Note: This document may not always reflect the actual appropriations determined by Congress. Final budget allocations for USAID's programs are not determined until after passage of an appropriations bill and preparation of the Operating Year Budget (OYB).
UGANDA
FY 1997 FY 1998 FY 1999 Actuals Estimate Request
Child Survival and Disease.......... $ 18,599,759 $20,814,000 $19,100,000 Development Assistance.............. $ 23,918,319 $23,900,000 $29,200,000 P.L. 480 Title II........................... $ 25,071,955 $29,012,000 $ 5,284,000
Introduction
Assistance to Uganda directly serves several vital U.S foreign policy interests. First, Uganda's economic re-birth and subsequent unparalleled growth, which have been achieved through adopting free market principles, serve as a model to other developing countries while directly increasing U.S. investment opportunities. Its political evolution allows it to serve as an increasingly stable regional ally which exerts growing influence on neighboring countries (Kenya, Tanzania, Rwanda, Democratic Republic of Congo and Sudan). A net food exporter with vast agricultural potential, Uganda is the country best-situated in the region to provide food for surrounding crisis situations (alleviating the U.S. and international burden). Uganda serves as a last refuge for several unique and globally important species including half the world's remaining mountain gorillas. Its effective and aggressive HIV awareness and treatment campaign has significantly reduced the rate of new infections and serves as a model for the rest of the world. Uganda's commitment to universal primary education provides the essential foundation to increase economic output and promote meaningful participation in governance. And, the unprecedented decentralization of government and the creation of a legal framework to guarantee women's political participation are unique innovations and deserve continued U.S support.
The Development Challenge
Decades of neglect and abuse by corrupt governments, rebellions, and anarchy have left the country in extreme poverty which is exacerbated by population pressures coupled with unsustainable use of natural resources, diminished agricultural productivity, a non-functioning health delivery system, and a crumbling education sector (primary enrollment hit an all-time low of 50% in 1985-86). Starting from this backdrop, and amidst continued violence and conflicts, the challenges and constraints to development are formidable.
Constraints notwithstanding, Uganda has embarked on a remarkable transition over the past 10 years. However, Uganda still remains a "Heavily Indebted Poor Country (HIPC)," with a debt burden of 64% of gross national product in 1995, and has been declared by the International Monetary Fund as one of the first beneficiaries under its HIPC-initiative. For continued growth, Uganda will require external assistance to finance a high percentage of its development budget for at least the next 10 years. Currently, approximately one-third of public expenditure is externally financed.
The USAID program supports Uganda's remarkable recovery from decades of complete social and economic collapse (gross domestic product has averaged 6.5% growth over the past three years), and assists in creating a more business-friendly environment to attract investment. USAID also promotes the successful economic exploitation of Uganda's comparative and competitive market advantages.
USAID addresses the development challenge by providing support in basic education, infrastructure (rural roads), decentralization, privatization, health, agriculture, the environment and financial services for small businesses. The program is also addressing constraints to full competitiveness through building human capital and technical competence. USAID's assistance has been instrumental in establishing a $100 million per year non-traditional agricultural export sector, rehabilitating 6,700 kilometers of agricultural feeder roads, reclaiming endangered habitat resulting in a surge of eco-tourism, reducing both fertility and HIV transmission, revitalizing the primary education system, and strengthening democratization.
Other Donors
In November 1997, donors collectively pledged $800 million at the annual donors' meeting convened by the World Bank, Uganda's largest donor. In 1996, the United States was the fifth largest donor overall and the third largest bilateral donor after the United Kingdom and Denmark. Donor coordination is good and USAID provides parallel financing for major health and education sector reform programs with the World Bank and other bilateral donors.
FY 1999 Program
USAID's program combines investments in economic growth, basic education, health, environmental management and pluralistic government. Broad-based, agriculture-led, market-oriented economic growth remains the linchpin of the program. USAID maintains a well-established predominance in the five strategic sectors in which it is active.
Smallholders, who dominate the agricultural sector, face limited access to credit and extension services, appropriate technology, adequate transportation systems, secure land tenure, marketing services and price information. Funds will impact Uganda's rural poor by focusing on agricultural productivity, infrastructure, access to financial services, and policy and regulatory reform to facilitate micro/small business development. Over the next three years, financial services will provide 50,000 new savers with access to credit, over half of whom are women. Development assistance will also build the basic educational skills necessary to raise productivity and provide an informed and responsible electorate. USAID's policy dialogue (through non-project assistance) has served as a catalyst to open the textbook market to competition, improve teachers' terms and conditions of service (salaries have increased ninefold), construct hundreds of classrooms, and train over 8,000 teachers.
