Geoffrey Atwine’s daughter is training in midwifery at a private health institution in western Uganda. Like many parents, he wants her to complete the course and gain practical experience.
But the Technical and Vocational Education and Training (TVET) Act’s new centralized assessment fees have thrown those plans into doubt.
‘Parents such as Atwine fear they may struggle to cope with the growing financial demands associated with health training under the new TVET framework,’ the concern reflects a wider pushback from learners and private institutions.
Uganda’s TVET reforms began with the 2019 policy and became law in December 2024. The Act took effect in March 2026, shifting health training to a modular, competency-based assessment model designed to test practical skills, not just final exams.
Private health training institutions say the model is sound in principle, but costly in practice.
‘We are therefore calling on all stakeholders to undertake reforms to the assessment fees. Otherwise, the country could face a decline in the number of health workers graduating from these training institutions,’ says Andrew Mugisha, General Secretary of the Uganda Private Health Training Institutions Association [UPHITA].
Under the new framework, learners pay tuition, about Shs35,000 in annual development fees, and Shs100,000 in maintenance fees. On top of that are assessment charges of between Shs200,000 and Shs230,000 per semester.
A recent survey by Dr. Gorrette Nalwadda Kayondo found Ugandan students pay far more than peers in the region. Kenyans pay about KSh2,000-KSh5,000 per semester, Ghanaians US$10-US$24, and South Africans US$43-US$65.
‘Whereas many countries integrate assessment costs into broader training frameworks, Uganda’s model places a more direct financial obligation on learners through recurring assessment charges,’ Kayondo notes.
The structure matters: students in Kenya, Ghana and South Africa typically pay professional assessment fees once, at qualification. In Uganda, a certificate student can pay for up to six external assessments, averaging about Shs480,000 a year.
Joseph Abala Mundu argues the levy should match the purpose of the exams.
‘If these examinations are conducted once as a qualification requirement, the levy should likewise be a one-time charge rather than a recurrent cost imposed on students throughout their training,’ he says.
Dr. Safinah Musene, Commissioner for Health Education and Training at the Ministry of Education and Sports, says the changes aim to improve quality assurance and regulation.
‘Previously, we may not have been doing this very well because the Ministry was handling all the functions, including training delivery and assessment. Now, we are saying let us improve the current regulation under the TVET Act 2025,’ Dr. Musene explains.
For Atwine and other parents, that is a potential ‘ray of hope.’ The question now is when the Ministry will revise the regulations to ease the cost burden and keep health training within reach.