Kampala, Uganda | THE INDEPENDENT | Juliet Nansubuga graduated with a Bachelor’s Degree in Nursing in 2024 after years of balancing work and studies as a diploma-qualified nurse. However, eight months later, she remains in the dark about her professional licensing and next steps.
Nansubuga told URN that she promptly applied for an internship placement upon receiving initial guidance from the Uganda Nurses and Midwives Council (UNMC). Later that year, the graduate nurse received a follow-up notice indicating that the government had waived internship requirements for extension nurses.
These are nurses who had been practicing with diploma qualifications before upgrading to bachelor’s degrees. However, since then, she has received no clear timeline on when she will be licensed. “They only told us to wait, without offering further guidance,” Nansubuga said with frustration.
Nansubuga is just one of the hundreds of nurses and midwives who upgraded their qualifications because of the delayed implementation of the internship waiver, which has slowed licensing and professional advancement. The silence is hard-hitting to individuals as promotions remain uncertain, and the pay gap deepens financial and career pressure, with a diploma nurse earning about Shs 2.6 million monthly, while a degree holder should earn about Shs 4 million, leaving many facing lost income, slower career growth, and growing mental pressure. Ellen Kansiime, another affected nursing officer who graduated in 2025 and now speaks for a growing group, paints a starker picture.
She said the matter was affecting people’s mental health, adding that they had gone back to school to upgrade but were still stuck at the same professional level, missing promotions, and finding the silence disturbing.
Kansiime estimates more than 300 colleagues, many who have waited since 2023, are in the same boat. Some direct-entry degree graduates (those who went straight from A-Level to university) have secured internship placements, yet they are often supervised by these very extension nurses still practicing under outdated diploma licenses.
The root of the impasse traces back to July 2024, when an inter-ministerial committee resolved to waive the mandatory one-year internship for upgrading nurses and midwives. Many had already accumulated 5–15 years of supervised clinical experience, essentially fulfilling the internship’s objectives on the job. The Ministry of Health endorsed this, aiming to fast-track experienced professionals into higher roles and ease workforce pressures in a sector perpetually short-staffed.
Yet nearly two years on, the waiver remains unoperationalized at the regulatory level. Hundreds of these nurses are “professionally paralyzed” and unable to practice at their new qualification level, secure deserved promotions, or even access the full benefits of their hard-earned degrees. Uganda Radio Network has seen a Feb 11th, 2026, letter from Dr. Diana Atwine, Permanent Secretary at the Ministry of Health, referencing a previous government circular on the matter.
In the letter, Atwine said she has received petitions indicating that the resolution has not been operationalized. Notably, the matter has not been presented to the council board for guidance and approval, which was inconsistent with the communicated government position on the matter and has significant workforce implications.“…this ought not to be a complicated process, as the affected nurses and midwives are already trained and practicing professionals within the health system,” the letter reads in part.
She further gave the council three directives, including presenting the matter to the council as required and issuing communications to the affected persons and stakeholders without delay. The third directive required the council to expedite all pending applications to ensure eligible practitioners are licensed in accordance with the government resolution. “This matter must be accorded the urgency it deserves. The continued delay undermines an official government resolution and adversely affects the professional progression and development of critical health workforce personnel,” she said.
Despite these directives from the top, the UNMC has remained largely silent. However, the Uganda Nurses and Midwives Council (UNMC) is still tight-lipped on the issue. When contacted, both Christine Nimwesiga, the Registrar, and Jacob Ampaire, the Public Relations and Communications Officer, said they will comment on the issue at a later date.
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