwine, was held on Monday 20th April 2019. During this meeting, the above issues were presented to the PS and her response was positive on all of them. We are currently following these up to ensure implementation of them effectively.

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A press statement highlighting key issues affecting Nurses and Midwives has been issued.

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A concept has been drafted highlighting key strategies that the think tank wishes to discuss and undertake. Significant progress made to implementing some of the elements of the concept.

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Continued Professionalism during COVID-19 Pandemic o

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The Uganda Nurses and Midwives Council (UNMC) has followed-up the case of Nurse Doris Okudinia who was reportedly harassed due to her heroic act of wheeling a patient to the Arua Regional Referral Hospital. The Council has engaged their lawyer to follow-up. The Registrar has remained constant communication with the nurse. As of end of last week, the council had received reliable reports that the harassment has stopped.

The Nursing Now Campaign (NNC) with support from Jhpiego sponsored an interview with Nurse Doris Okudinia in the Daily Monitor (April 16th 2020) which highlighted the issue.

Various leaders including the Speaker of Parliament and Minister of Health came out to publicly praise her heroic act via their social media platforms. We highly recommend that the public should separate professional issues from socio-political matters that can negatively affect the moral of the nurses and midwives in the country from delivering the required care.

Applied Research o

A critical strength of advocacy is evidence. Therefore, we would like to hear from nurses and midwives on the frontline. A survey is currently underway to collect the data that will guide our actions and the continued National Response. Other Nursing and Midwifery studies will be conducted to guide policy, guidelines and actions. Please respond to the ongoing survey here

IMPORTANT RESOURCES DURING COVID-19 Scope of Practice Issues emerging as a result of coronavirus: we encourage all nurses and midwives to consult the UNMC for guidance for any scope of practice issues emerging as a result of new practices associated with the care of COVID-19 patients. When in doubt, consult the regulators (UNMC) or the office of Nursing at the Ministry of Health.

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Resource Centers: We also encourage nurses and midwives to remain connected during this challenging time. Various WhatsApp groups have been established. These are useful groups for engaging with other like-minded professionals to discuss issues that affect your practice. We encourage you to join these groups.

However, let us continue to exercise prudence and limit the sharing of information from unreliable and unverified sources as this can be a source of anxiety, panic, and fear.

Mental Health Matters—Mental health risks related to Information overload, direct contact with COVID-19 patients, social isolation, and quarantine are sources of significant anxiety for the public as well as health care providers. We therefore encourage you to prioritize mental wellness. Take breaks from watching, reading, or listening to news stories, including social media. Discussing the pandemic repeatedly can be upsetting.

Prioritize readiness: Rapid changes and new clinical protocols require flexibility and openness to learn quickly and adapt. We encourage nurses and midwives to remain informed.

ON GOING The Think tank meets twice a week to check on progress and formulate strategies to support and advocate for Nurses and Midwives.

Our faith in you is steadfast. May you continue to rise up to the challenge in this International year of the Nurse and Midwife - 2020. More than ever, this nation needs you. We thank you and May God bless you.

Please feel free to contact us with your concerns.

For God and My Country.

Yours sincerely, Dr. Hajat Safinah K Museene Chairperson Nurses and Midwives Leaders Think Tank Commissioner BTVET, MoES Tel: +256 774 46 3085, Email: safinahm2002@hotmail.com Copy to:

The Hon Minister for Health The Permanent Secretary- Ministry of Health The Registrar, Uganda Nurses and Midwives Council The Chairperson- NATIONAL TASK FORCE COVID 19 The President of Uganda Medical Association The Ag. Commissioner- Nursing Services Ministry of Health All Nurses and Midwives in Uganda