18 December 2012

Uganda: Nation Not Meeting Health Goals - Review

Photo: Aphaluck Bhatiasevi/WHO
The health sector played a key role despite numerous challenges in the year 2012.

Uganda's gains in the fight against poverty could be reversed if government doesn't do something about the majority of people living on the fringes.

That is the conclusion of an assessment by the International Conference on Population and Development (ICPD) - Beyond 2014 review. The report says although 43% of Uganda's population is not living in absolute poverty, it remains insecure. The review shows that agriculture is declining, although 56% of the population depends on it.

Uganda joined 179 countries at the ICPD in Cairo, Egypt, in 1994 and agreed to a 20-year programme of action for the promotion of human development and rights. The main goal of the programme of action was to raise the quality of life and wellbeing of individual human beings and promote human development by recognising the interrelationship between population and development.

The programme of action aimed at eradicating poverty, achieving sustainable growth and development, education for all as a tool of human resource development, gender equity, equality and empowerment of women. It also aimed at reducing infant, child and maternal mortality and morbidity, and provision of reproductive health services.

The International Conference on Population and Development emphasised that by focusing on meeting reproductive rights at the individual level, larger population concerns and objectives would be addressed. In so doing, it shifted the emphasis away from demographics to individuals who have reproductive rights and needs, especially in terms of sexual and reproductive health, and access to an integrated and comprehensive package of reproductive health services.

The review done after 16 years was spearheaded by United Nation's Population Fund and coordinated by the Population Secretariat and Ministry of Finance, Planning and Economic Development.

For Uganda, as for all other countries, this is an operational review that was mandated by the UN General Assembly in 2010. The process will culminate in 2014 with a special report of the Secretary General, as well a UN General Assembly Special Session on ICPD Beyond 2014 in September 2014.

The report reveals that Uganda has lagged behind in terms of providing opportunities for maximising the potential of her youthful population. With 51% of the total population less than 15 years old and 57% less than 18 years old, the country has a very high youth dependency ratio. A very young population represents a major challenge for Uganda in the short and medium term, unless it's adequately planned for.

Young people need access to information and services on sexual and reproductive health, among other needs. Dr Apollo Karugaba, the lead consultant for Review of ICPD report 2014, says Uganda performed well in areas of economic growth and poverty reduction, gender equality, equity and women empowerment, but poorly in reduction of maternal and infant mortality.

"The poor performance in maternal mortality is a result of the gaps in utilisation of family planning, inadequate funding to the ministry of Health, poor infrastructure in health facilities and community, and inadequate human resources for health," Dr Karugaba said.

There has been a slight reduction in maternal deaths from 505 per 100,000 births in 1995 to 438 in 2011. The mortality rate translates to 6,000 women and girls dying annually. Bleeding remains the commonest cause of maternal deaths at 39%, while 27% die due to ruptured uterus. For every woman who dies, 30 more develop long-term disabilities such as obstetric fistula, ruptured uterus and pelvic infection.

Janet Jackson, UNFPA's Country Representative, says a lot more remains to be done especially in attaining the Millennium Development goals (MDGs) and improving access to family planning and reproductive health.

"We know that family planning is the most cost-effective intervention for addressing maternal mortality and morbidity. However, obstacles to achieving this objective still are many such as quality and availability of supplies and services in addition to cultural and social barriers," Ms Jackson said.

The UNFPA chief added that while it is commendable that President Museveni made a commitment during the recent London summit on family planning, it is urgent now that the strategy for implementing this is put in place.

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