Rural and remote inhabitants in Uganda experience low life expectancy and poor health status especially women and children.

For instance, the average life expectancy of women in rural Uganda is 48 years while their urban counterparts its 56 years and the maternal mortality rate in Uganda is 336/100,000 live births. Delivery with Trained Birth Attendance (TBAs) in rural Uganda is at 33 percent compared to 56 percent in urban areas. Shortage of health professionals is most pronounced in rural areas than urban areas.

In one district (Kasese) with a population of 923,345 population, there are only 15 medical doctors and of these only 5 reside in the health facilities where they work.

It’s notable to note too that over 70 percent of the morbidity and mortality cases are preventable and hence could have been fixed with a strong primary healthcare service system where the communities are involved and fully participate in promoting health. Majority of individuals in the rural areas are less informed and less likely to access health promotional information to make informed choices about their health coupled with poverty, and education access challenges.

The major challenges are; absence of competent health workforce at rural communities and yet majority of Ugandans live in the rural areas; inadequate participation and engagement of communities to championing health at their local level; funding for health at community level is farfetched and yet most disease burden is at rural level; and public policies that are less invested in health promotion

My most recent work has been geared at promoting community participation and engagement to demand better policies, plans and investment from their leaders (duty bearers). I have conducted community awareness, training, and capacity building (of community leaders, champions and grass-root organization) to demand accountability from the leadership but also to fully engage in driving the change they desire without necessarily becoming spectators in development.

Written by; Dr. Danny Gotto - Public Health Specialist, Uganda
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