16 women die every day in Uganda while giving birth or during pregnancy; that’s 5,800 deaths each year. Many more suffer from complications and childbirth injuries such as VVF.
Each year 100,000 babies die at birth, that’s 76 deaths per 1,000 live births.
The shame of these numbers is that these deaths are, on the whole, preventable. Mums need good ante-natal and post-natal care, safe delivery attended by trained staff, post-natal care for Baby and simple immunizations. Such care needs to be provided alongside other healthcare programmes that tackle the major causes of death such as pneumonia, diarrheoa and malaria. This in conjunction with Social and Environmental Health initiatives to ensure access to family planning, safe clean water, sanitation, waste disposal and better housing.
So if we know what should be done and most of it is not so difficult to implement, why does the problem persist and why, in most countries in Africa, does the trend seem to be going in the wrong direction?
Put simply it’s about MONEY and PRIORITIES.
The African Union agreed at the 2001 Abuja Summit that each country should spend 15% of its budget on healthcare. 9 years later most have failed to do so. Uganda spends just about 9% of its budget on healthcare and Maternal Child Health (MCH) gets just a small proportion of that, though this is set to increase to UGX 260b in 2010-11. At the recent AU Summit in Kampala, officials simply stated that 15% was unattainable in the foreseeable future. If all ministries were to be given the budget they were asking for, the total would be more than 150% of what’s available. A very significant percentage (~40%) of the UGX 600b Uganda health budget is provided by other donor countries and those are not able to make any further increases due to current worldwide commercial and economic pressures.
So we’re on our own and it’s even worse than that. Uganda needs to allocate more of its own domestic budget to healthcare. However there is growing evidence that even if it reaches the ‘magic‘ 15% this still won’t be enough. It is just too simple to talk about percentage of overall budget or GDP. One must also look at the actual amount being allocated and spent per person. Currently in Uganda less than USD 10 are spent on healthcare for each person. A 50% increase in budget allocation, to reach the 15%, would take this to about USD 15 per capita. That is still such a long way from the WHO recommendation of a minimum of USD 40 pp pa.
Maternal, infant and child health are the greatest challenges facing Africa ahead of the 2015 deadline for achieving the Millennium Development Goals. The Countdown Report estimates that it will cost an additional USD 8 per person per year to provide the required healthcare interventions mentioned above.
117 African Health, Social Development, Gender Based, Youth, Human Rights Organisations, and Trade Unions have joined together to recommend to AU member states progression towards a more comprehensive health, population and social development formula described as 15 % Plus.
Whilst this laudable and should get our support, I am not at all convinced that AU governments will make, or be able to make, such a commitment and implement it.
There has to be another way.
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