Leave nobody behind in service delivery

Every year, the international community observes the World Population Day on July 11 (tomorrow). This year’s celebrations in Uganda will be held at Bobi Community Polytechnic Playground in Omoro District, northern Uganda. This year’s World Population Day theme is: ‘Leaving nobody behind: Improving service delivery and accountability’. Looking back in our history, Uganda over time has put our population issues at the centre of its development plans and programmes. In 1995, the first National Population Policy was promulgated by government.

The policy highlighted the then rampant poverty levels in the country and the importance of integrating population factors into the Poverty Reduction Action Plan (PEAP) implementation at national and lower levels. This policy was revised in 2008 and recognised the need to tackle the persistent high mortality and fertility in the country.

As a result of these policies, Uganda increased spending and emphasis on preventive rather than curative programmes like immunisation and other maternal and child health programmes. These programmes were supplemented with reproductive health programmes to respond to the high fertility and the attendant high maternal mortality, but also to further augment successes realised in child health interventions. The high fertility policy response also saw the prioritising and expansion of primary education, culminating in universal primary education (UPE) in 1997.

As a result, Uganda has witnessed commendable progress in a number of areas as indicated in the last Census (2014 Census) as well as the most recent Uganda Demographic and Health Survey, 2016 UDHS. For example, Uganda has registered an impressive increase in longevity of its population. Life expectancy increased from 43 years in 1991 to 63 years in 2016 (UBOS). The population-responsive policy approach led to notable successes in drastically reducing childhood mortality.

Infant mortality dropped from 122 deaths per 1,000 live births recorded in 1991 to 43 deaths in 2016, representing a 63 per cent drop. Maternal mortality also declined from 506 in 1991 to 336 in 2016, a decline of 34 per cent. Fertility has declined from the 7.4 children per woman recorded in 1988 to 5.4 in 2016, a decline of 24 per cent. The increased child survival, coupled with persistently high fertility, and increased longevity, have led to a surge in total population, the majority of which is predominantly young people. At a population growth rate of 3.0 per cent, Uganda’s population has grown from 16.7 million people in 1990 to 34.6 million in 2014 and is expected to reach 40 million by the end of this year.

Uganda’s Vision 2040 recognises that this young population is an important resource and government will mobilise them for the country’s socioeconomic transformation and harness the demographic dividend. The demographic dividend is defined as “an opportunity for economic growth and development that arises as a result of changes in population age structure, which are likely to happen when fertility rates decline significantly, prompting the share of the working-age population to increase in relation to previous years”. This larger working-age population will enable our country to increase GDP and raise incomes.

This is the economic benefit that we plan to take advantage of as our population age structure changes.
In spite of this progress and prospects, we still face population-related challenges. Let me mention a few examples: Our children still die from immunisable diseases as well as those diseases that we can prevent through better hygiene. For example, Local governments can promote and emphasise hand washing using soap after visiting the toilet. The teenage pregnancy rate in Uganda remains high at 25 per cent and this has stagnated at that level for the last 10 years. This means that in Uganda, one out of every four teenage girls has had a baby before they reach 19 years old. This is a matter of national concern.

As we go to Omoro District to commemorate the World Population Day, I wish to note that the district has similar challenges like the rest of Uganda. Teenage pregnancy rate is even higher than the national average and stands at 28 per cent. According to the 2014 Census, crop production is the major economic activity in the district, employing about 95 per cent of the population. And 48 per cent of youth is neither in school nor working. Illiteracy among 10-30 years olds stands at 56 per cent. In addition, latrine coverage is low at 39 per cent and access to safe water is at only 53 per cent in the district.

The poor health conditions are mainly due to high poverty levels in the district and the high disease burden in the district is due to malaria, which is rampant and stands at 41 per cent. The NRM Government is addressing these challenges.
As we mark the World Population Day, we can improve on the health of our population by strengthening programs on nutrition, HIV/Aids, malaria control, etc. tackling life style diseases, ie non-communicable diseases like cancers, etc.

Mr Bahati is the State minister for Planning.