With the current NRM government theme dubbed: Kisanja Hakuna Mchezo,the President warned all civil servants against non-performance, and called upon them to deliver effective services. This includes health service delivery, which has always performed next to below standards on issues of maternal and child health, yet the international conventions which Uganda signed, and the domestic instruments (the constitution and policies) provides for good health as a human right.
Uganda is a member to many international human rights conventions that seek to uphold the standards of maternal health. Motivated by the Universal Declaration of Human Rights (UDHR), Uganda has signed both regional and international human rights instruments such as the International Covenant on Civil and Human Rights (ICCHR), African Charter on Human and People’s Rights (ACHPR), Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW), Convention on the Rights of the Child (CRC), and Convention on the Rights of Persons with Disabilities (CRPWD), which address good health in all its forms as an inalienable right that must be protected by law.
The country is also bound by domestic legal instruments, which affirm access to good health as a human right. Article 20 of the 1995 Constitution focuses on the human rights and freedoms of individuals, which are inherent and, therefore, not granted by the State. The right to good health is not treated in exemption. Article 21 disregards all forms of discrimination including on grounds of gender, while Article 22 emphasizes the right to life to which women and girls are also entitled. Human dignity is brought into the equation by Article 24 which bars Ugandans, including women and girls, from being subjected to inhuman, cruel, degrading treatment, and torture.
The 2010 Second National Health Policy and the Health Sector Strategic Plan III call for the promotion of people’s health to enhance socio-economic development. These aim at providing basic health services to people and promoting healthy lifestyles with a view that they remain productive and contribute to national development. n this reign of ‘steady progress’, these policies should be beefed up with action to promote maternal and child health by preventing disease, and streamlining systems for early diagnosis and treatment.
The World Health Organisation focuses on the health of women during pregnancy, childbirth and postpartum period, as an era for averting hemorrhage, infection, high blood pressure, unsafe abortion and obstructed labour which may lead to morbidity, and ultimately mortality. It equally emphasizes the health of the child from a newborn stage to age 18, according to the Ugandan standards since children are vulnerable to malnutrition and infections.
In any society, women and children should carry utmost priority including in health because women are mothers who give life and no society can survive without our ‘incubators of life.’ Second, children are prospects of success for any society and taking good care of them guarantees human capital any society can bank on for prosperity. However, they face all forms of discrimination that deny them the opportunity to make decisions about their lives especially on health.
The nature of maternal and child health in Uganda therefore attracts critical analysis in gauging government’s performance in health. PubMed, one of the leading research institutions in public health, published a 2016 report on the nature of maternal and child health titled “Generally the Young Mom Suffers Much: Socio-cultural Influences of Maternal Capabilities and Nutrition Care in Uganda.” This focuses on defining the relevant domains of maternal capabilities and their relationship to infant and young child feeding practices, where Ugandan caregivers defined three major constraints in their decision-making capabilities for childcare. These include early pregnancy, close child spacing, and polygamous marriage.
Women reported constraints in decision-making as the leading challenge to their ability to procuring food for their children. Future nutrition programs must therefore focus on improving women’s impact through activities that encourage their decision-making scenarios in households. They must equally strengthen women’s social support networks to improve access to their medication and that of their children as a way of bettering their health, especially in rural areas where the 2012/2013 National Household Survey puts 77 per cent of the Ugandan population.
Uganda has made strides in improving maternal and child health through increasing the prevalence of contraceptives to the rate of 39 per cent according to the recently launched Demographic Health Survey. It has equally improved the health of its population by increasing life expectancy to 62.3 in 2016; HIV prevalence down to 7.07 per cent, among others. However, this progress may be undermined by the recent gag rule that works to reduce funding on family planning given that the health budget depends greatly on external funding. Preventing a lax in the provision of health services in response to maternal and child health must, therefore, be central to realising a healthy population.
Time is ripe for Ugandans to invest time and energy in averting hemorrhage, infection, high blood pressure, unsafe abortion and obstructed labour conditions, together with upholding systems and frameworks that work to protect children from infections and malnutrition.
Mr Jjuuko is a researcher at the Center for Health, Human Rights and Development