Uganda's track record in expanding economic opportunity, USAID's successes, and on-going efforts in food security, favorably position Uganda to make effective use of funds to expand the production of food crops in direct support of the Greater Horn of Africa Initiative (GHAI) principles.
Uganda, one of USAID's Biodiversity Priority Countries, contains unique ecosystems critical to the conservation of globally important bio-diversity. Population pressures and other constraints mentioned earlier pose substantial environmental threats. Funding will address these challenges by assisting Uganda in responsibly managing targeted ecosystems through expanding protected critical habitats, expanding eco-tourism, and creating management systems which financially unite surrounding communities to save the nation's resources.
HIV infection; high fertility, closely spaced births and teenage pregnancies; and chronic under-nutrition are major contributors to infant and child mortality. Poor quality, inaccessible obstetric care and a large number of illegal abortions combined with poorly spaced births produce high rates of maternal mortality. USAID will continue to play a pivotal role in reversing indicators in all these areas through an aggressive social marketing program of condoms, a mass media HIV public awareness campaign, improved community health education, training, and the provision of HIV testing and counseling.
In 1997, Uganda devolved nearly all central powers to its 45 districts where one-third of all local office holders will be women. USAID is assisting the Ministry of Local Government and the Decentralization Secretariat in implementing this bold political move which places political decisions and accountability directly at the district level. USAID will assist in establishing standards of performance and accountability while increasing public awareness and civil society advocacy. USAID is also assisting the Parliament in establishing research and reference facilities and working with the Uganda Law Reform Commission to codify Uganda's laws and regulations.
UGANDA
FY 1999 PROGRAM SUMMARY
(in thousands of dollars)
USAID
Strategic and Special
Objectives
Economic
Growth &
Agriculture
Population
& Health
Environment
Democracy
Human
Capacity Development
Humanitarian Assistance
TOTALS
S.O. 1 Increase Rural Household Incomes
- DA
- P.L. 480/II
14,500
---
---
---
---
---
---
---
---
---
---
5,284
14,500
5,284S.O. 2
Critical Ecosystems Conserved
- DA
---
---
6,000
---
---
----
6,000
S.O. 3:
Quality Basic Educ. for an Increased Percent of Ugandan Children.
- CSD
---
---
---
---
8,780
---
8,790
S.O. 4: Increased Service use and Changed Behaviors for Reproductive, Maternal and Child Health.
- CSD
- DA
----
----
10,310
6,400
----
----
-----
-----
-----
-----
-----
-----
10,310
6,400S.O. 5: Demand for Constitutional Checks and Balances Institutionalizd.
- DA
----
-----
-----
2,300
-----
-----
2,300
Totals
- CSD
- DA
- P.L. 480/II
---
14,500
---
10,310
6,400
---
---
6,000
---
---
2,300
---
8,790
---
---
---
---
5,284
19,100
29,200
5,284
USAID Director: Donald B. Clark
ACTIVITY DATA SHEET
PROGRAM: UGANDA
TITLE and NUMBER: Increase Rural Household Income, 617-SO01
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $14,500,000 DA; $5,283,320 P.L. 480 Title II
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 2001
Purpose: To increase the income of rural families by increasing land and labor productivity and production of basic food crops, promoting non-traditional agricultural exports and facilitating the start-up and expansion of micro and small businesses.
USAID Role and Achievements to Date: Nearly 90% of Uganda's population derives most food and income from small-scale and cash-crop agriculture. Over the past decade, the agricultural sector has decreased from 57% to 45% of gross domestic product as industry and services have revitalized. Unlike many African countries, Uganda's vast tracts of fertile, uncultivated arable land and abundant rainfall offer vast potential. Despite Uganda's record economic growth, the World Bank estimates that about half of Uganda's population lives on less than $1 per day. USAID activities impact Uganda's rural poor, focusing on smallholders who face limited access to credit and extension services, appropriate technology, transportation systems, land tenure, marketing services, and price information.
