Poor sanitation kills 33 children daily, costs Uganda sh5.9 trillion

Uganda loses an estimated 33 children daily to preventable diarrhoeal diseases linked to poor access to safe water, sanitation and hygiene (WASH), while the economy loses about sh5.9 trillion annually because of illness and deaths associated with inadequate sanitation services, a new government report has revealed.

The report, Cost of Inaction on Water, Sanitation and Hygiene (2026), estimates that more than 4,500 children under five die every year from diarrhoeal diseases, with Busoga, Bukedi and urban centres bearing the heaviest burden.

“No country would be comfortable losing such a number of their children, especially the young children who are the future leaders,” Dr Herbert Nabaasa says.

The report also warns that Uganda could forfeit up to $27b (about sh109 trillion) over the next decade if gaps in WASH are not urgently addressed.

Presenting the findings at the Fourth Health Promotion and Disease Prevention Conference at Speke Resort Munyonyo in Kampala yesterday, Nabaasa, the commissioner for health services in charge of environmental health at the health ministry, said the country was paying an enormous human and economic price for underinvesting in sanitation and hygiene.

According to the report, poor WASH services cost Uganda the equivalent of 2.9% of its gross domestic product each year.

Nabaasa said the country loses around sh5.9 trillion annually through deaths and illness linked to poor sanitation, while another sh2.1 trillion is spent treating waterborne diseases such as cholera, dysentery, typhoid and diarrhoeal infections.

What can be saved

The report estimates that improved investment in WASH could save Uganda about Shs1.7 trillion in treatment costs annually.

“When people fall sick, you do not expect them to go and work. When they fall sick, they cannot make a living and also the government loses,” Nabaasa said.

The report also highlights the hidden economic burden carried by women and girls who spend hours fetching water.

Uganda also loses an estimated Shs500 billion annually through time spent collecting water, with many women walking at least five kilometres to access safe sources.

“If you invest wisely in WASH, you are going to jump-start investment in other sectors, such as agriculture, industry and fisheries,” he said.

Economic effects

Nabaasa warned that poor sanitation and waste management are degrading water bodies, threatening fisheries, tourism and manufacturing. He said rapid urbanisation has worsened the situation, noting that more than 50% of Kampala's waste is not collected.

Paying the price

The report shows that children are paying the highest price for the country's sanitation shortcomings.

According to the findings, about 34% of Ugandan children are stunted, a condition associated with chronic undernutrition and repeated infections linked to unsafe water and poor sanitation.

The report further links poor hygiene to newborn deaths, estimating that 31% of neonatal deaths associated with sepsis occur under conditions of inadequate hygiene, particularly in health facilities.

Nabaasa said improved hygiene practices in communities and health facilities could significantly reduce preventable deaths among newborn babies.

Girls most affected

The report also points to the impact of poor sanitation on education, particularly for girls.

According to the findings, about 10% of girls drop out of school because of inadequate menstrual health and hygiene support.

The report also found that 44% of primary schools lack handwashing facilities.

Nabaasa said the findings demonstrate that investments in WASH must go beyond water provision alone and include sanitation facilities in schools, handwashing stations, menstrual hygiene support and cleaner health facilities.

Leaders rally behind prevention drive

As the report was being released, government leaders and cultural institutions at the same event renewed calls for greater investment in disease prevention, arguing that many illnesses burdening Uganda can be avoided through improved sanitation, hygiene and community action.

Health minister Dr Chris Baryomunsi said as much as 75% of Uganda's disease burden could be prevented through effective public health interventions.

He said the country continues to battle communicable diseases such as malaria, HIV, tuberculosis and diarrhoeal infections, while cases of cancer, diabetes and cardiovascular disease are also increasing.

Baryomunsi said prevention must become a national priority if Uganda is to reduce pressure on health facilities and improve health outcomes.

Vice-President Jessica Alupo called for a shift from a health system largely focused on treating illness to one centred on preventing disease.

“Health does not begin in a hospital; it begins in our homes, our schools, our workplaces, our places of worship and our communities,” Alupo said.

Health ministry permanent secretary Diana Atwine said the Government has rolled out community health extension workers in 70 districts following successful pilot programmes.

She cited estimates showing that every dollar (about sh4,000) invested in community health saves $10 (about sh40,000) in treatment costs and urged local leaders, religious leaders and cultural institutions to take a greater role in promoting healthy practices within communities.

Busoga King (Kyabazinga) William Gabula Nadiope IV said cultural institutions can help government extend health programmes to households because of their trusted grassroots structures.

Gabula also raised concern over teenage pregnancy in Busoga and Bukedi, where rates stand at about 28% compared to the national average of 24%.

He said districts such as Mayuge, Kamuli and Namayingo were recording teenage pregnancy rates of between 29% and 30%, underscoring the need for stronger community engagement, education and support programmes.

The conference, which ends tomorrow (on October 16), has brought together government officials, health workers, cultural and religious leaders, development partners and local government representatives to discuss ways of strengthening health promotion and disease prevention across the country.