Official Administrative Guidance and Advisory Note
To: Hon. Balaam Barugahara, Minister of Local Government.
FROM: Association of Graduate Nurses and Midwives of Uganda (AGNMU)
DATE: September 23, 2026
SUBJECT: RE-EVALUATION AND RESCISSION OF DIRECTIVE REGARDING LEADERSHIP OF RECENTLY VISITED HEALTH FACILITY LEVEL III
The Association of Graduate Nurses and Midwives of Uganda acknowledges the Ministry of Local Government's ongoing efforts to enhance accountability and operational oversight across public health facilities. However, we write to formally address a directive issued following recent support supervision visits concerning the supervisory arrangement between Nursing Officers and Clinical Officers.
We respectfully request that the Honourable Minister rescind the directive deeming supervision of a Clinical Officer by a Nursing Officer inappropriate, as the current reporting arrangement aligns with established public service standing orders, academic qualifications, and professional grading.
Academic qualifications and professional hierarchy
Per public service standards and professional progression frameworks, supervision within health institutions is anchored on academic attainment and professional hierarchy:
Nursing Officer: The officer in question holds a Bachelor of Science in Nursing, representing a full undergraduate degree qualification.
Clinical Officer: At the entry level, a Clinical Officer holds a Diploma qualification.
It is a foundational principle of public administration and human resource governance that a junior officer holding a diploma-level qualification cannot supersede or exercise supervisory independence over a senior officer holding a higher academic degree within the multidisciplinary clinical setting.
Public Service Salary Scale and Grading Analysis
To provide further clarity on administrative ranking, the respective salary scales designated by the Ministry of Public Service explicitly establish seniority:
Nursing Officer (degree cadre): Positioned on salary scale U-4 Med-2, reflecting a senior professional level.
Clinical Officer (entry level/diploma cadre): Positioned on salary scale U-5.
In accordance with the Uganda Public Service Standing Orders and government human resource guidelines, grading dictates that a lower salary scale (U-5) denotes a junior position relative to a higher salary scale (U-4). Therefore, directing a senior officer on scale U-4 to report to or be subordinate to a junior officer on scale U-5 contradicts the established public service standing orders.
Call to action and recommendation
In light of the academic credentials, salary scale gradings (U-4 Med-2 versus U-5), and public service standing orders:
We urge the Honourable Minister to officially rescind the directive challenging the leadership structure at the respective health facility.
We request that the facility in charge of the facility in question and administrative supervision be upheld in accordance with the formal qualifications and grading structures established by the Ministry of Public Service, until the approved staffing structure for Health Centre III is implemented, which will introduce a new cadre.
But also, the language and the tone used demonstrated bias in the able leadership of a nursing officer who has been running the facility without any audit queries.
The Association remains committed to collaborating with the Ministry to ensure harmony, professionalism, and optimal service delivery across all healthcare institutions in Uganda. @BalaamBarugahar
CC
Minister of Health
Minister of Public Service
END
BREAKING NEWS ๐จ:
The Uganda Medical Association (UMA) has announced industrial action over the ongoing welfare and deployment crisis affecting medical interns and the wider medical profession.
Doctors have given government 14 days to provide clear, written and satisfactory commitments on the deployment and facilitation of medical interns.
If government fails to act, doctors across Uganda will commence industrial action.
Dear Honourables @BalaamBarugahar@JustineNameere
RE: CONDUCT OF MINISTERIAL INSPECTIONS AT PUBLIC HEALTH FACILITIES
The Uganda Medical Association (U.M.A.) acknowledges your Ministryโs commitment to rooting out corruption, absenteeism, and service delivery failures in local government. We share your goal of accountability.
๐๐ผ๐๐ฒ๐๐ฒ๐ฟ, we are deeply concerned about the ๐บ๐ฒ๐๐ต๐ผ๐ฑ๐ employed during recent inspections of health facilities; specifically, the presence of television cameras in clinical areas, the public interrogation of health workers, and arrests ordered before allegations have been properly investigated.