This activity directly tackles these constraints by: 1) increasing the productivity of basic food crop staples such as maize and beans (over 900 USAID-funded improved-seed demonstration sites each year reach about 40,000 maize and bean farmers; success can be measured by the demand for improved maize seeds alone which quadrupled this year) and 2) diversifying and expanding non-traditional agricultural exports (NTAEs). For example, one NTAE--flowers--has increased from two metric tons (MT) in 1990 to over 1,500 MT in 1997, worth over $12 million.
Over the past five years, over 100,000 micro and small businesses have been established. USAID has taken the lead in microenterprise development and works closely with Other Donors This activity will affect trade and investment by reducing regulatory impediments; for example, USAID has supported efforts to remove government "red tape" by computerizing and simplifying forms for registering businesses. To create an enabling environment for businesses, USAID has contributed to policy and regulatory reforms; for example, USAID has supported the National Forum, facilitating public/private sector dialogue, which has proven highly effective in persuading the Government of Uganda (GOU) to change policies and regulations that impede private sector development. In addition, USAID has contributed to the development of the dairy sector, which is combining sound cooperative development with effective business practices.
Description: USAID is well-positioned to improve the enabling environment in the economic growth sector. The Investment in Developing Export Agriculture (IDEA) activity helps to expand and diversify Uganda's export base by increasing food crop production and exports such as maize and beans to the Greater Horn of Africa and high value commodities such as fruits and vegetables, vanilla, and cut flowers to U.S. and European markets. IDEA is expected to reach tens of thousands of smallholders and significantly expand the number of commercial NTAE enterprises over the next five years. The Private Enterprise Support, Training and Organizational (PRESTO) development activity is expanding rural financial services to micro and small businesses, tackling second tier policy and regulatory constraints to business development, and improving capacity of local associations to attract and increase trade and investment opportunities. Within the next three years, financial services will provide 50,000 new savers with access to credit. PRESTO will facilitate the GOU's adoption of an arbitration unit for settling business disputes; work with Parliamentarians to pass laws for tax arbitration; and work with the GOU to ease inter-departmental actions. For example, the Ugandan Investment Authority certifies the investment level for companies which dictates the number of work permits that the
Immigration Office can issue; but the linkage needs improvement. The Agricultural Non-Traditional Export Promotion activity focuses on food crop production by improving crop handling and post-harvest storage methods. Currently, crop loss value is estimated at $18 million a year; USAID aims to reduce these losses by 30%, in effect increasing rural incomes by approximately $6 million per year. Through the activities of the Cooperative Agriculture and Agribusiness Support activity, the Cooperative Bank, a formal financial institution with the most viable rural banking network, is being restructured to achieve long-term sustainability. Cooperative Bank's rural banking network will provide over 100,000 rural inhabitants with direct access to financial services. P.L. 480 resources will support the Cooperative Bank, as well as rehabilitate and maintain 2,500 kilometers of rural feeder roads to increase food security among rural farmers and businesses. Finally, Greater Horn of Africa Initiative activities, including the ongoing design of an economic recovery program for Northern Uganda through cash infusion and basic infrastructure rehabilitation, are included in this SO. The Northern Uganda Food Security activity provides food to displaced persons while promoting a return to food security and the revival of trade links with southern Sudan.
Host Country and Other Donors: The GOU's "Poverty Eradication Action Plan," dated 1997, focuses on "increasing economic opportunities particularly in agriculture" as one component of its five-part strategy. Equally important is the GOU's commitment to creating a business-friendly environment through continued adherence to structural reforms and liberalized trade and payment systems. In addition to the GOU and the Ugandan private sector, USAID's partners in this sector include the World Bank, the European Union and bilateral donors including Denmark and the United Kingdom. Overall, donor assistance to economic growth activities is projected at $140.7 million over the FY 1997/1998.
Beneficiaries: Ten percent of Uganda's rural households, or 1,700,000 people, are expected to have increased incomes and improved food security directly as a result of USAID's program. Based on current experience, as many as 80% of the smallholders who grow non-traditional agricultural exports are expected to be women. Women are also expected to comprise more than half of the borrowers in USAID-supported micro-credit lending activities.
Principal Contractors, Grantees or Agencies: Implementors include Chemonics International, Agricultural Cooperative Development International/Volunteers Overseas for Cooperative Assistance (ACDI/VOCA), Foundation for International Community Assistance, Land O' Lakes, Mississippi State University, Management Services International, Africare, and World Vision.
