Uganda health goals stagnate
Sep 07, 2005
UNITED Nations Development Programme has released a disturbing report about Uganda’s state of health. The UNDP 2005 Human Development Report due for launch today, says Uganda has lost track of all the major health goals.
UGANDA'S state of health, including infant, child and maternal mortality have either stagnated or deteriorated, according to a UNDP Human Development report 2005. Arthur Baguma writes the highlights:
UNITED Nations Development Programme has released a disturbing report about Uganda’s state of health. The UNDP 2005 Human Development Report due for launch today, says Uganda has lost track of all the major health goals.
The report says Uganda’s health indicators, including infant, child and maternal mortality have either stagnated or deteriorated, with the under-five mortality rising since 1995. “One of the strongest Millennium Development Goal (MDG) performers in Africa, Uganda is now off track for all of the major health goals. The progress in the health sector has been hampered by deep structural problems.
Malnutrition is implicated in two-thirds of childhood deaths, less than one third of women give birth under the supervision of a trained staff and there has been no decrease in major childhood killers, such as malaria and measles,†the report states. However, out of the 177 countries considered in HDR 2005, Uganda’s position has improved from last year’s 146th to 144 ahead of neighbours Kenya (154), Rwanda, (159) and Tanzania (164).
Sierra Leone, which held the last position for the past seven consecutive years, moved a step up to the second last position. Famine ravaged Niger settled in the last position.
Over all, the Human Development Index value gives Uganda 0.508 points compared with the best performing country, Norway at 0.963 and the lowest ranked Niger at 0.281. With 0.474, Kenya is ahead of Rwanda with 0.450. Tanzania has the worst index value at 0.418. The HDI, which measures consumption and access to basic services, weighs the country’s performance between 0 and 1, with maximum being excellent and 0 as worst.
Uganda’s life expectancy has improved from 45.7 last year and 40.7 in 2000 to 47.3. In Rwanda, life expectancy is 43.9, while in Kenya and Tanzania it is 47.2 and 46 respectively. In education, Uganda is still a role model. The ratio of Ugandans enrolled in primary, secondary and tertiary education is 74% up from 71% last year. Kenya’s is 52%, Rwanda 55% and Tanzania has the poorest enrolment at 41%.
The report attributes Uganda’s education progress to poverty reduction priorities, which shifted to education in the 1990s. Free primary education was introduced and public spending increased. Primary school enrolment rose from 5.3 million to 7.6 million between 1997 and 2003. Universal enrolment is now within reach, but drop out rates make achieving universal completion by 2015 unlikely, according to the report.
Education minister Namirembe Bitamazire says the government is taking measures to achieve retention at primary level, where the drop out rates stand at between 5%-10%. “We are trying to improve the school environment, sensitise parents and stakeholders about the importance of education. We are promoting the girl-child education because girls are more likely to drop out at lower level than boys,†says Bitamazire.
The report notes that after recognising that failure to reduce child and maternal mortality threatens to undermine social and economic progress, the government convened a cross-ministry task force under the auspices of the ministry of Finance to identify solutions. When contacted, ministry of Health officials distanced themselves from the report, saying they will only comment after studying it.
“Allow us to digest the report and government will give its brief. We shall first study the report, I must comment basing on facts,†Health state minister Mike Mukula said.
High fertility rates and inadequate birth spacing are threatening the country (Uganda) with the third highest fertility rate in the world. The report states that inability by poor people to afford basic services has led to inequality, poverty and falling growth.
“The falling growth has coincided with rising inequality increasing the Gini coefficient from 34 in 1997 to 42 today-suggesting that Uganda may be in transition from a low-inequality to a high-inequality country.†It recommends that correcting this trend will require action to broaden the base of economic growth around smallholder farmers in rural areas along side a focus on more capital-intensive export agriculture. But Dr Augustus Nuwagaba, a senior Don and expert on poverty, said the recommendation cannot work for Uganda.
What they are saying worked in India where smallholder farmers were organised by government to pool their products and market them cheaply with the help of government. It can’t work here (Uganda) because of the land problem. we have a difficult land regime, especially in Buganda. The solution is to empower households in terms of organised production and marketing,†Nuwagaba says.
In 2001, as part of the national poverty reduction strategy, Uganda removed user fees for most lower level health facilities.
In 2002/03, outpatient attendance rose by more than six million, an 80% increase over attendance in 2000. Attendance increased more sharply among poor people than among the better off.
The report says in the first half of the 1990s, government policies focused on stabilisation and growth. Average incomes grew by 5% a year from 1990 to 2000.
Income poverty fell rapidly in the 1990s from 56% to 34%, putting the country on track to the 2015 MDG target. However since 2000 the incidence of poverty has risen. Poverty is concentrated in rural areas, especially in the North and East and is far higher among producers growing only food staples.
The report reveals that nearly 40% of the world’s conflicts are in Africa. It cites conflicts over livestock and grazing maintaining a spiral of violence between different pastoral clans in Uganda. The Karamoja region in northeastern Uganda, comprising the districts of Kotido, Moroto and Nakapiripirit, poses a unique development challenge.
Influxes of small arms following conflicts in Somalia and Ethiopia, and in the Great Lakes region, meant that these raids took increasingly bloody forms, as did the reprisals. In 2003, two health workers and five teachers were killed at their posts.
As a consequence, access to social services has declined. Failure to address pastoral destitution has encouraged the institutionalisation of violent conflict and raiding as part of pastoralism in Karamoja.
