By Esther Nakkazi
More children in Uganda, Rwanda and Malawi are living to see their fifth birthdays and get a healthy start to life than ever before. These countries are bending the curve on child mortality leading the way with the fastest decreases in under-5 mortality since 2000.
In Uganda, under-5 mortality has reduced by 6.4% from 148 to 46 deaths per 1,000 live births from 2000 to 2018. On child mortality, Uganda has the 3rd fastest rate of reduction among 54 countries in Africa.
Rwanda has reduced under-5 mortality by 9.1% from 183 deaths per 1,000 live births to only 35 and Malawi by 6.9% from 173 deaths per 1,000 live births to only 50 from 2000 to 2018 according to the Africa regional child health Universal Health Coverage (UHC) new scorecard report by the Tunisian Center for Public Health.
More children in Uganda, Rwanda and Malawi are living to see their fifth birthdays and get a healthy start to life than ever before. These countries are bending the curve on child mortality leading the way with the fastest decreases in under-5 mortality since 2000.
In Uganda, under-5 mortality has reduced by 6.4% from 148 to 46 deaths per 1,000 live births from 2000 to 2018. On child mortality, Uganda has the 3rd fastest rate of reduction among 54 countries in Africa.
Rwanda has reduced under-5 mortality by 9.1% from 183 deaths per 1,000 live births to only 35 and Malawi by 6.9% from 173 deaths per 1,000 live births to only 50 from 2000 to 2018 according to the Africa regional child health Universal Health Coverage (UHC) new scorecard report by the Tunisian Center for Public Health.
Universal Health Coverage (UHC) Day happens every 12 December and brings attention to the global goal to ensure that all people, everywhere, can get the quality health services they need without facing financial hardship. It is a fundamentally political goal, rooted in the right to health. It is also one of the smartest investments any country can make.
The countries have been able to bend the curves through a combination of interventions including increased breastfeeding, a dramatic scale-up of lifesaving vaccines, sanitation, and hygiene measures, to oral rehydration therapy and zinc, as well as new innovations like kangaroo mother care.
However, more than a quarter-million children are still consistently being missed with lifesaving interventions and new challenges like obesity, combined with ongoing poor vaccination coverage, are threatening to overwhelm already fragile health systems.
Immunization in Uganda:
Immunization saves 2-3 million lives globally each year from completely preventable diseases, such as measles, tetanus, and polio. Vaccines are safe. Vaccines work. However, nearly one in five infants miss out on the basic vaccines they need to stay healthy and keep their communities safe and over 1.5 million children around the world die each year from vaccine-preventable diseases.
In Uganda, 253,633 children are still missing out on life-saving vaccines. To bridge the gap in vaccination, it is important to target the poorest and most marginalized communities, the report recommends.
Uganda has a multi-year plan for immunization and a standing technical advisory group on immunization as well as a national system to monitor adverse events following immunization.
In 2018, 84% of districts had 80% or more coverage for the DTP3 vaccine. 57% of districts had 80% or more coverage for the MCV1 vaccine.
Uganda has every vaccine recommended by the WHO in its national immunization program, besides the measles second dose vaccine. No case of wild poliovirus has been recorded since 2010 but difficulty reaching marginalized communities and increased vaccine hesitancy have contributed to multiple measles outbreaks in Uganda and make vaccination campaigns challenging.
In October 2019, Uganda launched the measles and rubella vaccination campaign with the goal of immunizing over 18 million children under 15 (approximately 43% of the population). This campaign was a launchpad for introducing the measles-rubella vaccine into the national immunization program.
Uganda has seen multiple measles outbreaks and has taken steps to respond including by organizing the measles and rubella vaccination campaign in 2019.
Uganda launched a nationwide HPV vaccine rollout in 2015 for girls age 10 protecting millions from cervical cancer and other diseases. At present 3.6% of women in Uganda have HPV type 16 or 18, which cause over 70% of cervical cancers and pre-cancerous cervical lesions.
Annually, 54.8 per 100,000 women get cervical cancer, the first leading cause of female cancer in Uganda.
Vaccines Funding:
Immunization saves 2-3 million lives globally each year from completely preventable diseases, such as measles, tetanus, and polio. Vaccines are safe. Vaccines work. However, nearly one in five infants miss out on the basic vaccines they need to stay healthy and keep their communities safe and over 1.5 million children around the world die each year from vaccine-preventable diseases.
