Situation analySiS

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Situation analySiS of Children in uganda 2015INSTITUTIONALISE CHILD INDICATORS IN NATIONAL STATISTICS, SURVEYS, ANDPOLICY DOCUMENTS SUCH AS THE NATIONAL DEVELOPMENT PLAN: Child-specificindicators are necessary to monitor and assess progress in children’s wellbeing. Theindicators should be disaggregated by socioeconomic characteristics to measuredisparities in child wellbeing within the country. The overall policy framework shouldaim to eliminate inequalities in access to services, opportunities and outcomes forchildren. This can only be achieved if child-focused indicators are regularly collectedand monitored, and national policy includes specific goals to improve children’swellbeing.DEVELOP A NATIONAL CHILD PARTICIPATION STRATEGY: Child participation remainscharacterised by fragmented and time-limited initiatives. Developing a national childparticipation strategy to serve as an action plan with main interventions, timeframes,targets, key institutions and their specific roles and expected outcomes is a criticalstep towards establishing a better enabling environment for child participationin Uganda. Anchored on Uganda’s constitution and legal framework, and firmlyharnessed on the UNCRC, this strategy can pave the way for sustainable avenues forchildren to participate in discussions around issues that affect them at the nationaland local level.7.4 SERVICES AND SECTORS: CHALLENGESAND RECOMMENDATIONS7.4.1 The right to survivalCHALLENGESThe Government has committed to a number of national and international goals related tohealth-service provision and sanitation, with respective targets for 2015, 2017, 2025 and2040. While it is unlikely to meet all its health and sanitation targets by 2015, the countryhas made steady progress, particularly in reducing HIV and AIDS, especially mother-to-childtransmission.Given that poverty, gender, health and hygiene are interlinked, improvements in socialnorms, women’s empowerment, economic empowerment, education and access to WASHfacilities all positively impact on health outcomes. However, there is limited adherence tonational guidelines, clinical protocols and proven strategies such as integrated communitycase management (iCCM) and integrated management of childhood illness (IMCI). Manyrural health facilities are geographically inaccessible and there are inadequate referralsystems. Clinics are housed in inadequate buildings, with a lack of skilled workers andequipment, and frequent medicine stock-outs.92 KEy ChaLLENGES aND PoLICy rECoMMENDatIoNS
Situation analySiS of Children in uganda 2015Financing is a key constraint to effective health sector development in Uganda. Accordingto the National Budget Framework Paper FY 2014/15 – FY 2018/19 (MoFPED, 2014) andthe Budget Speech FY 2014/15 (State House of Uganda, 2014), in FY 2014/15 the healthsector share of the total budget was reduced from 8.6% to 8%. Uganda is therefore yet tocomply with the Abuja Declaration to assign 15% of national budgets to health care by 2015(Kagumire, 2010).As well as addressing gaps in service provision, the Health Service Strategic and InvestmentPlan (HSSIP) requires greater investment in preventive interventions. In the longerterm, this has the capacity to change behaviour to prevent illnesses (or pregnancies) arisingand reduce the strain on health facilities. While there has been steady progress in reducingHIV and AIDS and in eliminating mother-to child transmission (eMTCT), increasing HIVinfections, especially among adolescents, and the limited coverage of eMTCT services areof concern. Policies that monitor the implementation of eMTCT will benefit the reversingtrend of HIV infections and commitments to global initiatives such as Family Planning 2020demonstrate that Uganda will persevere past 2015 to keep women’s reproductive health onthe government health agenda.Finally, understanding of the mutual advantages that child-sensitive social protection andchild protection system strengthening bring to child survival outcomes is making progress.The Social Protection Sector Review (MoGLSD, 2014b) provides relevant insights relatingto child survival by focusing on the non-contributory dimensions of social security (directincome support) as well as some elements of social care and support services. The issue ofchild-friendly governance systems can also be promoted by using participation as a criticalmodality through which survival-orientated services can gain efficiencies.RECOMMENDATIONSHarness women’s voices and include men in health-seeking behaviour forchildren by funding communication interventions and implementing technicaltraining on knowledge, attitude and practice surveys and associated M&E systems.Address the evolving and special needs of adolescents, especially adolescentgirls, through mainstreaming adolescent health programming and strengthening thecapacity for implementation of a comprehensive HIV/AIDs response.Focus efforts in stunting reduction and child development through strengtheningthe office of the Prime Minister’s capacity to coordinate and lead a multisectoralresponse, rolling out the ‘1,000 Days’ programme and improving the scale andquality of community-based management of acute malnutrition, jointly with parentaleducation about infant and young child feeding.Strengthen intersectoral collaboration regarding water and sanitation and ensureaccountability of relevant sectors through: scaling up community-led total sanitationand WASH in schools and health facilities; fostering public/private partnerships forinnovative sanitation technologies and maintenance of WASH facilities.KEy ChaLLENGES aND PoLICy rECoMMENDatIoNS93
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Situation analySiS

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