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The East African : Nov 14th 2015
28 The EastAfrican OUTLOOK NOVEMBER 14-20,2015 S U S TA INAB L E D E VE LO PME N T Uganda has met just a third of MDGs, final country scorecard says Expe≥ts blame Kampala’s dismal pe≥fo≥mance on a lack of commitment to imp≥ove public se≥vice delive≥y By DICTA ASIIMWE Special Correspondent T he Ugandan government’s fifth and final Millennium Development Goals scorecard is a damning statement of the country’s performance, with just one-third of the 18 targets achieved. The targets are increased ac- cess to essential drugs, access to information technology tools and reduced debt service obligations. The country also halved the proportion of people earning less than a dollar a day although in districts like Buvuma, central Uganda, 97 per cent of the population still lives in poverty. Also achieved were access to HIV/Aids treatment as well as reducing the incidence of malaria and other major diseases like measles and tuberculosis. “The malaria prevalence rate among children fell by more than 50 per cent in just five years between 2009 and 2014, mainly due to the large-scale dissemination of insecticide-treated bed nets,” the report notes. The report, which was launched on October 26, also notes that the target on comprehensively dealing with debt problems for developing countries has been achieved, following a 2005 agreement by the G8 to cancel Uganda’s external debt TARGETS MET Women wait to be attended to at a hospital in Bududa, eastern Uganda. Picture: File This report reveals a troubling lack of progress, particularly regarding the global goals on health,” Asia Russell, executive director, Health Global Access Project in Uganda service. This enabled the country to increase fiscal space to invest in public infrastructure. Uganda’s debt service requirements now stands at just 5.2 per cent of exports or $140 million. Ugandans also have access to affordable essential drugs, through agreements with international firms. The Ministry of Health data shows that availability of first line anti-malarial drugs, measles vaccines, oral rehydration salts and depoprovera increased from 21 per cent in 2009 to 57 in 2013. Despite these successes, ex- perts say Uganda’s performance was dismal. “This report reveals a trou- bling lack of progress, particularly regarding the global goals on health,” said Asia Russell, Health Global Access Project ex- ecutive director in Uganda. Uganda missed by a wide mar- gin the health targets including, reducing by three- quarters the maternal mortality rate, and stopping the spread of HIV/Aids. According to the 2014 World Health Organisation figures, 360 women died for every 100,000 live birth in 2013 against the MDG target of reducing this figure to 131. Hunger targets Minimal reductions were also seen in the number of underweight children. Uganda narrowly missed the target to halve the proportion of people suffering from hunger, which currently stands at 14 per cent against a target of 10 per cent. The country also missed the target on reducing by two-thirds Increased access to essential drugs Access to information technology tools Reduced debt service obligations. Halving the proportion of people earning less than one dollar a day Access to HIV/Aids treatment as well Reversing the incidence of malaria and other major diseases like measles and tuberculosis. the under-five mortality rates. The latest Uganda Health and Demographic Survey shows that by 2011, the under-five mortality rate stood at 90 per 1,000 live births against the MDG target of 56 per 1,000. The proportion of people without sustainable access to safe drinking water stands at 87 per cent and 68 per cent in urban and rural areas respectively, way below the MDG targets of 100 per cent for urban dwellers and 70 per cent in rural areas. Joseph Enyimu, a senior economist with the Ministry of Finance said that Uganda’s achievements were largely the result of individual efforts. For instance, in 1992/93, Uganda’s middle class stood at 1.8 million people, a figure that increased to 12.6 million 20 years later. This coincided with the increase in private spending on education and health. “Uganda’s capacity to meet these MDG targets was the result of improved household incomes and not because of improved public service delivery,” he said. Statistics from the national budgets show that in 2002/03, government spent an average of Ush6,0130 ($17) per primary school pupil, a figure that has increased to Ush78,917 ($22). But this has not impacted on the outcomes. For instance, the introduction of Universal Primary Education in 1997 led to a rise in the net enrolment rate from 57 per cent in 1996 to 87 per cent, but Ministry of Education data shows that the rate now stands at 82 per cent, with just 9 per cent of pupils completing primary school on time. According to the report, the poor public service delivery is due to a lack of effectiveness in the government. It notes that the government failed to build systems that can innovate, and that it also failed to learn from public feedback. “If the government had ac- corded stronger political priority to life saving health service delivery for example, perhaps Uganda would have made better progress,” argued Ms Russell. The Abuja Declaration re- quires that 15 per cent of the budget is allocated to health. However, the government has consistently allocated less than 8 per cent of budget towards the health sector. Kenya unveils ≥evised mala≥ia cont≥ol plan to end epidemic by 2018 By CHRISTABEL LIGAMI Special Correspondent THE KENYAN government has launched a revised national malaria control programme, aimed at making the country free of the disease by 2018. The revised Kenya Malaria Strat- egy Plan 2009-2018 will cost the government $542.2 million. Under the revamped plan, all core malaria interventions namely vector control, prevention, diagnosis testing, as well as treatment will be scaled up to cover the entire population and not just the high malaria endemic regions. Prevention measures will include the use of the new malaria vaccine RTS,S, which is expected in clinics in the next two years. Kenya joins countries such as Namibia, Myanmar, Cambodia, Thailand and Vietnam that have updated their national malaria strategies to reflect changing global trends such as the emergence of drug-resistant parasites. Malaria is one of the epidemics that the United Nations hopes to end by 2030, under the Sustainable Development Goals on good health and well being of all people. Others are Aids, tuberculosis and neglected tropical diseases. James Macharia, Kenya’s Cabinet Secretary in the Ministry of Health said that the objectives and implementation arrangements in the revised strategy are aligned to the tenets enshrined in the Constitu- tion and the overall health sector strategic plan. “The UN Sustainable Devel- opment Goals call for an end to epidemics and universal health coverage, which we are pursuing, and the Global Fund is using national strategies as a basis for its new funding mechanism,” said Mr Macharia. The Global Fund is an interna- tional financing organisation that targets Aids, tuberculosis and malaria. Mr Macharia said that malaria control programmes in Kenya had 20,000 Number of deaths due to malaria in Kenya, Uganda Tanzania in 2014 helped reduce infant mortality rates from 52 per 1,000 to 39, and under five mortality from 74 per 1,000 of the population to 52. “We have also observed a down- ward trend in the proportion of out-patient cases attributed to malaria, from 30 to 14 per cent over the past four years,” he said. Malaria epidemics are preva- lent in Kenya, Uganda and Tanzania especially in the highlands and river basins. About 20,000 deaths were reported last year across the region, with the three countries accounting for 90 per cent of the cases. In Tanzania, the Ministry of Health through a five-year strategic plan advocates four main approaches in the fight against the disease: Improved case management; vector control using insecticide-treated mosquito nets; prevention and control of malaria in pregnancy and epidemic preparedness, prevention and control. In Uganda, the Malaria Con- trol Strategic Plan complements a broader five-year Health Sector Strategic Plan that is part of the country’s Poverty Eradication Action Plan. Under the plan, mosquito nets are re-treated and plans are on course for large scale indoor residual spraying. Also in place is home based delivery of anti-malaria medicine to children under five years, while a shift to the new, more effective malaria treatment — artemisinin-based combination therapy — is in its final stages.
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