Kampala — Uganda has reduced poverty and child mortality by half, and has enrolled most primary-age children in school. However, new service delivery data published today suggest that the quality of education and health services remains weak, posing serious challenges to the country's long-term social and economic progress as outlined in its Vision 2040 for the future.
The new Uganda Service Delivery Indicators (SDI)--based on independent surveys of 5,300 teachers and health workers in 400 primary schools and 400 health facilities--show that Uganda is still very far from achieving optimal performance in schools and health centers. SDI is an Africa-wide initiative led by the World Bank, the African Economic Research Consortium, and the African Development Bank. The Uganda SDI surveys were implemented by the Economic Policy Research Centre, Uganda.
A key Uganda SDI finding is that there are significant knowledge gaps among teachers and health workers in both public and private schools and clinics. Only a third of public health workers could correctly diagnose at least 4 out of 5 very common conditions such as diarrhea with dehydration, or malaria with anemia; and only 1 in 5 teachers showed mastery of the curriculum they taught.
"Being able to pinpoint weaknesses in health and education services will enable the kind of change that is extremely important not only for the progress and prosperity of individuals and families, but also for the entire Ugandan economy." said Moustapha Ndiaye, Country Manager, World Bank, Uganda.
Absenteeism is also a major issue, the SDI data show. Over half (52%) of public health providers were not present in the facility when surveyed. Much of the absence was sanctioned, calling for better management. In public schools, roughly 1 in 4 teachers was absent from school, and of those present in school, 1 in 3 were not teaching. As a result, 40% of public school classrooms did not have a teacher teaching in them.
SDI data also reveal regional inequalities, with the Northern region and rural areas faring worst in terms of knowledge levels of teachers and health workers. Further, the average Northern public school Primary Four pupil received about 90 days of teaching time less in a school year than his/her Kampala counterpart.
"Education and health services do not improve overnight, which is why we need to make sure that the authorities take evidence-based action right now to secure the future for all young Ugandans," said Sarah Ssewanyana, Executive Director, Economic Policy Research Centre, Uganda.
Finally, while most types of infrastructure and equipment were largely available, both public and private schools and health facilities fared badly on the availability of textbooks and essential drugs. Overall, just 11% of Primary Four classes were observed using textbooks during English and Mathematics classes.
"Even in the best-equipped schools and clinics, children and patients will not get good services unless teachers and health workers are well-trained and motivated," said Ritva Reinikka, Director, Human Development, Africa at the World Bank. "Uganda Service Delivery Indicators are an objective snapshot of what teachers and health providers know and do on the job, raising systemic and management issues in a country which has already shown progress on increasing accountability for service delivery outcomes."
SDI findings are already available for Kenya, Tanzania, and Senegal, and will soon be available in Nigeria, Togo and Mozambique. Surveys will be repeated every two to three years in each country.