According to the report, Sub-Saharan Africa is still behind schedule of the MDG with almost 100 million more people living on less than $1 a day in 2001 than in 1990.
UNITED Nations Development Programme has released a disturbing report about Uganda’s state of health. The UNDP 2005 Human Development Report due for launch today, says Uganda has lost track of all the major health goals.
The report says Uganda’s health indicators, including infant, child and maternal mortality have either stagnated or deteriorated, with the under-five mortality rising since 1995. “One of the strongest Millennium Development Goal (MDG) performers in Africa, Uganda is now off track for all of the major health goals. The progress in the health sector has been hampered by deep structural problems.
Malnutrition is implicated in two-thirds of childhood deaths, less than one third of women give birth under the supervision of a trained staff and there has been no decrease in major childhood killers, such as malaria and measles,†the report states. However, out of the 177 countries considered in HDR 2005, Uganda’s position has improved from last year’s 146th to 144 ahead of neighbours Kenya (154), Rwanda, (159) and Tanzania (164).
Sierra Leone, which held the last position for the past seven consecutive years, moved a step up to the second last position. Famine ravaged Niger settled in the last position.
Over all, the Human Development Index value gives Uganda 0.508 points compared with the best performing country, Norway at 0.963 and the lowest ranked Niger at 0.281. With 0.474, Kenya is ahead of Rwanda with 0.450. Tanzania has the worst index value at 0.418. The HDI, which measures consumption and access to basic services, weighs the country’s performance between 0 and 1, with maximum being excellent and 0 as worst.
Uganda’s life expectancy has improved from 45.7 last year and 40.7 in 2000 to 47.3. In Rwanda, life expectancy is 43.9, while in Kenya and Tanzania it is 47.2 and 46 respectively. In education, Uganda is still a role model. The ratio of Ugandans enrolled in primary, secondary and tertiary education is 74% up from 71% last year. Kenya’s is 52%, Rwanda 55% and Tanzania has the poorest enrolment at 41%.
The report attributes Uganda’s education progress to poverty reduction priorities, which shifted to education in the 1990s. Free primary education was introduced and public spending increased. Primary school enrolment rose from 5.3 million to 7.6 million between 1997 and 2003. Universal enrolment is now within reach, but drop out rates make achieving universal completion by 2015 unlikely, according to the report.
Education minister Namirembe Bitamazire says the government is taking measures to achieve retention at primary level, where the drop out rates stand at between 5%-10%. “We are trying to improve the school environment, sensitise parents and stakeholders about the importance of education. We are promoting the girl-child education because girls are more likely to drop out at lower level than boys,†says Bitamazire.
The report notes that after recognising that failure to reduce child and maternal mortality threatens to undermine social and economic progress, the government convened a cross-ministry task force under the auspices of the ministry of Finance to identify solutions. When contacted, ministry of Health officials distanced themselves from the report, saying they will only comment after studying it.
“Allow us to digest the report and government will give its brief. We shall first study the report, I must comment basing on facts,†Health state minister Mike Mukula said.
High fertility rates and inadequate birth spacing are threatening the country (Uganda) with the third highest fertility rate in the world. The report states that inability by poor people to afford basic services has led to inequality, poverty and falling growth.
“The falling growth has coincided with rising inequality increasing the Gini coefficient from 34 in 1997 to 42 today-suggesting that Uganda may be in transition from a low-inequality to a high-inequality country.†It recommends that correcting this trend will require action to broaden the base of economic growth around smallholder farmers in rural areas along side a focus on more capital-intensive export agriculture. But Dr Augustus Nuwagaba, a senior Don and expert on poverty, said the recommendation cannot work for Uganda.
What they are saying worked in India where smallholder farmers were organised by government to pool their products and market them cheaply with the help of government. It can’t work here (Uganda) because of the land problem. we have a difficult land regime, especially in Buganda. The solution is to empower households in terms of organised production and marketing,†Nuwagaba says.
In 2001, as part of the national poverty reduction strategy, Uganda removed user fees for most lower level health facilities.
In 2002/03, outpatient attendance rose by more than six million, an 80% increase over attendance in 2000. Attendance increased more sharply among poor people than among the better off.
The report says in the first half of the 1990s, government policies focused on stabilisation and growth. Average incomes grew by 5% a year from 1990 to 2000.
Income poverty fell rapidly in the 1990s from 56% to 34%, putting the country on track to the 2015 MDG target. However since 2000 the incidence of poverty has risen. Poverty is concentrated in rural areas, especially in the North and East and is far higher among producers growing only food staples.
The report reveals that nearly 40% of the world’s conflicts are in Africa. It cites conflicts over livestock and grazing maintaining a spiral of violence between different pastoral clans in Uganda. The Karamoja region in northeastern Uganda, comprising the districts of Kotido, Moroto and Nakapiripirit, poses a unique development challenge.
Influxes of small arms following conflicts in Somalia and Ethiopia, and in the Great Lakes region, meant that these raids took increasingly bloody forms, as did the reprisals. In 2003, two health workers and five teachers were killed at their posts.
As a consequence, access to social services has declined. Failure to address pastoral destitution has encouraged the institutionalisation of violent conflict and raiding as part of pastoralism in Karamoja.
According to the report, Sub-Saharan Africa is still behind schedule of the MDG with almost 100 million more people living on less than $1 a day in 2001 than in 1990.