COMMENTARY: Soaring numbers hinder Uganda's development goals

Posted: 12 May 2008

Author: Dennis Kawuma

Renewed concern about Africa's rapidly growing population is now coming from Africa itself. It is reflected in this Opinion piece by Dennis Kawuma, which appeared in a recent edition of The Monitor in Kampala, Uganda. He concludes that without a greater effort to slow Uganda's fertility rate, the Millennium Development Goals may not be achievable.

After a long day's work, I hit the road with the hope of catching some rest at home. What I needed the most was to get back to a fine homely environment, quiet and organised, away from the hustle and bustle that had filled my day.

On approaching the vicinity of my neighbourhood, the situation was chaotic. Ragged and scruffy-looking children were screaming while running all over the place. They seemed to be enjoying themselves, not caring about their squalid playing area.

The sheer number of these children in just about the same age category was simply provoking. I quickly thought about the seemingly unstable or actually unstable homes that many of these children come from.

I thought about them getting into their teenage years in a few years; what would happen when they became adults? Would they easily find employment? What will they turn out to be? No easy answers, as they all point to a rather bleak future.

Perhaps my neighbourhood would have been a little more endearing if it were not for those many unattended and unsightly children screaming and running all over the place. The big number of these children in an unsanitary playing area was just but a partial reflection of Uganda's rapidly increasing population.

Undesirable fertility rate

The Executive Director of Reproductive Health Uganda (formerly Family Planning Association of Uganda), Mr Elly Mugumya says that Uganda's current fertility rate is undesirable and he attributes it to the limited attention that's being accorded to population and family planning as development matters.

He argues that population as a variable has an impact on economic and development plans. A high population for instance in Uganda's case overshadows Uganda's limited available resources. "More than 50 per cent of Uganda's population is not in productive employment hence increasing dependency and poverty," says Mr Mugumya.

Some have argued that a big population is good for Uganda. Their arguments, however, make little sense when one looks at the social-economic welfare of the average Ugandan home.

The head of Information and Communication at Uganda's Population Secretariat, Mr Hannington Burunde says that a large population can have adverse effects on development: "If you have a large population that cannot make a substantial contribution to development and yet it is demanding social services, then that population is a liability.

"There are about 29 million people in Uganda presently, and credible global population reports show that Uganda's population rate is one of the fastest growing in the world. Current United Nations Population Fund (UNFPA) indicators put Uganda's rapid growth rate at 3.5 per cent per year, making it the third fastest growing country (population terms) in the world.

On an average scale, the Ugandan woman gives birth to seven children in her lifetime. This is an unusually high fertility rate, which has interestingly remained unchanged for over 20 years. Uganda's rate of contraceptive use stands at 23 per cent and many women are still sceptical and rather cynical of birth control methods.

Mr Burunde recognises the need to strengthen family planning campaigns and for the government to prioritise family planning as one of the vital measures that ought to be taken to curb the high fertility rate. Close to half of Uganda's population is under 16 years of age and will soon get into the childbearing age.

Reducing maternal mortality

And by 2025, the population will almost double to 58 million. Uganda is one of the 191 nations that in September 2000 became a signatory to the Millennium Declaration which was launched at a UN summit in New York.

The declaration outlines eight Millennium Development Goals (MDGs), which countries are aiming to achieve by 2015. The attainment of these goals will certainly translate into a better life for each and every Ugandan.

Much as the Ugandan economy continues to register impressive growth rates, it is quite obvious that the critical goals to development will not be easy to attain by 2015. The rapid population growth poses a unique challenge to the attainment of most MDGs within the next seven years.

Even with impressive economic performance, Uganda still faces several challenges in relation to meeting its targets of the key economic and social indicators.

The 2007 Uganda Progress Report on the MDGs for instance indicates that Uganda's average growth rate has been at about 5.6 percent over the past five years and this is below the 7 per cent target that is required to reduce absolute poverty to below 10 per cent of the population by 2017.

Goal 5 for instance aims to improve maternal health by reducing the maternal mortality rate by three quarters between 1990 and 2005. It is however unlikely that this target will be achieved by 2015. Estimated maternal mortality from the Uganda Demographic survey is 435 per 100,000 live births.

Uganda will need to reduce its mortality rate from 435 to 131 deaths per 100,000 if it is to meet this particular MDG by 2015. A high fertility rate at 6.7 births per woman is given as a contributing factor to Uganda's maternal mortality rate.

Reproductive health budget

The high fertility rates that normally translate into an overwhelming population cause other challenges which make access to quality maternal care difficult besides straining the capacity of health facilities to manage various health complications.

In a bid to explain why population campaigns have been rather unsuccessful, Mugumya says: "We exist in a community that generally desires large families. The levels of literacy are still low and it therefore takes more time for people to understand the benefits of family planning."

He also adds that the government has not been such an active partner in regard to population matters and that over the years, a rather small percentage of the health budget has been allocated to issues of reproductive health.

Uganda has made modest attempts at pursuing the MDGs. There are however only two areas where Uganda is on course as far the MDGs are concerned; that is Universal Primary Education and HIV/Aids reduction.

Much as the country is on course when it comes to the Universal Primary Education programme, the quality of education is still poor. The high rate of enrolment which fuels logistical challenges, is mainly a result of Uganda's high population and this easily passes as the major reason as to why the quality of the primary education programme is challenged by widespread low standards.

Still, much as the country has done fairly well in fighting HIV/Aids and other diseases, serious challenges remain to be addressed especially in regard to improving access to health care.

As the country's population soars, there is even more need to increase access to health care facilities and further improve health service delivery. Besides the aforementioned two, Uganda is not on course for the rest of the MDGs and their associated targets.

The failure to be on course towards the attainment of the other MDGs has been blamed on the country's high population growth, inefficiency in the management of the social budget and inadequacy of resources as stated by the 2007 Uganda Progress Report on the Millennium Development Goals.

Inadequacy of resources for instance is clearly related to the demands of a high population which normally make it difficult to apportion resources out of a limited resource basket like that of Uganda.

Indeed a startling population growth rate of about 3.5 per cent per annum could make achievement of many MDGs impossible without the provision of sufficient resources that could be used effectively.

This Comment article was first pubished on the web on February 12, 2008.