Prime
We need a population control policy urgently
W.A. Luwemba
What you need to know:
- The plight of Mulago hospital is merely emblematic of the broader failure of public services to cope with the pressure resulting from rapid population growth.
I had always heard of the sorry state of Uganda’s health facilities and was knowledgeable about some statistics but such statistics are normally abstract until actual reality is encountered.
I visited Old Mulago Hospital Ward 16, a paediatric ward and the pain of our insufficient health services hit home – the ward is overcrowded, the large number of patients necessitates that they have their own attendants who end up sleeping on floors and the medical personnel are evidently overwhelmed by the enormous number of inpatients.
This insufficiency and inefficiency of public/social services is undoubtedly partially resultant from public sector leviathan corruption and previous political instability but it is to a large extent more attributable to government’s failure to curb the rapid population growth which hasn’t been planned to congruently fit with the available social services.
Mulago hospital, started in 1913 was one of Uganda’s first major health centres and in retrospective seems to have been sufficient to cater for medical needs of a proportion of Uganda’s population which was then around a paltry 2.5million (basing on the 1911 population census) yet the hospital hasn’t expanded to match Uganda’s population growth that has almost increased 14 times its size then (34,856,813 million according to the 2014 population census). Yet the plight of Mulago hospital is merely emblematic of the broader failure of public services to cope with the pressure resulting from rapid population growth hence the resultant abysmal inefficiency of these services.
It’s a situation that draws parallels to what the British clergyman Thomas Malthus envisaged in his famous 1798 Theory on population, where he foresaw a progressively geometric population growth rate overlap a consistently arithmetic food production growth rate over the same period of time resulting in the inability of the human race to sufficiently sustain itself hence effects like starvation that would have to lower the population to match the food production capacity – except that in our case it is the infrastructural growth and development rather than the food production growth that has failed to cope with the exponential growth in population even though the adverse effects such as high infant and maternal mortality rates, high rate of road accidents exist they cannot bring the population to an optimum level to match the infrastructural growth thus necessitating the direct intervention of government to curb this rapid growth.
Proponents of a high population as a precursor for economic development often bat around the Chinese example – arguing that a high population not only provides labour but also a ready market for both industrial and agricultural products and while this ought to be ideal it ignores the economic concept of ‘effective demand’ – where demand for something is backed by the ability to acquire it which isn’t evident in contemporary Uganda as the overwhelming constituent of the population is that of dependents hence the high age-dependency ratio (102.3 per cent according to the 2016 Uganda Demographics Profile) yet dependents directly contribute nothing to government’s resource envelope thus constraining its ability to develop and sustain a commensurate public infrastructure, a situation further compounded by the damning fact that population is higher in comparatively low income areas like rural (28,430,800 people living in rural areas compared to the 6,426,013 in urban areas – 2014 Uganda population census) yet it’s mostly the rural people who essentially depend on public social infrastructure and yet comparatively have little ability to contribute to its sustenance hence the strain.
The current ambitious investment in infrastructure like the extension of Mulago, construction of new Mulago and generally massive investment in roads is commendable albeit still insufficient to solve this massive strain on public infrastructure which imperatively necessitates government to develop a deliberate population control policy in order to make the population size symmetrical to the infrastructure thus, not only improving the quality of public services but also achieve far-reaching sustainable development that trickles down to all.
Mr Luwemba is an economist.
