Family planning, education pay (Population and Development )

By Catherine Mwesigwa Kizza

Economic reforms, without investing in family planning and education means Uganda will not meet its target of a per capita income of $9,500 by 2040.

Investing in family planning and education will give the additional benefit of $3,000 to achieve a per capita income of $9,567, instead of $6,084, which is projected, if only economic reforms are pursued to achieve the Vision 2040 dream of transforming the Ugandan society into a modern, prosperous country in 30 years. The projections were arrived at using the DemDiv, a modelling tool developed by the Health Policy Project.

Current development efforts emphasise economic reforms, focussing on infrastructure for various sectors, including energy, transport, oil and gas. In the same vein, significant resources are being invested in promoting innovations and science and technology to steer development.

However, in a July 2014 report by the National Planning Authority, titled Harnessing the Demographic Dividend and Accelerating Socioeconomic Transformation in Uganda, experts argue that this approach alone may not achieve the Vision 2040 dream target.

Uganda’s population is predicted to increase to 93 million in 2040, if no significant investments are made to improve health and education services to impact family planning uptake. Such a huge population would affect the attainment of the Vision 2040 target per capita income.

The Vision 2040 target can only be achieved with a slow down in population growth, from the current 3.2% to at least 2.4% per year, achieving an reduction to 71 million people, thereby increasing per capita GDP to $9,567.

This is an increase in GDP by an additional 20.5% above the expected 2040 projections if the country were to only focus on just economic reforms. If nothing is done, Uganda will only achieve a per capita income of only $927 by 2040.

 

WHAT WILL MOVE UGANDA TO ACHIEVE SMALLER, MANAGEABLE FAMILIES?

 Speaking at a United Nations Population Fund (UNFPA) strategic planning meeting last year, Bunyole West MP Jacob Wangolo observed that communities’ perspectives and mindsets are a major draw-back to making socio-economic progress.

“We are failing to sensitise people to change their mindsets. Mobilisation and sensitisation materials require money. We need materials with data and information that can be displayed in order for people to understand translated reading materials,” he said.

Wangolo shared how education changed his life, despite having been raised in poverty because of a huge family of 89 children, with a father who had eight wives.

“My father could only educate you up to Primary Seven. He could not afford fees for all of us. So, from Senior One to Senior Four, I worked very hard in the gardens to raise my school fees,” he said.

Wangolo was motivated to push for his education because he admired educated people and those who worked in offices. He remembers a clan member who worked at Parliament and would visit them in the village while driving a big car.

“Looking at our family background, we faced lots of problems. I decided to work hard to change the trend,” he confessed.

Wangolo went on to complete his education due to his resourcefulness. He said he teamed up with one of his siblings, whose dream was to become a businessman. Together, they worked in the garden, sold produce and made enough money to finance their dreams.

Today, he is married and a father of only four children. He is a strong advocate for young people, calling for support of their small investments and training in how they can make money from agriculture, which is currently the country’s mainstay.

 

GRAPHIC BY BRIAN SEKAMATTE

 

Sexual and reproductive health services are key

Without giving access to sexual and reproductive health services to especially women, not much can be achieved.

“A large family size makes it difficult for families and the Government to make the requisite investments in education and health, that are needed to develop high quality human capital and achieve higher incomes and socio-economic development,” the report states.
Ugandan women have an average of 6.2 children, a number that has hardly reduced from the 7.1 children per woman in 1970.

By the age of 19, 60% of girls have started having children. Fifteen per cent of married women aged 20 to 29, according to the 2011 Uganda Demographic Health Survey report, were married by 15 years, while 49% were married by 18 years.

The contraceptive prevalence rate (proportion of married women of reproductive age using at least one contraceptive method) is only 26% for modern methods and 4% for traditional methods. This is after over 50 years of availability of modern contraception services in the country.

To improve the quality of the population, Vision 2040 commits to reducing the high fertility rate as a means to create a more sustainable population age structure in the next 30 years.

The Government hopes to achieve this by increasing access to reproductive health services, keeping all children of school-going age in school, with more emphasis on girls.

In 2012, President Yoweri Museveni committed to increase government spending on family planning, pledging $5m to the cause. The Government has also implemented universal primary and secondary education programmes to improve education access.

The Uganda Demographic and Health Survey (UDHS) 2011 shows a direct link between education and initiation of childbearing.

Women aged 25-49, with secondary education, started having children two years later than those with primary education or no education at all.

There is also a demonstrated difference in teenage pregnancy levels according to the level of education. The survey found that only 15% of girls with secondary education had begun their reproductive life, compared with 50% of those with no education. There are, however, service delivery challenges resulting in an unmet need for family planning at 34.3%.

Speaking at a pre-World Population Day public dialogue in Kampala recently, Dr. Betty Kyadondo, the head of the family health department at the Population Secretariat, said Uganda’s family planning costed implementation plan if rolled out, can reduce the family planning unmet need to 10%.

If met, the demand for family planning could slow down the population growth rate to what is necessary to accelerate progress so as to achieve the dividend.

However, Kyadondo decried the poor implementation of government programmes due to inadequate funding. She gave an illustration of Kabale district in south western Uganda, which last year received sh45b, but over 39b went to the wage bill, leaving only 6b for implementation in all sectors.

To address other health sector challenges, Vision 2040 also proposes a shift to a householdbased health delivery system. This should empower communities to take charge of their health by promoting healthy practices and lifestyles.

Also proposed is the reduction of malnutrition in young children and women of reproductive age.

The Government plans to improve nutrition, which is expected to increase the national economic productivity by $65m per year. Improved nutrition is expected to reduce the number of maternal deaths by over 6,000 and child deaths by over 16,000 every year.

According to The Cost of Hunger in Africa report released in June 2013, Uganda loses $899m annually due to the effects of malnutrition, which is equivalent to 5.6% of the country’s GDP.

Reducing malnutrition is expected to provide a six-fold return on public investment in terms of increased productivity for every sh1,000 invested. It is hoped that this will improve nutrition and reduce stunting in children, reduce micronutrient deficiency and improve maternal health.

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A HUGE DEPENDENCY BURDEN

Experts explain that the demographic dividend is about youth development, not just employment. The demographic dividend offers a window of opportunity when a bigger youth population that is empowered with skills and education, contributes to the country’s development.

But a demographic dividend is not automatic, they warn. A demographic transition has to happen.

The combined investment in economics and the demographics, including human capital development is expected to reduce the population to 71 million and reduce the number of children per woman to 2.2, achieving a population of 35% under 15 years, thereby changing the population structure to what is desired in order to gain a demographic dividend.

The demographic dividend refers to the accelerated economic growth that begins to happen following such a change in the age structure of a country’s population as it transitions from high to low birth and death rates.

Currently, 60% of Uganda’s population are children under the age of 18, yet 11% of the children below 18 are orphans. This creates a huge dependency burden.

There is need for a definite reduction in infant and child mortality rates, a sustained fertility decline, massive investment in education, which influences the two and concerted effort in human capital development. This will kick-start progress to achieving the demographic dividend.

Reductions in child mortality are happening. The infant mortality rate reduced by 39% from 89 deaths per 1,000 live births in 1995 to 54 per 1,000 live births in 2011. The under-five mortality rate, reduced by 37% over the same period, from 143 deaths to 90 deaths in 2011. This is an indication that the desired change can happen.

As Dr. Kyadondo has observed: “We should have done what we are talking about yesterday.”