Improving child survival in Uganda has had mixed results. Infant and under-five mortality rates have dropped since 1990 but there has been no progress in neonatal and maternal mortality. Chronic malnutrition – stunting – remains high while HIV is now the second leading cause of death in adolescents. Access to improved sanitation is low and hygiene habits such as hand washing are not practised often enough. The quality, coverage and uptake of maternal and child health care services, including those for HIV and tuberculosis, are inadequate, especially in rural areas and under-developed parts of the country.
Uganda has over the years recorded steady decline in infant and under-five mortality while no real progress is observed in reducing neonatal and maternal deaths. The immediate causes of under-five mortality are pneumonia (16 per cent), malaria (13 per cent), diarrhea (10 per cent) and HIV and AIDs (7 per cent).
Child mortality is not evenly distributed across the country. The highest mortality is in Karamoja, Southwest, West Nile and western regions. Rural areas are significantly higher than in urban areas, although even in urban areas rates are comparatively high. There are also substantial regional differences in under-five mortality, with significantly higher rates having been reported from the North (West Nile and North) and the South West.
While the absolute number of HIV/AIDS-related death in children aged 0-4 years has decreased by more than half from over 100,000 between 2000 and 2012, the number of deaths in adolescents aged 10-19 years has increased from less than 50,000 to over 100,000 during the same period. (UNAIDS 2012 HIV/AIDS estimates). Two thirds of all new HIV infections in 2012 were among adolescent girls. HIV is now the second leading cause of death among adolescents, 300 deaths every day.
Progress in Nutrition has remained slow. Progress was relatively more visible in reduction of stunting levels from 38 per cent to 33 per cent against the target of 13 per cent compared to wasting rate which decreased only from 6 per cent to 5 per cent and underweight from 16 per cent to 14 per cent (against a target 10 per cent). UDHS 2011 data showed a decline in children born with low birth weight over the past 10 years from 13 per cent (2006) to 10 per cent (2011) Vitamin A deficiency: Children under five years: 38 per cent; Women of childbearing age: 36 per cent.. Although breastfeeding as a practice is close to being universal in Uganda, the rate of exclusive breastfeeding at 6 months stands at 63 per cent, after dwindling towards 6th month.
The national coverage of access to improved sources of drinking water increased from 67 per cent in 2006 to 70 per cent of households in 2011 (Urban 89.6 per cent and Rural 66.6 per cent); (UDHS 2011). With regard to sanitation, 16 per cent of households use improved toilet facilities that are not shared (21 per cent in urban areas and 15 per cent in rural areas) (UDHS 2011).
Although evidence shows that hand washing with soap alone can reduce water
and sanitation-related diseases by 43 per cent in children, the current coverage is still low and diarrhoea continues to be one of the major killer diseases for children under five years.