Poverty Traps Adolescent Girls!

                                                           SOCIAL-ECONOMIC SITUATION IN BUSOGA REGION

Simon Mugudde – MAKEXAFRICA – Jinja Uganda: Busoga region comprises the 12 districts of Iganga, Jinja, Buyende, Luuka, Kamuli, Kaliro, Namutumba, Mayuge, Bugiri, Namayingo, Buvuma, and Bugweri comprising 73 Sub-Counties, 571 parishes, and 5659 villages – making up Busoga region. Busoga has the second largest regional population share of 9.7% of Uganda’s 48,582,334 people (only second Buganda region with 11.5%). UBOS (2021) observes that, “there is high population density in Busoga but with low levels of economic activity”. Poverty as major catalyst, has many consequences on Busoga, one of which is teenage pregnancy (2016 UDHS). Approximately, 33.5% of teenagers in the poorest households in Busoga were reported to begin childbearing, compared with only 15.1% in wealthy households (UBOS, 2021). 

Uganda National Household Survey (UNHS) 2016/17 reported as high as 14.5% the rate of poverty in Busoga, followed by Bukedi at 10.4% and Acholi at 10.3%. Out of the 8.3 million people believed to be below the poverty line in Uganda, 1.162 million people are in Busoga sub region. Approximately, 14% of all poor people in Uganda are in Busoga. UBOS (2020) ranked Busoga the poorest region in Uganda, attributing it to “poor population planning”. Poverty in Busoga increased from 8 million poor people in 2016/2017 to 8.3 million people in 2019/2020, indicting a 22% increase.

Compared to other regions of Uganda, the dependency ratio in Busoga is worryingly high. For instance, according to UBOS (2019) between 2012 and 2020 Busoga’s dependency ratio averaged at 114, which is higher than Buganda’s 88, Elgon’s 69, and Kampala’s 54. The worrying dependency ratio in Busoga is precipitated by the fact that the majority of the population lies in the 0-14 years age bracket (the dependency bracket). Further, many of the adults in the working age bracket of 15-64 years of age, are actually non-productive dependants. Moreover, there are also many people in the category aged above 65 years of age, who are complete dependants.

Approximately 29% of households in Busoga are headed by women, compared to 31.1% in Buganda, 36.6% in Kampala, 26.5% in Teso, 64.7% in Karamoja, and an average 31% across Uganda. Approximately, 11% of marriages in Busoga are polygamous, compared to only 2.6% in Kigezi, 7.6% in Buganda, 4.7% in Lango, 5.9% in Tooro, and 3.2% in Kampala. Polygamy is one of the fronted precipitator of poor health at household level, especially malnutrition, indicating that polygamous families are more likely to not afford enough nutritious food, given the large numbers of household(s) members.

For the period 2020-2021, overall literacy of persons aged 10 years and above in Busoga averaged at 67.4% compared to Kampala’s 93%, Buganda’s 83.5%, West Nile 75.2%, Bukedi’s 59.6%, and Kigezi’s 78.3%. Busoga’s literacy levels are not far different from the rest of the regions in Uganda, so why is the region consistently registering poor indicators, especially in health. More specifically, for instance, UBOS (2019/2020) reported that different parts of Busoga register different levels of literacy. In Bugiri literacy levels are at 39.8%, in Namayingo 17.7%, in Mayuge 39.6%, in Iganga 31.6%, in Kamuli 31.4%. According to the Uganda National Household Survey (2020), surprisingly, between 2018 and 2021, an approximated total of 41% of children between 3 and 5 years of age were in school, higher than Kampala’s 34.5%, and Kigezi’s 37.2%. Primary school enrollment in Busoga in 2020-2021 was averaged at 83%, compared to Kampala’s 87.3%, Bukedi’s 82.5%, Karamoja’s 43%, and Buganda’s 87%. Secondary school enrollment in Busoga in the same period was averaged at 33.9%, compared to Kampala’s 50.4%, Teso’s 7.7%, Lango’s 16.2%, and Ankole’s 28.7%. Questions still linger about why, with the high early enrollment in school, there is such a low school retention rate in Busoga.

According to the 2023 Uganda Demographic Health Survey, Busoga has one of the highest fertility rates at 5.7%, only second to Karamoja which is at 6.7%. Busoga also has one of the highest infant mortality rates, at 41.4 (for every 1,000 live births), compared to Teso’s 21.1 and Karamoja’s 26.1. For under 5 mortality, Busoga registers 65.1 (for every 1,000 lives births), the second highest in Uganda after West Nile’s 79.5. In 2021 KOICA reported a Uganda national maternal mortality rate of 336 compared to a 448 rate in Busoga region (for every 100,000 live births).

The national Sickle Cell Trait prevalence in Uganda stood at 13.3%, while in Busoga it was at 20%, according to a LANCET Global Health Study in 2017. Since 29% of the blood donated in Uganda is used to treat people with severe malaria and 17% to treat people with Sickle Cell Disease, and yet Busoga region has the highest prevalence of malaria and Sickle Cell Disease in Uganda, the need for establishment of a blood bank in Busoga is a matter of life and death. Further, while the average national prevalence of malaria in Uganda is 9%, Busoga has a prevalence rate of 21%.

The Uganda Demographic Health Survey (UDHS) 2022 shows that teenage pregnancy across Uganda regions, varies largely. Since 2011 the highest teenage pregnancy rates, have consistently, been reported in East-Central Uganda, registering 30.6% in Busoga, and this figure growing to 36.3% among 15–19-year-olds in 2021. As far as taking initiative to seek medical treatment, UBOS found out in 2021 that 33.7% of people in Busoga were reluctant to seek medical treatment because they though their illness was mild, while 30.6% indicated a lack of funds for medical consultations. Compared to other regions of Uganda, including Bukedi, Elgon, Teso, Karamoja, Lango, Acholi, West Nile, Bunyoro, Tooro, Ankole, and Kigezi, it was only Busoga with the highest percentage of people failing to seek medical attention because they could not afford medical costs. Approximated 83.8% of people in Busoga move a distance of up to 3 Kilometers to the nearest health center, while 5.2% moved a distance of over 8 kilometers. The distance to the nearest health center in Busoga is shorter than in some regions of Uganda but the willingness to seek treatment in other regions is higher than that in Busoga.









By Simon Mugudde

SIMON MUGUDDE is a project planning, monitoring, and evaluation consultant and founder of MAKEXAFRICA a Community Development Organisation improving health and well being of adolescent girls and young women in Jinja - Uganda. He has offered consulting services for various organizations, such as CIPESA, Busoga Health Forum, and USAID. Previously, he earned experience designing and implementing research and rural development projects. While at the UN he worked alongside expert researchers participating in large scale projects. He has supervised international interns and volunteers in Uganda, and has presented papers on rural development to local governments, Civil Society, and at international conferences. Simon attended the Queen of Apostles Philosophy Center where he graduated with a bachelor's of Philosophy. He attended Uganda Management Institute (UMI) where he graduated with a Post-Graduate Diploma in Project Planning and Management (PPM), a Post-Graduated Diploma in Project Monitoring and Evaluation (PME), a masters in Monitoring and Evaluation, and a Masters in Business Administration (MBA). His core priority currently is networking with individuals, groups, and institutions to further contribute to healthier lives and wellbeing of adolescent girls and young women in Jinja - Uganda.