Major Results Indicators: Baseline Target (1999) Average household expenditures Central Region $52 (1992/93) $104 Western Region $46 (1992/93) $64 Eastern Region $43 (1992/93) $55 Production of maize and beans (in millions) 1.05 MT (1995) 1.8 MT Gender-differentiated baseline data, available from 1995, and targets for one of the projects are: Average household income of NTAE project participants Low Value NTAE (MH)See footnote 1 $74 (1995) $97 Low Value (FH)See footnote 2 $47 (1995) $63 High Value (MH) $83 (1995) $102 High Value (FH) $67 (1995) $86 Number of rural savers and borrowers 5,000 (1995) 26,500
ACTIVITY DATA SHEET
PROGRAM: UGANDA
TITLE AND NUMBER: Critical Ecosystems Conserved to Sustain Biological Diversity and to Enhance Benefits to Society, 617-SO02.
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: 6,000,000 DA
INITIAL OBLIGATION: FY 1997; ESTIMATED COMPLETION DATE: FY 2001
Purpose: To maintain the integrity of biologically diverse, economically important ecosystems through strengthening appropriate management entities; to reduce destructive pressures on the ecosystems; and to promote an environmental policy framework compatible with conservation.
USAID Role and Achievements to Date: Uganda is one of USAID's key biodiversity countries because ecosystems critical to the conservation of globally important biological diversity lie within its borders. Improper or inadequate management of these ecosystems, together with external pressures brought on by poverty and population growth, have placed Uganda's unique biological diversity at risk. Managed wisely, these ecosystems can continue to serve as repositories for biological diversity while providing a foundation for sustainable economic growth in Uganda. The economic vitality of each component of the country's agricultural sector - livestock, fisheries, food and cash crops - hinges on the health of these natural resources. USAID assists Uganda in conserving targeted biologically diverse and economically important ecosystems through the Conservation of Biodiversity for Sustainable Development activity.
At the national level, USAID has strengthened Uganda's policy and institutional framework for environmental management. At the local (e.g., protected area) level, USAID assists the Uganda Wildlife Authority (UWA), the organization responsible for managing protected areas (national park reserves), non-governmental organizations (NGOs), and local governments and communities to better manage critical ecosystems. USAID's efforts have led to major improvements in the policy and institutional framework. A National Environmental Action Plan (NEAP) has been adopted and landmark enabling legislation passed. Dialogue on land tenure reform has led to a new draft law, compatible with both conservation and development. Six new national parks have been created since 1991, bringing to 10 the number of parks within Uganda's protected area system. These new parks currently represent the core of USAID's target ecosystems for conservation. Important progress has been achieved in these areas, as well as in other ecosystems not formally protected in Uganda. Implementation of the NEAP and its enabling legislation has been supported through the National Environment Management Authority (NEMA), which is responsible for overseeing, coordinating and monitoring all activities concerning the environment. USAID has assisted NEMA to achieve important progress in enhancing monitoring and information dissemination capabilities, environmental impact assessment standards, environmental education policy, and sensitization of politicians to environmental issues.
USAID is a key player in the ongoing restructuring of UWA, helping to build a solid foundation for long-term effective management of Uganda's protected area system. Prospects for increases in nature-based tourism are good, although regional insecurity negatively impacted tourism levels during 1997. However, in western Uganda, further growth in the tourism sector is anticipated as security is re-established. Privatization of state-owned tourism concessions has been completed and important investment in tourism-related enterprises continues. USAID has successfully stimulated small-scale investment in conservation-friendly activities such as tourism ventures launched by local communities (for example, small lodges for accommodations and meals). Such investment continues to be an important factor in boosting tourism, local revenues and employment.
New policies for sharing the benefits of improved conservation of protected areas with neighboring communities, including revenue sharing, access to in-park resources, and participation in management planning and management have encouraged communities to embrace conservation of park resources.
Increasingly, local communities are seeing the benefits of conservation of these ecosystems and are becoming stakeholders, as opposed to adversaries, in conservation. For example, villages receive 15% of park revenues and have used this income to build classrooms and health clinics.
Finally, USAID assists the Government of Uganda (GOU) in its response to the uncontrolled spread of destructive water hyacinth plants in Lake Victoria, a regionally important ecosystem and the second largest fresh water lake in the world. Important progress has been made in devising a control plan and in deploying available resources to combat the hyacinth problem in severely affected areas.
