Uganda's health indicators improve

By Raymond Baguma    
                                                                                
There has been an overall improvement in Uganda's health indicators in the last ten years, according to the 5th Uganda Demographic and Health Survey report of 2011 released by the Uganda Bureau of Statistics (UBOS).

The survey examined progress in the various health sector indicators in fertility, maternal and child health, nutrition status, fertility rate, mortality, malaria prevalence, HIV/AIDS knowledge, attitude and behaviors, women empowerment and access to family planning services.

The survey which covered households in 10 sub regions of Uganda shows a drop in national female fertility rates, improvement in access to contraceptives for women and family planning services, and decline in maternal and child mortality.

The survey also reveals improvement in antenatal attendance, increase in immunization coverage, improvement in breastfeeding, HIV/AIDS awareness as well as malaria prevention strategies.

According to Male Mukasa, the UBOS executive director, the demographic and health survey which compiled information from across the country, is a tool used to monitor the progress in implementing the National Development Plan.

The state minister for planning Matia Kasaija said that the results of the survey would help government to plan for the health sector, address challenges, and provide information to track progress to attain the Millennium Development Goals (MDGs).

Fertility and Family planning:
The total female fertility rate in Uganda has dropped on average from 6.9 children in 2001, to 6.2 children per woman in 2011. This is in women between 15 and 49 years of age. However, the fertility rate for rural-based women is at 6.8 children per woman, while that the fertility rate of urban women is at 3.8 children per woman.

Also, educated and wealthier Ugandan women tend to have fewer children than their poorer and least educated counterparts. However, the report establishes that female fertility is highest in eastern Uganda where women on average have 7.5 children.

However, Ugandan women on average have their second deliveries after intervals of 30 months; while the median age of first birth for Ugandan women is 18 years, which is also the median age of Ugandan girls having sex for the first time. Also, 24 percent of Ugandan women between the 15-19 years of age are pregnant with their first child or, they are already mothers.

The report says that nearly all of Ugandan men and women know at least one modern methods of contraception. However, the use of contraception is still generally low, with sexually active, unmarried women using mainly male condoms, injectable contraception, pills and implants. According to the report, the trend in contraceptive use amongst married Ugandan women indicates an increase in contraceptive use from 19 percent use in 2001, up to 30 percent contraceptive use by 2011.

Also, the unmet need for family planning methods amongst married women has declined from 38 percent in 2006, down to 34 percent in 2011. Women are considered as having an unmet need for family planning if they wish to limit child bearing, but are not using contraception.

Maternal health and mortality:
Under this, the report examined the number of antenatal visits by expectant mothers, supervised delivery, and postnatal care, and challenges in accessing health care. The survey also shows that more pregnant women went for antenatal care in 2011 compared to 2006, and accessed services that included taking iron tablets, having their weight, and blood pressure measured; having blood and urine samples taken as well as being informed of pregnancy complications.

Also, in 2011, 56 percent of pregnant women in Uganda received two or more tetanus injections during their last pregnancy. This was an increase from 51 percent in 2006.

Also, there was an increase in the number of women who delivered from health facilities in the country. The number of women delivering from public health facilities increased from 29 percent in 2006, up to 44 percent in 2011. Conversely, the number of women delivering from home declined from 59 percent in 2006, to 42 percent in 2011. Also, the percentage of women with anemia dropped from 41 percent in 2006, down to 23 percent in 2011.  

On maternal mortality, the survey shows that the number of mothers dying while giving birth has declined from 550 deaths per 100,000 live births in 2001, to 438 deaths per 100,000 live births in 2011.

Child health and mortality:
Under early childhood mortality, the survey indicates that the under-five mortality rate has registered a decline from 158 deaths per 1,000 live births in 2001, to 90 deaths per 1,000 live births in 2011. Also, infant mortality has declined from 89 deaths per 1,000 live births in 2001, and is now standing at 54 deaths per 1,000 live births.

Also, neonatal mortality has declined from 33 deaths per 1,000 live births, to 27 deaths per 1,000 live births. However, childhood mortality is generally higher among children of women with low education and children from poor households. Also, child mortality is highest among children who are born less than two years after a pervious birth, and those born to mothers below 20 years of age.

Also, the report shows that there has been an increase in immunization coverage of children aged between 12-23 months against the common killer diseases such polio, tuberculosis, measles, tetanus, diphtheria. In 2001, immunization coverage stood at 37 percent, and has risen to 52 percent in 2011, according to the latest UDHS.

Also, the survey reveals that exclusive breastfeeding has improved from an average duration of 3 months in 2006, up to an average of 6 months of exclusive breastfeeding in 2011. Exclusive breastfeeding is recommended for babies in the first six months of life because breast milk contains all nutrients that a baby needs.

However, the nutrition status of children shows a decline, with the number of stunted and wasted children in the country, recording an increase, compared to previous years. For instance, the number of stunted children increased from 39 percent in 2001, to 47 percent in 2011. Also, the percentage of wasted children rose from 4 percent in 2001, to 7 percent in 2011. However the number of underweight children dropped from 23 percent in 2001, to 17 percent in 2011. Also, the prevalence of anemia in children dropped from 73 percent in 2006, to 49 percent in 2011.

HIV/AIDS awareness and Malaria prevention:
The survey also examined ownership and use of insecticide treated mosquito nets (ITNs), prevention of malaria during pregnancy, treatment of malaria in children as well as indoor residual spraying (IRS).  The survey also examined knowledge of HIV/AIDS issues, attitude, behaviour and testing as well as HIV/AIDS and youths.

Analyzing the trend of ownership of mosquito nets, the report shows that the use of mosquito nets by households has increase from 16 percent in 2006, to 60 percent of households in 2011. However, the West Nile region has the biggest number of households with a mosquito net while the central region has the lowest coverage of mosquito nets.

With HIV/AIDS, the survey also established that majority of Ugandan women and men know that the risk of getting HIV/AIDS can be reduced by using condoms and limiting the number of sex partners to only one.