The dangers that a fast growing population poses to Uganda

Dr Sekamatte warns that at this current growth rate, Uganda’s population is likely to double yet again in 22 years. “This poses serious planning challenges in terms of the limited availability of resources,” Sekamatte adds. This rapid growth is attributed to natural increase, due to the high fertility of Ugandan women, each producing an average of six children in their life time.

The existence of a large number of young potential child bearers has created a high momentum that has accelerated population growth, such that even if fertility was to drop drastically to replacement levels of around two children per woman, the population will continue to grow for the next 50 years or so. This, according to the 2008 National Population Policy for Transformation and Sustainable Development, has affected development of individuals, families, communities and the nation at large.

It adds that this has also undermined the economic gains the country has made in an effort to eradicate poverty at household level, in addition to putting pressure on provision of health services. We look at the various effects the high population has had on the country.

Less workers, more dependents

The fact that Uganda’s population is mainly constituted of young people aged 15 and below resulting into a high dependency ratio means means majority of Uganda’s population is unproductive and that the small population of the working Ugandans must support not only themselves, but at least two other people. According to the Uganda Bureau of Statistics, at the growth rate of 3.2 per cent, Uganda adds at least 1.2 million people to its population every year, worsening the dependence burden.

With 78 per cent of Uganda’s population being below 30 years, the country’s youth unemployment is said to be the highest in Africa. According to the recent study by Action Aid, youth unemployment is at 62 per cent, although the African Development Bank says it could be as high as 83 per cent. All this is because a high fertility rate produces a non-favourable age structure with more dependents than workers.

Dr Ssekamatte explains that in a situation of widespread poverty, high population growth rate is most unlikely to stimulate production and demand for goods and services because such a population lacks purchasing power.

Like President Museveni, some economic experts have argued that “the wealth of a country is not stones in the ground but its people”, but this view is not shared by Dr Jonathan Musinguzi. “There is no doubt that such a surge in population would increase pressure on government’s ability to provide social services as well as increase pressure on land and environmental protection,” says Musinguzi.

He adds that government needs to support measures that help individuals to plan their families as well as continue promoting voluntary family planning so that the country can have a rate of population growth that is manageable and is in tandem with the economic resources.

Dr Ssekamatte also argues that while it’s true that a country’s most precious resource is its population, for that population to be a useful resource it must meet certain conditions. With more than 50 per cent of the 34 million people being children who are dependents, unproductive and basically consumers, it instead becomes a burden.

Low quality of education

Dr John Sekamatte of the National Planning Authority explains that most of the bills paid by the government or households are on maintaining children in terms of health and education. “Because of the high proportion of children, it means that at macro level government is spending a non-proportionately high percentage of the resources on education and health and the same thing happens at household level. It will therefore be difficult for the family to break out of the poverty cycle.

“In terms of education a bigger population means more schools, more scholastic materials, more teachers etc, which is not achievable in the short and medium term hence low quality of education,” says Dr Jonathan Musinguzi the Africa regional director of Partners in Population and Development.

According to the Education and Sports Sector Performance Review 2012/2013, the teacher- pupil ratio is expected to reduce to 1:45 from 1:57 but the situation is different on the ground.

Mr Patrick Kaboyo the executive director Private School Teachers Association says “classes remain congested from primary right up to university level. At Makerere University for instance, the lecture rooms have been so congested that those who do not come early cannot even get a chance to get what the lecturer is saying, which is why we need to address the issue of population explosion.”

To try and address this, the government has been increasing budgetary allocations to the two sectors. In the financial year 2013/2014, the health sector received Shs940b, up from Shs852b in 2012/2013, accounting for about 7.2 per cent of the national budget of Shs13.1 trillion. The education sector received Shs1.8 trillion, the second biggest allocation after the roads and transport sector.

According to finance minister Maria Kiwanuka, government also increased salaries for Primary School Teachers by 15 per cent, and Science Teachers in Post Primary Education and Training Institutions received a 30 per cent wage increment. Even then, the sector still struggles.

Women with many children suffer ill health frequently

“Every pregnancy costs a woman nutrients to help the baby grow, including breastfeeding, so if the woman is going to get pregnant immediately after birth , she has not restored her own nourishment and consequently the child or both will suffer malnutrition,” says Hanifa Namusoke a nutrition expert at Mulago Hospital’s Mwana Mugimu Nutrition Centre.

She says the woman may not necessarily be small but she will be short of important body nutrients like calcium and iron. In the initial days of pregnancy, the baby is made of only blood as it grows inside the womb, increasing the demand for iron to support the baby to grow. The reserves that the mother has are then used to sustain the baby up to six months of age from birth.

