Oyam District’s Violent Past
Oyam District’s Health Profile
Uganda’s Health Profile
Until 2007, Oyam, and northern Uganda had been subject to 20 years of armed conflict and insurgency. Under the Joseph Kony and his Lord’s Resistance Army, 2 million people were displaced from their homes. Some 20,000 children were abducted and forced to work as soldiers, sex slaves or porters. During this time, villagers were forced to live in refugee camps. There was widespread social breakdown. Traditional lifestyles and values were lost as families and clans were dislocated and often destroyed.
Oyam District contains 910 villages within 61 parishes. Despite a government recommendation for each parish to have a health center, only 30 health centers operate in Oyam District. Many health centers are understaffed, lacking the recommended midwife, enrolled nurse, 2 nursing assistants, and a health assistant.
Maternal and child health continue to be a major cause of morbidity and mortality in Uganda, besides HIV and Malaria. With a health expenditure of 6.53% of GDP (WHO, 2018), it would be a miracle for the country to achieve its targets for Millennium Development Goals (MDG) 4 and 5. The high infant mortality rate of 33.8/1,000 live births (UNDP, 2018), out of which 19/1,000 live births are neonatal deaths, reflects the need to capitalize on Primary Health Care opportunities for children at birth and in the first year of life. Similarly, the Maternal Mortality Rate (MMR – 343 per 100,000 live births) has not declined in the past decade. Exacerbating the already gloomy situation, the fertility rate has remained high at 6 children per woman, primarily due to a variety of factors, including lack of access, cultural desire for more children and early initiation of sexual intercourse (UNICEF, 2015). Many of these problems are linked, at least in part, to limited service delivery in rural areas, the community and household levels, and to the quality of the services that do reach them.
The tragedy and opportunity – is that most of these deaths can be prevented with cost-effective health care services. Reducing maternal mortality and disability will depend on identifying and improving those services that are critical to the health of Ugandan women and girls, including antenatal care, emergency obstetric care and adequate postpartum care for mothers and babies, and family planning and STI/HIV/AIDS services.