๐ฃ๐ฎ๐๐ถ๐ฒ๐ป๐๐ ๐ฎ๐ฟ๐ฒ ๐ป๐ผ๐ ๐ฒ๐ ๐ต๐ถ๐ฏ๐ถ๐๐. Filming patients in wards, maternity units, and consultation rooms without informed consent violates the Patients' Rights and Responsibilities Charter, the Data Protection and Privacy Act, and Article 27 of the Constitution, which guarantees the right to privacy. ๐ ๐ต๐ผ๐๐ฝ๐ถ๐๐ฎ๐น ๐ถ๐ ๐ฎ ๐ฝ๐น๐ฎ๐ฐ๐ฒ ๐ผ๐ณ ๐ต๐ฒ๐ฎ๐น๐ถ๐ป๐ด, ๐ป๐ผ๐ ๐ฎ ๐๐ฝ๐ฒ๐ฐ๐๐ฎ๐ฐ๐น๐ฒ.
๐ฅ๐ฒ๐๐ ๐ฎ๐ป๐ฑ ๐น๐ฒ๐ฎ๐๐ฒ ๐ฎ๐ฟ๐ฒ ๐ป๐ผ๐ ๐ฎ๐ฏ๐๐ฒ๐ป๐๐ฒ๐ฒ๐ถ๐๐บ. Finding a health worker away from their station proves nothing without first verifying the duty roster, leave records, night-duty history, and on-call arrangements. Compensatory rest after night duty, annual leave, and sick leave are lawful entitlements under the Employment Act and Article 40 of the Constitution. Accusations of absenteeism must follow verification, not precede it.
๐ฆ๐๐๐๐ฒ๐บ๐ถ๐ฐ ๐ณ๐ฎ๐ถ๐น๐๐ฟ๐ฒ๐ ๐ฐ๐ฎ๐ป๐ป๐ผ๐ ๐ฏ๐ฒ ๐ฏ๐น๐ฎ๐บ๐ฒ๐ฑ ๐ผ๐ป ๐ณ๐ฟ๐ผ๐ป๐๐น๐ถ๐ป๐ฒ ๐๐ผ๐ฟ๐ธ๐ฒ๐ฟ๐. Ugandaโs public facilities are staffed at roughly a third of established needโ34% against Ministry of Health norms, with diagnostic services at 47.7% and medicine availability at 58.9%. Where a worker refers a patient due to a stock-out or missing test, that is a systemic failure, not corruption. The two must be distinguished.
๐๐๐ฒ ๐ฝ๐ฟ๐ผ๐ฐ๐ฒ๐๐ ๐ถ๐ ๐ป๐ผ๐ ๐ผ๐ฝ๐๐ถ๐ผ๐ป๐ฎ๐น. Articles 28 and 42 of the Constitution guarantee the presumption of innocence and a fair hearing. Arrests and public humiliation cannot substitute for proper investigation through established @PoliceUg, public-service, and professional-regulatory channels.
U.M.A therefore recommends that;
- ๐๐ฎ๐บ๐ฒ๐ฟ๐ฎ๐ ๐ฟ๐ฒ๐บ๐ฎ๐ถ๐ป ๐ผ๐๐ ๐ผ๐ณ ๐ฎ๐ฐ๐๐ถ๐๐ฒ ๐ฐ๐น๐ถ๐ป๐ถ๐ฐ๐ฎ๐น ๐ฎ๐ฟ๐ฒ๐ฎ๐!!!
- @GovUganda fixes the system and funds recruitment and supplies.
- Humiliation Health Workers stops immediately.
- @MoLGUganda either leaves health facility inspections to @MinofHealthUG and it's organs or requests their active involvement.
๐๐ฐ๐ฐ๐ผ๐๐ป๐๐ฎ๐ฏ๐ถ๐น๐ถ๐๐ ๐ฎ๐ป๐ฑ ๐๐ถ๐ด๐ป๐ถ๐๐ ๐ฐ๐ฎ๐ป ๐ฎ๐ป๐ฑ ๐บ๐๐๐ ๐ด๐ผ ๐๐ผ๐ด๐ฒ๐๐ต๐ฒ๐ฟ.
Service with Honour,