THE Uganda Local Government Association (ULGA), an association that brings together district chairpersons, district speakers, and chief administrative officers (CAO), met in Arua town on January 8 and 9 for their 17th annual general meeting.
This is the first time it was held in West Nile region, underlining the return to peace.
Not surprising, therefore, that the theme of the meeting was: â€œThe role of local government in promoting peace and service deliveryâ€. This was a chance also to underline the significant role that district leaders have in ensuring acceleration to achieve the countryâ€™s development objectives, including the Millennium Development Goals (MDGs).
While addressing the meeting at Arua Regional Referral Hospital, ULGA president, John Karazarwe, recalled that in 1964, districts had to seek permission from the central government to construct a latrine. However, with decentralisation, districts can decide for themselves what needs to be constructed.
It is the district leaders who control the district plans and budgets and they enjoy the confidence and trust of their electorate. With this power, they have the responsibility to plan and budget. It is in this context that the district leaders have committed themselves to investing more in delivering on the MDGs, especially the targets set for maternal health; reducing by 75% maternal mortality and ensuring universal access to reproductive health by 2015.
With the recent launch of the MDGs report for Uganda 2010, which called for joint action, the onus is on district leaders to make sure maternal health is prioritised when allocating resources.
In discussing this at the meeting, district leaders realised that a plethora of maternal health are being undertaken across districts. However, unless these are coordinated and address nationally agreed priorities, the net effect at the aggregate level could be blurred. The non-uniformity of prioritising maternal health across the 112 districts was identified as a bottleneck to the effectiveness of interventions. Ugandaâ€™s MDG report calls for maternal health to be prioritised across relevant sectors and departments at district level.
In practical terms, this means, for example, that as the water department conducts its planning, water supply in health units should be counted as priority. Likewise, the works department should ensure it opens up community and feeder roads, to make it easy for mothers to access health units. Security agencies too should make night travel possible and safe for mothers to be able to access emergency obstetric care in health centres or at the nearest district hospital.
Given the decentralisation of decision making in planning and resource allocation for service delivery, district leaders need to follow agreed frameworks, such as the Road Map for Accelerating the Reduction of Maternal and Neonatal Mortality and the Uganda Chapter of the African Union Campaign for Accelerating the Reduction of Maternal Mortality Reduction in Africa. These set well the path for Ugandaâ€˜s maternal health improvement. The ULGA has an important oversight role in championing this effort across all districts in Uganda.
District leaders, however, should not stop at prioritising maternal health. Other social servicesâ€™ provisions should also be on their conscience. For example, they should be concerned that Uganda will soon have a population that is mostly made up of people aged between 15 and 64 years.
Given Ugandaâ€™s population size, this is a massive potential waiting to be harnessed and harvested. In economic terms, this has the potential to contribute positively to transform society in the countryâ€™s quest to become modern and prosperous. Population experts call this the demographic window of opportunity.
From lessons around the world, this would also mean that as Uganda achieves its goals of universal primary and secondary education and health for all, families will in turn choose to have fewer children. This is already happening in the countryâ€™s urban centres, most notably Kampala. As more girls complete schooling and join the labour force, they are more likely to delay their first pregnancy and space subsequent births so as to remain competitive in their jobs. For this to happen, women and couples must have a choice on the timing and spacing of births.
Unfortunately, about 41% of women who would like to delay or stop pregnancies in Uganda are not able to access modern methods of contraception. And this number is expected to increase unless concrete action is taken on maternal health at district level. District leaders must take upon themselves this leadership and responsibility. With a mobilised district leadership and an empowered population at community level, Uganda can accelerate its progress towards achieving the MDGs.
Representative of the United Nations Population Fund in Uganda
District leaders have a role in ensuring maternal health