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Uganda's Situation United Nations Population Fund Issue Brief 05 Worlds apart in Uganda: Inequalities in women’s health, education and economic empowerment Uganda’s Situation 37.7M Uganda’s population 51% Gender inequalities, inequities and implication to Uganda’s development 49% More than ever before, there is global all women and girls, calls for gender consensus that the path to sustainable equality and empowerment, including but development for the next 15 years must not limited to ending all forms of violence Females constitute be built on a foundation of equality, and discrimination against all women and 51% of the total inclusiveness and universal enjoyment girls, as well as ensuring universal access population of rights. Several studies have further to sexual and reproductive health and indicated that closing the gender gap can rights. SDG 10: Reduced inequality within accelerate development. In this regard, and among countries; ensures equal 3.7% all the 17 Sustainable Development Goals opportunity and reduced inequalities (SDGs) address issues of gender equality of outcome, including eliminating and ensuring that nobody is left behind. discriminatory laws, policies and practices 23% Goal 5 and 10 are specific on gender and promoting appropriate legislation, equality and addressing inequalities. SDG policies and action in this regard. 55% 5: Achieve gender equality and empower Youth (18-30) Children below 18 Older persons Uganda adopted and aligned to the Global Agenda 2030 Sustainable development goals. Uganda’s Vision 2040 statement prioritizes gender equality as a cross-cutting enabler for socio-economic transformation, highlighting the progress made in the legal Three in every ten and policy arena, in political representation, and in lowering gaps in education. The households (31%) are National Development Plan II (NDP II, 2015-2020) prioritizes the empowerment of women and gender equality as a means to inclusive growth and social development. headed by females. It makes specific reference to sector-specific gender issues that relate to women’s empowerment and access to sexual reproductive health information and services. 1 UNFPA, State of the World Population, 2017; Worlds Apart: Reproductive Health and Rights in an Age of Inequality Uganda’s situation based failings, with women invariably more marginalized than men. Women are marginalized in aspects of access Uganda’s population is estimated at 37.7 million of which to and control over productive resources, education and more than half are females. Females constitute 51% of the health services, decision making platforms, and political total population. One in every four households (31%) are representation. Socio-cultural norms and harmful traditional headed by females. Marginalized and vulnerable groups practices including gender based violence, female genital include, women, children, youth, older persons, persons with mutilation, teenage pregnancy, child and forced marriage, disability and ethnic minorities. Fifty five per cent (55%) of the among others, perpetuate gender inequality. The high social population are children below the age of 18; Youth (persons tolerance of gender based violence, with inequality between age 18-30) constitute 23%; older persons constitute 3.7% of men and women accepted as a normal undermines efforts the population. In regard to other vulnerable groups, 12.5% towards gender equality and women’s empowerment. are persons with disabilities; and 1.4% are ethnic minorities. Inequalities between men and women in Uganda affect All together, these categories constitute over 80% of many aspects of women’s lives, starting with sex preferences Uganda’s population, yet they continue to face a wide range in various sectors such as education and employment, which of challenges including discrimination, marginalization, and affect job opportunities, property rights, access to health exclusion. and political participation. The pattern of social history that disempowers women and girls produces a cycle of According to the Global Gender Gap 2016, Uganda ranks undervaluing them, providing only peripheral access to 61 overall position out 144 countries in terms of addressing healthcare and schooling, thus less opportunities to take on the gender gap . Vision 2040 points out that in spite of high level jobs or training, which in turn exacerbates the issue progress in the political and decision making arena, other of low political participation and marginal social rights. conditions sustaining gender inequality in Uganda remain salient, including: gender disparities in access and control Gender inequality is measured using the Gender over productive resources like land; limited share of women Inequality index which combines three main factors that in wage employment in non-agricultural sectors; sexual and tend to create achievement gaps between the genders. gender-based violence; limited participation in household, community and national decision-making. 