In Uganda, 253,633 children are still missing out on life-saving vaccines. To bridge the gap in vaccination, it is important to target the poorest and most marginalized communities, the report recommends.
Uganda has a multi-year plan for immunization and a standing technical advisory group on immunization as well as a national system to monitor adverse events following immunization.
In 2018, 84% of districts had 80% or more coverage for the DTP3 vaccine. 57% of districts had 80% or more coverage for the MCV1 vaccine.
Uganda has every vaccine recommended by the WHO in its national immunization program, besides the measles second dose vaccine. No case of wild poliovirus has been recorded since 2010 but difficulty reaching marginalized communities and increased vaccine hesitancy have contributed to multiple measles outbreaks in Uganda and make vaccination campaigns challenging.
In October 2019, Uganda launched the measles and rubella vaccination campaign with the goal of immunizing over 18 million children under 15 (approximately 43% of the population). This campaign was a launchpad for introducing the measles-rubella vaccine into the national immunization program.
Uganda has seen multiple measles outbreaks and has taken steps to respond including by organizing the measles and rubella vaccination campaign in 2019.
Uganda launched a nationwide HPV vaccine rollout in 2015 for girls age 10 protecting millions from cervical cancer and other diseases. At present 3.6% of women in Uganda have HPV type 16 or 18, which cause over 70% of cervical cancers and pre-cancerous cervical lesions.
Annually, 54.8 per 100,000 women get cervical cancer, the first leading cause of female cancer in Uganda.
Vaccines Funding:
Gavi has invested over US$400 million into vaccination in Uganda ensuring funds remain in place to cover the cost of vaccines is key to maintain progress on child survival. 38% of funding for routine immunizations is provided by the government.
For every US$1 spent on immunization, US$21 are saved in healthcare costs, lost wages and lost productivity due to illness. If we take into account the broader benefits of people living longer, healthier lives, the return on investment rises to US$54 per US$1 spent.
However, there are increased vaccine hesitancy, misinformation, and mistrust although progress in how vaccines are stored has helped increase access in the hardest to reach communities.
But countries have a duty to keep vaccines cold and safe until they reach children, countries must invest in their health systems to maintain progress on vaccine coverage and make sure no children fall through the cracks.
Child Obesity in Uganda:
10 percent of school-aged children are overweight and obese, putting them at a lifelong risk of serious health complications. On child obesity, Uganda has the 3rd lowest rate among 54 countries in Africa.
Over 41 million infants and young children are overweight or obese around the world, and in the African region, the number of overweight or obese children has more than doubled since 1990. Childhood obesity is a global epidemic.
Obese children are more likely to continue to be obese through to adulthood, putting them at a lifelong risk of serious health complications and illnesses like diabetes and heart disease.
In addition to immunization, a child’s health and life prospects hinge on nutrition. While nearly half of deaths in children under five are due to poor nutrition, developing countries face a rapidly growing epidemic of childhood obesity. Undernutrition and overnutrition can exist at the same time in the same community.
Breastfeeding in Uganda:
Breastfeeding is crucial for child development and reduces child mortality by protecting against disease. It is the best source of nourishment for infants and young children and has health benefits that extend into adulthood.
In Uganda, 66 percent of infants receive breastmilk within 1 hour of birth, which is crucial to protect against disease. On early initiation of breastfeeding, Uganda has the 10th highest rate among 54 countries in Africa.
However, gobally only 40% of infants under six months of age are exclusively breastfed. Initiation of breastfeeding within the first hour of life, exclusive on-demand breastfeeding for the first six months and then breastfeeding alongside appropriate foods for two years are all crucial for child development.
Health Care professionals:
Uganda has 0.4 health professionals per 1,000 people, compared to WHO’s recommended minimum of 4.45 per 1,000 people to meet the SDGs by 2030. Uganda must fill this gap and invest in its health workforce.
By strengthening its health system and addressing vaccine-preventable diseases, child obesity, breastfeeding, health workforce shortages and more, Uganda can make great strides toward UHC.
Sources and additional data can be found here: http://bit.ly/2D0n0sw
Sources and additional data can be found here: http://bit.ly/34Cyxdz