“A lot of calcium is needed from the woman for bone formation, head, and skull, etc. Unfortunately a woman can only save or deposit calcium up to the age of 35. After that, there is depreciation because of age and if she continues to give birth she is at risk of suffering from osteoporosis (depletion of calcium from the bones),” Namusoke adds.

On top of depleting nutrients, when there are multiple births, all these children need attention and it’s primarily given by the mother who divides her energies both physically and emotionally. Unfortunately, it’s at the cost of her own wellbeing because she has to satisfy the children and deny herself happiness which causes physical and emotional stress or even break down in extreme cases.

Less food leads to stunted growth

Another area that is seriously threatened is agriculture and food security. Households do not have sufficient resources for investment and improvement of their livelihoods; they have been trapped in primary agriculture which is not conducive for food security.

According to Kaboyo, the high poverty levels resulting from having large families, continue to contribute to the school drop-out rate now standing at 33 per cent. He however says that with conscious planning this can be turned into a resource if the fertility rate can be reduced from the current six children to about three per woman in a life time.

The high population growth rate has affected the quality and quantity of food at the household level resulting into food insecurity in some communities. Women and children are the most affected leading to widespread malnutrition with 38 per cent of children below five being stunted, according to the latest report by UNICEF (2013).

Uganda’s Health, Nutrition and Food Security Assessment in Ibanda, Kabale, Kanungu and Pader districts shows that 34.9 per cent of children below five are stunted.

One man’s big family dilemma

The story of Paul Owori of Misoli village in Mayuge district mirrors the situation in many homes that are grappling with huge family sizes.
A father of 12 children aged two to 24, Owori says he can hardly produce enough food for his children because he owns a piece of land just big enough for his two bedroomed mud grass-thatched house.
Only two of his children are in school while the rest have dropped out to help out with tilling other people’s gardens for the day’s meal.
With limited resources, the huge family size has undermined Owori’s savings and has thus made it increasingly difficult for him to adequately feed, clothe, house, educate and provide medical care for his children.

A burden to the woman
Frequent child bearing has also deprived Owori’s wife, Christine the opportunity for gainful employment and career advancement. It has also increased susceptibility to ill health. “My wife has not been able to avoid a pregnancy even when we didn’t want to have a baby because we just do not know how to do it. “All the options that we are usually given have got serious side effects, some cause cancer and even barrenness. I can’t let her use them,” Owori explains.

Little does he know that even having many children also wears out the woman’s body quickly.
With 12 mouths to feed, Owori and his wife have to deal with the competition for food not only in terms of quantity but quality as well, because the more children, the less food available with adequate nutrients hence malnutrition. But that’s not all that the couple has to deal with. Since there are many children, Christine uses a lot of physical energy yet reproductive health experts recommend that a woman needs to rest for her body to nourish itself and prepare for a new child.

This however does not happen because she does not have time to rest as she is busy cooking among other house chores and is always tired. As a result, at the age of 43, Christine looks twice her age and this has affected her productivity in the garden and house chores. There are many families like that of Owori, producing child, after child without being able to give them a better future. And this unfortunately results in a vicious cycle.

Fertility rate has to be managed well

To reverse all these negative effects of population explosion, Dr. Ssekamatte suggests that the family planning unmet need be addressed to reduce the fertility rate by about 30 per cent. Additional expenditure was seen last financial year in an attempt by government to improve human development with 6,172 health workers recruited to work at Health Centres and remuneration of Medical Officers at Health Center IVs enhanced. This was meant to among other things bring reproductive health services including family planning closer to the rural population that is most affected.

Population experts have downplayed the fear that the President may have to lose the large population with all its benefits, explaining that the current young generation will continue to grow for the next 60 to 70 years even if the fertility was cut by half today.

Dr Musinguzi explains that what will change though is the age structure. This means that fewer children will be added to the population every year, the dependence ratio will be turned around, having more people in the working age bracket.

The challenge then remains with raising the quality of this growing population so that the country can benefit from this demographic “bonus” instead of turning out to be a demographic “burden”.
Meanwhile Dr Patrick Birungi, the director in charge of planning of NPA gives a ray of hope saying government is in the process of reviewing the population policy with focus on investing in improving quality of the population to increase productivity.

He adds that the planning strategy for the next five years is focused more on improving education and health services, to not only help keep the girl child in school longer so as to reduce the number of babies she can have in a life time, but also increase her access to family planning services.
Dr Birungi also says government is now focusing on investing more in the youth in terms of right skills and education through such programmes like Skilling Uganda.