Description: At the national level, USAID assistance focuses on development and implementation of a comprehensive strategy to address environmental issues through policy, legislation and institutional reform encompassed in the NEAP and its associated legislation. USAID provides technical assistance and training to NEMA, the institution charged with implementing the NEAP. USAID also supports the work of the GOU and U.S. and local NGOs to better manage ecosystems through capacity-building of local and national partners and through the development of sound natural resource management practices. These organizations also work to create conservation incentives for local communities that result in more broadly shared benefits from conservation and increases public awareness. USAID also supports management-oriented research designed to better inform the decisions of ecosystem managers.
Host Country and Other Donors: USAID works most closely with NEMA on broad policy and institutional issues, and with the UWA on protected areas management. On conservation issues concerning non-protected areas, USAID works with local governments and NGOs. USAID collaborates with other donors, including the World Bank, the United Nations Development Program, European Union, German Technical Cooperation, and Danish International Development Agency to ensure overall donor coordination in natural resource management. USAID also works closely with the U.S. Peace Corps and U.S. Department of Interior.
Beneficiaries: Loss of biological diversity presents a threat to the global environment. Within Uganda, activities implemented under this SO benefit the nation by increasing the efficiency of management of natural resources and by increasing foreign exchange and employment from the growing nature-based tourism industry. Activities implemented by NGOs in areas adjacent to national parks benefit rural communities. Water hyacinth control activities benefit the people of Kenya and Tanzania as well.
Principal Contractors, Grantees or Agencies: Activities under of SO 2 are implemented by U.S. contractors, private for-profit companies, and U.S and host country private voluntary organizations and NGOs, including Associates in Rural Development, Aquatics Unlimited, Agricultural Cooperative Development International/Volunteers in Overseas Cooperative Assistance (ACDI/VOCA), Consortium for International Development, Cooperative for American Relief Everywhere (CARE), World Wildlife Fund, and African Wildlife Foundation.
Major Results Indicators: Baseline Target (2001) Annual park user fee revenues $67,000(1990) $3 million Number of critical ecosystems operating under management plans 3 (1991) 22 Area under highest level of protective status (square kilometers) 7,540 (1991) 11,023 Population of key indicator species: Mountain Gorilla 280-300 (est. 1990) 300 Area of water hyacinth covering Lake Victoria (hectares) 6,000 (1995) 750
ACTIVITY DATA SHEET
PROGRAM: UGANDA
TITLE AND NUMBER: Quality Basic Education for an Increased Percentage of Uganda Children, 617-SO03
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: 8,790,000 CSD
INITIAL OBLIGATION: FY 1992; ESTIMATED COMPLETION DATE: FY 2001
Purpose: To improve quality basic education for an increased percentage of Ugandan children by continuing the development of delivery systems to improve school quality and addressing issues of equity, specifically measured to increase girls' persistence in primary education.
USAID Role and Achievements to Date: Uganda's ability to build a free democratic society relies on the knowledge, attitudes and skills of its citizens. This ability is severely constrained by the poor quality of basic education. Decades of civil strife left the Ugandan education system in shambles. Although significant improvements have been made in the quality of primary education since 1992, these achievements will have to be recast in the context of the bold Government of Uganda (GOU) decision to embrace universal primary education (UPE). The UPE initiative which allows free education for four children in every family approximately doubled the primary school population from 2.7 to 5.2 million students in 1997. While the GOU's commitment to increased access for all children to primary school is laudable, it has put strains on the effectiveness of the primary education system. Sustaining Uganda's remarkable economic recovery and spreading its benefits require an effective education system. Evidence from other developing countries has convincingly demonstrated the link between investments in basic education and agricultural and manufacturing productivity, reduced fertility and poverty, improved income distribution, and the establishment and functioning of non-governmental institutions in civil society. USAID's decision to support primary education in Uganda is based on the recognition of the role education will play in the country's continued revival and the links between human resource development and the achievement of USAID's other strategic objectives.
