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Gaps in social care support services and the emergence of some 'unreligious'  institutions in Uganda

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Added 25th May 2018 05:53 PM

While society still upholds the moral responsibility of caring for the vulnerable members, the traditional social protection system has greatly declined.

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While society still upholds the moral responsibility of caring for the vulnerable members, the traditional social protection system has greatly declined.

By Benard Mujuni 
For a long time, the majority of vulnerable groups in Uganda have received emotional, material and financial support from traditional social protection mechanism, including family, kinship and the clan system. 
Specifically, both nuclear and extended families have acted as the first line of care and support for orphans, widows, persons with disabilities (PWDs), older persons and the chronically ill. 
While society still upholds the moral responsibility of caring for the vulnerable members, the traditional social protection system has greatly declined, providing a very fertile entry ground for the growth of “pseudo” unreligious institutions and profiteering “uncaring” agencies in Uganda. 
Children 0-17 years constitute 55.1% of the national population, corresponding to about 19.0 million people (NPHC 2014). A significant proportion of children are vulnerable due to poverty, neglect, abandonment, exploitation, early marriage, and teenage pregnancy, conflict with the law, orphan hood and child labour. This category has been targeted by the so-called caring orphanages that have ended up trafficking and exploiting them. Most of these orphanages are somehow linked to an emerging unreligious institutions or churches. They have such names as Gods love, God’s Mercy, Good Hope to mention.
Children and families from poor households and those living on the streets are more exposed to physical, mental, psychological and sexual abuse. Yet parents and adult caregivers are the most common perpetrators of physical violence against children aged 13 to 17 years. Children exposed to physical violence are more likely to perform poorly in education and are more likely to leave school, resort to substance abuse and engage in abusive relationships. 
UDHS 2016 indicates that 25 percent of adolescents aged 15-19 in Uganda have begun childbearing. Adolescent childbearing is more common in rural than in urban areas, with 27 percent of teenagers aged 15 to 19 years in rural areas having begun child bearing compared 19 percent in urban areas. Teenagers in the lowest wealth quintile tend to begin childbearing earlier than those in the highest quintile (34 versus 15 percent, respectively). This care burden has provided the ‘caring’ institutions insatiable supply side of the vulnerable people. No wonder human trafficking and crime rate is increasing.
Older persons have increased incidences of diet-related chronic and non-communicable diseases such as diabetes, hypertension and stroke, yet public health facilities lack comprehensive geriatric services. 
 More so, there are very limited specialised services for older persons such as health care services geriatrics, drugs, insurance schemes and gerontologists. In some instances, older persons have been abandoned. Another challenge faced by older persons is property grabbing especially land, which deprives them of their livelihood.
The other victims of weak social care support are people with disabilities. Overall, the disability prevalence rate for the population aged 2 years and above is 12.4 percent while for 5 years and above, it was 14 percent. Disability is higher among women (13.7%) compared to men (11%). 
The disability prevalence rate is higher among those living in the urban areas (13.3%) compared to those in the rural areas (9.3%).  The disability rate among children is approximately 13%, (MGLSD 2014). 
Again, many charities and non-government organizations have industriously emerged to benefit from their plight.
There is inadequate mental and palliative care services coupled with limited access to information due to institutional barriers.  
PWDs have limited opportunities for employment due to added costs associated with their challenges, such as aides, devices, etc.  
Women with disabilities suffer most especially through sexual harassment while children with disabilities are voiceless and suffer significantly.
 Among the PWDs, there is discrimination against people who got involved in accidents, people living with albinism and little people.
On the other hand, Uganda is home to a large number of diverse ethnic and linguistic groups. Some ethnic groups continue to be disproportionately affected by Uganda’s development problems, including regional conflicts, uneven development, and inadequate health care and poor education provision.  Ethnic minority groups are scattered across Uganda, but include: in the north –Alur, Ik (Teuso), Kakwa, Karamojong cluster, Lugbara, Luluba, Ma’di, Nubian; in the east –Bagungu, Bakenyi, Bavuma, Ik (Teuso), Soo; and in the west –Abayanda (Batwa), Ba’amba, Bakonzo. Since more than three -quarters of Uganda’s population live in rural areas. 
Even within this context, minorities are often the most disadvantaged and often exploited by some NGOs and other groups through fundraising.
Finally women in Uganda provide the bulk of unpaid care work and labour especially child care and caring for family members.  
As highlighted in the Uganda Social Institutions and Gender Index (SIGI), (UBOS 2014), such high levels of female unpaid care work, limits women’s opportunities and labour productivity. Women from 15 – 49 years are more vulnerable to poor nutrition, preventable diseases, uncontrolled fertility, and violence. 
Surely, it is a lost economic digit in quantifying women contribution to Uganda’s GDP.
Economic violence leads to loss of capacity to work, social and psychological trauma and impaired ability to provide child care or welfare for the family. Several organisations are taking advantage of this challenge to raise resources, but positive impact is lacking!
UDHS 2016 indicates that women in Uganda are more than twice as likely to experience sexual violence as men. More than 1 in 5 women aged 15-49 years (22 percent) report that they have experienced sexual violence at some point in time compared with fewer than 1 in 10 (8 percent) men.
Uganda has renewed its commitment to eliminating HIV in Uganda; championed by His Excellency, the President of the Republic of Uganda who launched the Fast Track Initiative in June 2017.
 Despite the above measures, the country continues to have a high burden of the disease as indicated by a high prevalence rate of 7.3% in the general population among adults 15 to 49 years as well as high infections in specific sub-populations and sub-regions.  This is despite of heavy international investments in eliminating the vice. The number of organizations targeting HIV/AIDS funding is equally increasing instead, regardless of the negative results.
Wherever there is a social challenge; someone is busy taking advantage of it. The level of sophistication baffles. 
There is need to fast track the proposed law on Social Impact Assessment and Accountability by the Ministry of Gender Labour and Social Development. 
This law will require all development practitioners to regularly undertake and submit social impact reports but also make the development processes more people centered, accountable and impact focused.
The writer is an inclusive legal and policy specialist

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