African Health Sciences Makerere University Medical School ISSN: 1680-6905 EISSN: 1729-0503 Vol. 8, Num. 1, 2008, pp. 4-5

African Health Sciences, Vol. 8, No. 1, March, 2008, pp. 4-5

Editorial

Only poverty reduction will curtail population growth

Nuwa Nuwagaba

Makerere University, Faculty of Social Sciences, P. O. Box 7072, Kampala, Uganda, reevconsult@infocom.co.ug

Code Number: hs08002

The Ministry of Finance, Planning and Economic Development under the Population Secretariat has been reviewing the Uganda National Population Policy. I am pleased to have served as a Consultant in this exercise. The first Uganda Population Policy was developed and enacted in 1995 but since that time, a number of new issues and dispensations such as the Poverty Eradication Action Plan (PEAP) and Millennium Development Goals (MDGs) dictated the need for the review of the policy. The aim is to ensure that the Population Policy is consistent with the objectives and goals of the new dispensations. On Monday July 24, 2006, there was a National Consultative meting held at Statistics House in Kampala and this meeting called for stakeholders to contribute to the review of the National Population Policy. Having traversed the whole country and assessed the socio-economic status of the local households, I was able to come up with the following findings:

1. There is still rampant poverty among the majority of households in Uganda. In our language of poverty reduction, about 38 out of every 100 people in Uganda live under absolute poverty. Literally, this means that these people are not sure of their source of their next meal!! These households are characterized by many children whom they are unable to adequately look after and to provide even the basic necessities such as food, clothes, health care and school fees. These households are living under total deprivation and impoverishment. Most of the children in these households are prone to diseases since these households can not afford quality health care.
2. The prospect of having mothers bearing a manageable number of children is still difficult to achieve. In many households I visited, children provide labour in agricultural activities including tendering for livestock and others are urged to help their parents run their small businesses. When asked about why parents were not enthusiastic about letting their children to go school, they argued that it was not rewarding as those that have completed schooling were not able to get jobs!! One parent asserted that he has sold his land to pay fees for his son but the son has never secured a job ever-since graduating from Makerere University in 2002. "So what is the purpose of educating children?" he retorted. From further interviews regarding child education, I found out that girls are viewed as source of wealth through payment of bride price. Many families did not find difficulty in terminating the girl's education if suitors wanted to marry their daughter. This reminds me of a one Mr. Bafokorora hailing from Kabale district that married off her nine (9) year-old daughter and was boasting of the two (2) cows promised to him as bride wealth!! These cultural artefacts are indeed disastrous. There is no other explanation for marrying off a nine year old apart from abject poverty!!.
3. Increasing household income is a daunting task especially in the situation where 68% of the population in Uganda is fully engaged in subsistence farming with rudimentary methods. In all the districts I visited, it is apparent that without the practice of commercial farming, households engaged in agriculture can not significantly improve their incomes.
4. Ensuring child survival also remains one of the greatest impediments to reducing fertility. With Infant Mortality of 83 per 1,000 per year, mothers will continue to produce many children. This implies that, out of every one thousand children born alive, 83 of them can not celebrate their first birthday. This high rate of child decimation forces mothers to produce children for insurance against death. This simply implies that it would be unwise for the Ministry of Health to urge mothers to produce few children unless the mothers are convinced that the children they already have will survive to adulthood. Mothers are rational beings who will recognize that actually few children can still survive. I am however aware that Queen Victoria of England between 1840 and 1857 had nine children! This is not because she was illiterate or poor but because she was a monarch. Mothers in Uganda cannot use this argument!! Family Planning initiatives should transcend distribution of contraceptives and focus more on ensuring child survival if they are to achieve their objective of controlling child bearing.
5. Uganda's economic setup is characterized by smaller holder farming activities, low productivity, lack of marketing infrastructure and a weak financial sector. All these have culminated into low yields, low farm prices and hence diminishing household incomes. Over the years of research on poverty, I have found out that due to large family sizes, most of the produce is consumed leaving households in deprivation and with little or nothing to sell. Relatedly, the inability of the majority of women to be engaged in gainful employment, has exacerbated the poverty scenario. Given that most of the current employment opportunities are provided by the private sector, I would on this point wish to advise young ladies that while government has increased Maternity leave from 45 to 90 days, this will not apply in the private sector. This is because, the private sector is driven by yielding profitability and not generating social comfort. So producing children year after year and then accruing maternity leaves is not something that will enhance ones competitiveness in the private sector. It is rather capacity and output that will enhance one's performance rating and these are definitely incompatible with producing children frequently!!.
6. There is also an apparent "low cost of producing children" which encourages people to have a large family size. In many homes, that I visited younger children use facilities (nappies, beds, clothes etc) of the older siblings hence, the mothers do not feel the cost of producing the extra child. The reason why rural households do not mind large family size is that the cost of producing an extra child (what we call in Economics the Marginal cost of Parity progression) is very low. This is because what the parents purchased as the necessities for the first born can be re-used for almost all the subsequent children. Therefore the marginal cost of producing subsequent children diminishes with each additional child. Ironically, this has worsened by UPE where parents do not feel the pinch of paying fees for their children at Primary. Secondly, graduated tax has been scrapped! In most villages I vistedthe relief of not paying tax has taken many to senseless drinking as they boast that the President “yabaawe edembe, naweela abaana ate nabajjako nomusolo”(literally meaning that government introduced UPE and scrapped graduated tax and thus there is no bother to engage in h a r d gainful work. This clearly indicates how well meaning social policies can be misinterpreted to retrogressively misdirect the polity.

I would therefore wish to submit that the following are the major issues that the National Population Policy must address if we are to generate a population that is responsive to development initiatives.

• Ensuring child survival so that mothers are not persuaded to produce many children for insurance against deaths.
• Developing a competitive education and training curriculum to impart competitive skills as demanded by the labour market. This will increase employability help individuals to apply their skills to fight poverty.
• Political support for management of population variables as important aspects of development. At national and local government levels, there should be prioritization of population activities in planning and budgeting. There is need for political leaders to understand the linkage between population growth and poverty.
• Educate households on the link between population growth and poverty. It is apparent that many a household in Uganda do not directly relate household welfare to household size yet evidence shows that large family sizes have impoverished households .
• Ensuring sustainable household income and poverty reduction is the paramount strategy for achieving all other population and development programs.
• Enhance women’s participation in gainful employment so as to enhance their competitive skills and economic status.

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