USAID's Support to the Uganda Primary Education Reform activity finances key elements of the GOU's education reform program. After five years, significant results have been achieved. Some 8,000 principals, teachers, and tutors, representing 11% of the primary teaching force, are currently enrolled in USAID-sponsored in-service training programs. USAID policy dialogue was a major factor in the GOU's decision to quadruple primary education expenditures between 1992 and 1997 (from $30 million to $120 million) and increase teachers' salaries nine-fold (from $8 per month to $72 per month). Moreover, accumulation of savings has dramatically increased in selected pilot areas through the development of teachers' credit unions. In order to foster transparency, every school is now required to publicly display budgets specifying their GOU allocations, to inform parents and teachers and allowing them to fully participate in decisions affecting their locale. Instructional materials and textbooks, once a government monopoly, have been converted to a competitive market, eliminating inefficiency and corruption. This policy has led to the growth of vibrant local publishing and printing industries and to the growth of the local retail book market. Individual schools are now able to select the materials they need most. Approximately four million USAID-financed textbooks have been distributed to schools. Research on school quality is providing insights into the impact of educational reform activities and suggesting new approaches.
Description: USAID's education program targets five policy objectives as precursors to establishing an environment in which primary education can flourish for a majority of Ugandan children. First, USAID will work with the GOU to establish and promote a policy framework that enables all children to go to primary school. A related objective is to work with the GOU to formulate policies to govern critical financing decisions supporting UPE. Although the GOU has quadrupled its allocations to primary education over the past five years, the cost of UPE exceeds current levels of financing. A third objective is to continue improving the quality of instruction by expanding in-service teacher training
programs to the remaining half of the country, sustaining policies which improve teachers' terms and conditions of service, and providing instructional materials on a continual basis. Fourth, USAID will continue to actively promote analysis, dialogue and programs that improve girls' participation and achievement in primary school through community awareness programs. Finally, as the GOU's policy of decentralization places management responsibilities for primary schooling with local government, USAID will support activities that strengthen the institutional capacity of district administrations and promote the formation of civic organizations in order to effectively lobby for improved education services and increased accountability.
Host Country and Other Donors: Donor participation in the education sector has increased significantly since 1992 due to the GOU's proven commitment and because the GOU's educational reform program provides an effective framework for coordinating external finance to the sector. USAID has been the largest donor in the sector, and its resources are complemented by those of Other Donors The educational activities of USAID and the World Bank were designed simultaneously to ensure integrated support to primary education reforms as identified by the GOU. Based on the results being achieved, other donors have entered the sector. The European Union and Dutch, Irish and British governments are financing expansion of educational reform activities to areas of the country that are underserved and are planning to provide budget support to common policy and implementation frameworks in coordination with USAID. Denmark, Germany, ActionAid, and other NGOs have been active in the area of education for teachers, adults, the handicapped, and disadvantaged groups such as AIDS orphans. UNICEF has a program to educate out-of-school girls through non-formal approaches.
Beneficiaries: Five million school-aged children and the country's 75,000 primary school teachers directly benefit from USAID's program.
Principal Contractors, Grantees, or Agencies: Activities contributing to the achievement in basic education are implemented by a number of U.S. institutions including the Academy for Educational Development, the American Institute for International Research, Creative Associates, the University of Massachusetts, and the Research Triangle Institute.
Major Results Indicators: Baseline Target (1995) (2002) Grade 4 completion rate 63% 83% Grade 7 completion rate 35% 60% Gross enrollment ratio (Number of students as % 73% 85% of total school age population)
ACTIVITY DATA SHEET
PROGRAM: UGANDA
TITLE: Increased Service Utilization and Changed Behaviors Related to Reproductive, Maternal and Child Health, SO04
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $10,310,000 CSD; $6,400,000 DA
INITIAL OBLIGATION: FY 1995; ESTIMATED COMPLETION DATE: FY 1999
Purpose: To reduce fertility, the transmission of HIV and maternal and child mortality by: 1) improving the availability and quality of reproductive, maternal and child health services; 2) increasing knowledge and changing attitudes related to reproductive, maternal and child health; and 3) enhancing the financial sustainability of primary health care services.
USAID Role and Achievements to Date: USAID-funded programs are active in 15 of Uganda's 45 districts, which include about 35% of the country's population. USAID has major program activities in 12 of those districts in addition to a national contraceptive social-marketing program.
USAID's program emphasizes maternal and reproductive health. Over the past several years, USAID has been responsible for major initiatives in upgrading the skills of health care providers in family planning and maternal health, mass-media communications, community health education, contraceptive social marketing, and HIV testing and counseling. More recently, USAID has increased its emphasis on sexually transmitted diseases (STDs), a major factor in HIV transmission, and in health-care financing and private-sector development.