1. Adolescent birth rates and maternal mortality - to demonstrate reproductive health 2. Labour market participation rates – economic status Intersection of inequalities in health, 3. Proportion of women who work in Parliament and levels of education – Empowerment education and gender Gender inequality is one of the most significant identity 2 Uganda Bureau of Statistics, Census 2014. 3 World Economic Forum, Global Gender Gap Report, 2016 2 Health Inequalities - Sexual Reproductive Health: Adolescent birth rates and maternal mortality among the Gender Inequality Indices illustrate the contribution of reproductive health to attainment of gender equality and equity. Adolescent birth rate - Adolescent fertility is important on both health and social grounds. Teenage mothers are more likely to experience adverse pregnancy outcomes and are more constrained in their ability to pursue educational opportunities than young women who Fig 2: Percentage young people (girls) started child delay childbearing. In Uganda today, one in every four girls bearing by 19 years aged 15-19 years have begun childbearing. Adolescent childbearing is more common in rural than in urban areas at Adolescents from poor households start child birth earlier 27 versus 19 percent, respectively. Teenagers in the lowest compared to their counterparts from the highest wealth wealth quintile tend to begin childbearing earlier than those households - 34 versus 15 per cent respectively . Those in in the highest quintile i.e. 33.5% had begun child bearing rural areas have twice as many births as their counterparts compared to 15.1% respectively. in urban areas. A girl between the age of 15 and 19 is twice as likely to die during pregnancy or childbirth as a woman Child motherhood denies a girl of her childhood, disrupts in her 20’s. If she is under 15, the risks are 5 times higher. her education, limits her opportunities, increases her risks of Child marriage is one of the significant drivers of adolescent violence and abuse and jeopardizes her health. In Uganda pregnancy; ninety per cent of adolescent pregnancies occur 49% of girls are married by the age of 18 years. Once girls to girls who are married before 18 years and who have little are married, they do not have control over their destiny. Only or no say in decisions about when or whether to become 11.4% use contraceptives. pregnant. When girls marry at an early age they are deprived of an opportunity to education that can propel them, their Keeping girls in school is one way of supporting them families and communities from poverty. A World Bank to delay pregnancy. Differences are observed between study shows that an extra year of primary school education education levels i.e. 34.6% with no education had begun child boosts girls’ future wages by 10% –20%, and an extra year of bearing compared to 28.7% with primary education, 17.0% secondary school adds 15 – 25 per cent. with secondary education and 11.0% with above secondary level. In hard-to-reach areas where services such as health Keeping girls in schools and ensuring that they access and education are lacking, there are high levels of teenage sexual reproductive information will ensure delayed onset pregnancy e.g. in Islands – 48.3%. Levels of education in of childbirth and marriages. Preventing child marriage and the islands are very low and this form of deprivation, leads teenage pregnancy would help reduce the risks of HIV/AIDS to early pregnancy. However, in mountain areas, teenage infection, maternal death and disability including obstetric pregnancy was 24.3% while in greater Kampala, it was 16.7%. fistula. 4 UBOS, Uganda Demographic and Health Survey, 2016 3 year. In addition, many mothers do not receive any post-natal Maternal Mortality ratio (MMR) There has been slow progress in reduction of maternal check-up yet over 60% of maternal deaths occur 23-48 hours mortality in Uganda. The maternal mortality ratio (MMR) after delivery, mostly due to hemorrhage and hypertensive came down from 506 per 100,000 live births in 1995 to 435 disorders or after 48 hours because of sepsis. per 100,000 live births in 2006, to 438 per 100,000 live births in 2011, UDHS 2011 and currently estimated at 336 per 100,000 Skilled Birth Attendance live birth in 2016 . Most of the causes of maternal death in Antenatal Care (ANC) from a skilled provider is important to Uganda are preventable. monitor pregnancy so as to reduce morbidity and mortality risks for the mother and child during pregnancy, delivery, and the postnatal period (within 42 days after delivery). Six in every ten women go for fourth ANC visit. Women in urban areas with easier access to health services are more likely to have four or more ANC visits than rural women – 65% versus 58% respectively. Regional variations in ANC attendance are noted, with Bunyoro and Bugisu sub-regions having the lowest percentage of women who have had four or more ANC visits (45% and 47% respectively). ANC attendance also increases with the level of women’s education. Among women with no education, 53% attended four or more ANC visits, compared with 72% of women with more than a secondary school education.
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