Party manifestos shun maternal health

A televised poll conducted on 10th February 2011 during NTV Uganda’s popular TV talk show ‘On the Spot’ revealed that 87% of Ugandans did not think maternal health was prioritized in the political party manifestos. The TV program, sponsored by Forum for Women in Democracy and FEMNET, was held to discuss and analyze the positioning of maternal health in Ugandan politics.

Guests included, Hon. Betty Kamya Presidential Aspirant, Dr. Ruhakana Rugunda representing the NRM presidential candidate, Hon Nabila Sempala Nagayi for IPC Presidential candidate,  and two health experts; Ms. Robinah Biteyi from White Ribbon Alliance and Dr. Daniel Murokora, the head of the Association of Obstetrics and Gynecology in Uganda.

An analysis given by the health experts presented a grim picture emphasizing the need to redress maternal health in Uganda. The experts noted that although Uganda boasts of reducing maternal mortality ratio from 505 to 435 for 100,000 live births, this figure is still unacceptably high and is far behind the Millennium Development Goal 5, which recommends reducing maternal mortality to 131 for every 100,000 live births by 2015.

In his submission, Dr. Rugunda, confirmed
that maternal and infant mortality rate is high stating that it is a condition prevailing mainly in developing societies. He applauded the NRM government efforts towards reducing maternal and infant mortality. He further mentioned that reducing maternal and infant mortality is a priority in the NRM party manifesto although he never mentioned any set targets.

Key factors attributed to inefficiencies in the health system during the TV debate included a fast growing population and high fertility rate of close to 7 children per Uganda woman, which does not match the increase in quantity or quality of service delivery. For instance Mulago Hospital, the national referral hospital, delivers approximately 30,000 women a year, the highest in Uganda, yet it has only three labour wards and two theatres. Other factors that panelists tagged to poor planning in the health sector included, lack of skilled health personnel, shortage of drugs and medical equipment and inadequate investments in maternal health.

There was a call for an interactive legislation that is well matched with real life situations. “existing legislation has not improved the plight of pregnant women either and has instead worsened the situation whereby women ‘are totally ignored because of the abolishment of Shs 2,000 fee which they had to part with before getting service’, said Hon. Nabila Nagayi.

While the NRM manifesto spells out ‘intentions of attracting more personnel to the health sector through enhanced training and increased remuneration, it calls on the public private partnership to increase involvement of the private sector in the provision of health services. In his submissions, Dr. Rugunda stated that for the last three years, government constantly increased its allocations to the health sector, a move expected to continue until they fulfill the Abuja declaration, which requires a ‘15 % of budget for health. In her argument, Hon. Betty Kamya stated Local Governments should be given mandate to manage their resources which will enable them prioritize key issues. Her party manifesto proposes a public health insurance policy, believed to increase access to health services for especially the poor.

While presenting the proposals from the IPC Manifesto, Hon. Nabila Nagayi highlighted rehabilitation of hospitals, recruitment of health workers, motivation of health workers, family planning, decongestion of hospitals, increased funding as the priority issues for the IPC party stating that for  both IPC and FDC, maternal health is not just a women’s issue but a key development issue .

In their submission, parties claimed to have prioritized the party manifestos, but an analysis of the various party manifestos point to goal setting as the major problem. Although many political parties’ manifestos mention maternal health there are no tangible targets spelt out set to improve maternal health, with many arguing that targeting is an implementation detail. From the calls during the show and results of the poll, it was clear that Ugandans need assurance that the leaders they elect into office will deliver on maternal health.