These activities have increasingly measurable effects. In 11 of the 12 districts where USAID has major activities, contraceptive use has increased since 1995 from 13.2% to 19.4%. (Due to security concerns data can not be gathered in the 12th district at this time.) During the same period, women not using contraception because of incorrect information or lack of a known source of service have declined from 20% to 16.8%, and the percentage of adults who know that condom use can prevent HIV infection increased from 22% to 58%. Data continues to indicate that declines in HIV prevalence have continued for the fifth consecutive year among ante-natal mothers at sentinel surveillance clinics in areas where USAID programs are being implemented. USAID-funded HIV testing and counseling are now available at 18 sites in eight districts.
Description: USAID's greatest potential and established comparative advantage for reducing mortality and lowering high fertility are in those areas associated with childbirth and high-risk sexual behavior. USAID will continue to fund activities to: 1) increase the availability and quality of health services related to family planning, HIV and other STDs, and to the care of mothers and infants; 2) encourage the adoption of behaviors which will reduce the risk of acquiring HIV, unwanted pregnancies, and maternal and child death, including optimal breastfeeding and nutritional education; and 3) enhance financial sustainability of maternal and child health services by increasing revenue generation at public facilities and increasing the private-sector provision of care, including the establishment of endowments for private health-care organizations.
Host Country and Other Donors: USAID is the most significant donor in the areas of maternal and reproductive health in Uganda, in terms of the amount and the quality of resources provided. Donors of direct relevance to USAID's program include Britain's Department for Overseas Development, the UN Population Fund, and the World Bank. The World Bank is the largest donor in the sector with active projects related to STDs, delivery of basic health services at the district level and a new nutrition project which is about to begin. Other major bilateral donors include Denmark, which provides significant funding for essential-drug supply and management, support for the Ministry of Health's training and planning units, pre-service training, and improved primary care in three districts. UNICEF and World Health Organization provide assistance in child survival and maternal health.
Beneficiaries: Approximately seven million people are potential beneficiaries of USAID's health activities, including about 1.5 million women of reproductive age. In addition, the contraceptive social marketing program serves the commercial market for condoms nationwide.
Principal contractors, Grantees or Agencies: U.S. NGOs: Pathfinder International, African Medical and Research Foundation, Cooperative for American Relief Everywhere (CARE), AVSC International; U.S. Universities: Johns Hopkins University, University of North Carolina; U.S. firms: E. Petrich and Associates, The Futures Group, John Snow International; Ugandan NGOs: The AIDS Information Center, The AIDS Support Organization.
Major Results Indicators: Baseline Targets(1999) Contraceptive Prevalence (9 districts) 13.2% (1995) 25% Assisted deliveries (sample of facilities) 59,000 (1996) 77,000 Exclusive breastfeeding, 4-6 mos. (9 districts) 21% (1995) 50% Condom sales 9.5 mil/yr (1996) 15 mil/yr HIV testing/counseling (persons) 35,000 (1997) 80,000
ACTIVITY DATA SHEET
PROGRAM: UGANDA
TITLE AND NUMBER: Demand for Constitutional Checks and Balances Institutionalized, 617-SO05
STATUS: Continuing
PROPOSED OBLIGATION AND FUNDING SOURCE: FY 1999: $2,300,000 DA
INITIAL OBLIGATION: FY 1997; ESTIMATED COMPLETION DATE: FY 2003
Purpose: To strengthen and increase the demand for constitutional checks and balances in the Ugandan political culture in order to make government more accountable to its citizens.
USAID Role and Achievements to Date: Uganda has embarked on a remarkable transition over the past 10 years, moving from endemic anarchy, internecine violence, pervasive human rights abuses, wholesale government corruption accompanied by outright looting, and the near-destruction of both a functioning government and civil society counterparts. The combined Amin-Obote era and its aftermath brought Uganda international notoriety and ridicule, leaving most observers in doubt as to whether order, let alone progress, could successfully be re-established. Beginning in 1986 when the National Resistance Movement gained control, Uganda has undergone phenomenal change and achieved enviable progress on all fronts. The resulting transition has changed Uganda's political culture from violent, arbitrary despotism and anarchy to respect for the rule of law and the emergence of democracy. Benchmarks of this change include promulgation of a new constitution, the election of a government by universal adult suffrage, the devolution of authority and resources to local government, and a reduction in state-sponsored human rights abuses - all important steps in the right direction. These achievements are, however, diminished by corruption, restrictions on free competition among political parties, and institutions, including the Parliament, the judiciary, the press, and citizen advocacy groups that are not yet effective in enforcing the checks and balances included in the new constitution. In addition, because statutes have never been revised, contradictory laws and accompanying regulations abound. Further, there is no compilation of statutes uniformly available to either the bar or the judiciary resulting in random access and inconsistency. In some cases, bills have been drafted only to discover that the law already exists.
