As the United Nations family prepares for the final push toward the 2015 deadline for the review of the Millennium Development Goals (MDGs), I am glad to report that my country, Uganda, has made real progress, not only in changing health indicators, but also in laying the groundwork for change in the future. As we look toward 2015, I hope that Uganda will benefit from the experiences of other countries and that our experience will, in turn, provide critical lessons for other parts of Africa and around the world.
When I consider Uganda’s experience, there are two critical lessons from which I believe other countries can learn. First, our experience shows that progress in the health arena is possible. Uganda’s rapid decrease in the prevalence of HIV is well known: we have reduced the infection rate from 30% to less than 7% over the last 25 years. Perhaps most impressively, Uganda managed to achieve this goal, not because our country is rich, but because our Government chose to adopt a comprehensive “Multi-sectoral Approach” strategy and continues to provide unwavering public support for all nationally coordinated efforts aimed at tackling the epidemic. As a direct result of this focused and coordinated effort, all of Uganda’s stakeholders, to include policymakers, parliament, government ministries, local governments, civil society organizations, professional bodies, academic, private sector, religious and cultural institutions as well as donors and international organizations, are now able to effectively fulfill their respective roles.
Another area in which I feel Uganda’s success may serve as a positive example for other countries is our reduction of infant and child mortality rates. In 1990, 175 out of every 1,000 babies born did not make it to their fifth birthday. That number is now below 100. I learned recently that our infant mortality rates are falling even more dramatically, with new reports showing a decline from 76 to 54 deaths between 2006 and 2011. When I look back at the steps our country has taken to make this change possible, or look ahead at the important steps we still have yet to take, one thing is clear: we must work together.
Researchers: With increasing research, information and knowledge, we have come to gain a clear sense of where we are making progress and where moving forward remains a challenge. At the same time, careful research provides us with important insight regarding the causes and underlying conditions that continue to undermine the health status of our women and children. The evidence is clear: not only does poor maternal health impact the well-being of so many of our nation’s unborn children and families at large, but research shows the simplest of interventions for these very women have measurable, far-reaching and positive effects. We have seen time and again the benefits of interventions like family planning and immunization. Indeed, evidence now shows us that family planning is to maternal health what immunization is to child health: a low-cost, effective way to avoid preventable health risks.
International, regional bodies and forums: International meetings like the Millennium Summit as well as the International Family Planning Meeting that took place in 2009 in Munyonyo, Uganda, have provided critical opportunities to turn evidence into action. The priorities these meetings set for action have reinforced our understanding that making simple, low-cost interventions available can save lives—a notion which reflects the commitments of our stakeholders and is supported by governments, continental bodies (such as the African Union) and development partners (such as donor agencies).
In particular, we rely on our development partners to act from a shared understanding of the close, mutually exclusive relationships that exists among social development, economic development and health issues, and to put out a call to action. We know well the far-reaching impact of individual women and children’s good health on their families, communities and countries. At the same time, we rely on our partners to work with us on the priorities we set for ourselves.
Government: As First Lady and Patron of Save Motherhood, I am firmly committed to ensuring that women and children are healthy. In Uganda, I have spoken on many occasions about the need for a zero-tolerance policy regarding maternal deaths, and have spent much time reflecting on the lessons that our experience addressing the HIV/AIDS epidemic have taught us. I know the Government of Uganda is doing everything it can to put a stop to the needless deaths of women in pregnancy and childbirth. Just as when we were faced with frighteningly high levels of HIV infection in the 1980s, we now know that it is the highest levels of government leadership that are truly responsible for ensuring all stakeholders, from community members to health providers to religious leaders, are engaged and committed to making a change.
In Uganda, I was associated with the official launching of the “Roadmap” to reduce maternal mortality and newborn deaths in 2008. The Roadmap is Uganda’s comprehensive strategy for bringing all key stakeholders together to play their respective roles, each according to their comparative advantage. In this Roadmap, Uganda is very clear that its main focus of interventions will be antenatal care, safe deliveries under trained and skilled health personnel and improved human resources for health, along with family planning.
Communities: Communities provide a level most critical to the improvement of women and children’s health because on a human level, members of a community understand the toll these issues can take on its families, as well as the community at large. In order to make a positive change in this arena, community participation is vital, namely because members must be committed to ensuring that key health interventions reach the women and children who need them. I have seen the benefits of community participation first-hand while travelling the country to mobilize and energize Village Health Teams (VHTs) and in my touring of hospitals which provided life-changing care for women suffering from obstetric fistula.
As we approach the review year 2015 for the MDGs, we do not have much time left. We in Uganda, as in so many countries around the world, continue to make some progress, but it is not enough. In Uganda, we still face many challenges, especially in the area of women and children’s health. I am counting on everyone to work together, in partnership, to ensure good health for Africa’s women and children.