Healthcare is a complex phenomenon, and is often defined by the quality of life, life expectancy, mortality rates, nutrition level, and natality rates, and therefore, any policies, interventions, and resources that can affect these factors, affect health in general. Uganda is a developing country in East Africa, and like many developing countries, it exhibits several challenges when it comes to health. The three factors critically affected include maternal and child care, immunization, and nutrition. It is, therefore, critical to assess the epidemiological and policy aspects of these factors in an attempt to unmask the quality of healthcare in Uganda.
Maternal health is critical as it usually defines the health of the mother, as well as that of the infant within two months of their birth. Improved maternal health, therefore, means that there is an improvement in the health of the mother, as well as a decrease in infant mortality. However, due to the limited accessibility of maternal healthcare and utilization barriers in Uganda, the maternal mortality rate is high, ranging from 356 to 438 per 100 000 live births (Morgan, Tetui, Kananura, Ekirapa-Kiracho, & George, 2017). Maternal, and thus child health, has been affected by other factors, including poverty, lack of transportation, and inadequate primary delivery supplies. Expectant mothers are often forced to cater to their supplies, and to those of low socioeconomic status, this can prove a challenge. Men are also often reluctant to support their women during pregnancy and delivery, as a result of the attitudes expectant women usually have and negative perception of fatherhood, and this leaves the burden to the women.
Policies and interventions formulated to tackle the issue of maternal mortality in Uganda have considered the supply and demand side of the problem. A quasi-experiment conducted by the Makerere Public University and John Hopkins University presented the supply side of maternal health as factors including the training of healthcare workers to offer ample services to the expectant mothers, as well as the provision of pharmaceutical provisions and equipment in healthcare facilities (Morgan et al., 2017). Transportation, gender involvement of the males, and access to maternal services were highlighted as the demand-side of the interventions.
Improvement in maternal health does not conclude the journey for the child, as they are often susceptible to other communicable and non-communicable diseases. Immunizations therefore provide the defense that these infants require against life-threatening diseases. International vaccination often targets several diseases such as tuberculosis, measles, whooping cough, diphtheria, polio, and tetanus, among others. Despite this, the infant mortality in Uganda is still high, with 78 deaths in every 100,000 live births for infants and 137 per 100,000 live birth for children under five years (Bbaale, 2013). Several factors have been exposed regarding this trend, among them poor maternal education, socioeconomic status of a family, literacy of the parents, access, and utility of antenatal care, and immunization plans, among others. The Ugandan government channels most of its resources and research on the promotion of high immunization coverage. While this possess high efficacy, the critical issue was on the timeliness of the vaccines. In a study including 821 children, 77.2% had been fully vaccinated with the timeliness for the vaccines ranging from 67.5% for measles and 92.7% for BCG (Babirye et al. 2012). However, even though these numbers are encouraging, about a quarter of infants in Uganda do not get the vaccines they need in time, and this poses a threat to their health and quality of life.
Nutrition is another critical factor that determines the health of individuals. Africa, in general, has a 43% rate of death for children under five years as a result of malnutrition. The prevalence of nutritional issues in Uganda is at 2.3 million young children with chronic malnutrition, 16% of the children below five years underweight, 6% of the children wasted, and 12% of the women malnourished (Uganda Nutrition Action Plan, 2011). Malnutrition, more so in children, is caused by inadequate dietary consumption, frequent illness, limited access to healthcare, food insecurity, poor maternal and child care, and inadequate finances. To tackle this problem, the Ugandan government, through its National Development Plan (NDP), aims at reducing malnutrition by improving nutrition advocacy, implementing plans for the production of nutritious foods, improving family nutrition care, and facilitating cost-effective programs at district and national level. Public education is also crucial as it facilitates behavior change and avails nutrition information to the public.
Maternal health, immunization, and nutrition are three aspects of healthcare that possess the potential to either improve or deteriorate health. This is more so in developing countries such as Uganda, where socioeconomic disparities and lack of resources jeopardize healthcare. Therefore, exploring the factors that affect the three tenets of health, as well as policies formulated to tackle these issues, creates a sense of awareness regarding health on a broader scale.
Babirye, J. N., Engebretsen, I. M., Makumbi, F., Fadnes, L. T., Wamani, H., Tylleskar, T., & Nuwaha, F. (2012). Timeliness of childhood vaccinations in Kampala Uganda: a community-based cross-sectional study. PloS one, 7(4), e35432. doi:10.1371/journal.pone.0035432
Bbaale E. (2013). Factors influencing childhood immunization in Uganda. Journal of health, population, and nutrition, 31(1) Pp.118-129. Doi:10.3329/jhpn.v31i1.14756
Morgan R., Tetui M., Kananura R. M., Ekirapa-Kiracho E., & George A. S. (2017). Gender dynamics affecting maternal health and health care access and use in Uganda, Health Policy and Planning. 32(5).pp. 13-21, https://doi.org/10.1093/heapol/czx011Uganda Nutrition Action Plan (2011). Scaling up Multi-Sectoral Efforts to Establish a Strong Nutrition Foundation for Uganda's Development. Pp. 1-30. Retrieved from http://www.health.go.ug/docs/UNAP_11_16.pdf
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