USAID's partnership is strengthening constitutional checks and balances to achieve: 1) a better informed and functioning parliament, 2) a strengthened electoral system, 3) a cohesive framework of laws and regulations, 4) a more accessible and accountable government, 5) more efficient local government, and 6) a network of strong civil society groups. This vision of civil society as a cornerstone for fostering political pluralism and improved functioning is grounded in Uganda's unique decentralization of all government services, a move unparalleled throughout Africa. In August 1997, Uganda devolved nearly all central powers and decentralized the Government of Uganda (GOU) budget to its 45 districts. Constitutionally-mandated elections at the local government level in early 1998 will result in women holding one-third of elected local offices. USAID is assisting the Ministry of Local Government (MOLG) and the Decentralization Secretariat (DS) in implementing this bold political experiment which re-defines the roles of Members of Parliament (MPs) and central GOU ministries, and places political decisions and accountability at the district level.
To date, USAID has played an important part in assisting with drafting the constitution, assuring the success of presidential and parliamentary elections, and supporting the Law Reform Commission's complete codification of existing statutes and related regulations (which are not uniformly accessible and date back to the colonial era; laws and regulations have never been systematically repealed or homogenized by successive legislation). Other activities include workshops for women running for political office, building the capacity of women parliamentarians, and training the officials of the Interim Election Commission. In addition, funds have supported human rights efforts aimed at ending female circumcision, advising women of their legal rights, assisting prisoners' advocacy groups and assisting non-government organization (NGO) human rights advocates. Finally, U.S. assistance has been critical in the demobilization and reintegration of 37,000 soldiers and the expansion of civic education.
Description: USAID's four related approaches work together to achieve this objective through: 1) building parliament's capacity to be an effective check on executive authority; 2) standardizing the legal framework; 3) building local government capacity; and 4) strengthening civil advocacy groups.
MPs, all recently elected, are operating with a new constitution and committee system and have no organized access to reliable information. USAID is strengthening Parliament's institutional capacity though a series of workshops and seminars on a variety of topics from rules and procedures to budgeting, legislative drafting and revenue generation. Concurrently, USAID is assisting Parliament to establish and expand a research and reference capacity (currently non-existent) which will be available to all MPs with an emphasis on serving the standing committees. Meanwhile, USAID will continue its work with the Law Reform Committee which seeks to compile all existing legislation and applicable regulations and submit draft legislation which is coherent, current, and non-contradictory.
Host Country and Other Donors: Ugandans and other donors view the United States as being at the forefront, in both experience and innovation, in promoting pluralism and good governance. Donor participation in the democracy and governance sector, particularly in view of the rapidity with which decentralization was implemented, is increasing significantly. Denmark and Germany are working extensively in selected districts to strengthen decentralization. The United Kingdom is working closely with USAID to assist in publishing the revised statutes and regulations, once revision is completed and is assisting Uganda to redraft commercial legislation. USAID takes a lead role in building the capacity of parliament and in strengthening the MOLG and the DS.
Beneficiaries: Parliamentarians, local councils, women candidates and office holders at all levels, potential litigants who benefit from legal codification, citizens' advocacy groups, and voters.
Principal Contractors, Grantees, or Agencies: Activities contributing to the achievement of this strategic objective will be implemented by a combination of U.S. and local institutions and NGOs. U.S. contractors and/or grantees will be competitively selected in 1997/1998.
Major Results Indicators: Baseline Target (1996) (1999) Parliament initiates major legislation None One sectoral reform initiated Number of schools that publicly display budgets None 75% Uniform sectoral legal codes established None Coherent legal codes in place More effective civil advocacy None Civil groups network established to affect policy reform and implementation in one sector
Footnote: 1 MH = Male headed households
Footnote: 2 FH = Female headed households
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