Reproductive health Voucher project fails, poor mothers miss out

By Deo Wasswa

A new report shows that the Uganda Reproductive Health Voucher project funded by world bank in Uganda failed to extend maternal health services to the vulnerable groups as expected.

The USD 1.7 million Voucher project intended to provide essential maternal services to the less privileged, but instead it promoted discrimination and didn’t serve for the purpose.

Through the project, the less privileged were entitled to access Vouchers in which they would receive a coupon that a mother can exchange for specified services from an approved health facility.

Field research conducted by initiative for social and economic rights (ISER) between November 2019 and March 2020 found that in areas where the project was present,68% of the beneficiaries were either middle class or rich and only 32% could be classified as poor.

Further the report shows that some mothers were paying upto 100,000 Uganda shillings to access Vouchers instead of 4000 shillings.

The project also favored private health facilities as service providers raising a question about whether this the most effective use of money.

Salima Namusobya, the executive director ISER says even the districts selected for the project are not among those ones with poorest communities.

In western Uganda the project covered districts like Kiruhura, Mbarara, Ibanda, Rubirizi, Mitooma, Isingiro, Ntungamo among others.

She further noted that the private health facilities forced many pregnant women to undergo C-section in order to claim much money from project funders.

The Uganda Reproductive health Voucher scheme has a number of Actors including World Bank, Government of Uganda, Marie stopes as the Voucher Management agency, Village health teams as Voucher distributors.

Report indicates that 1.7 million children die due to environmental pollution

Second-hand smoke, unsafe water, lack of sanitation and inadequate hygiene kill at least one in four children every year, according to two new reports published by the World Health Organisation-WHO today.

The first report’ Inheriting a Sustainable World: Atlas on Children’s Health and the Environment reveals that a large portion of the most common causes of death among children aged 1 month to 5 years – diarrhea, malaria and pneumonia; are preventable by interventions known to reduce environmental risks, such as access to safe water and clean cooking fuels.

But failure to take appropriate action has resulted into the death of 1.7 million children annually, according to the reports.

WHO Director-General Dr Margaret Chan says such harmful exposures often start in the mother’s womb increasing the risk of premature birth, an increased risk of pneumonia in childhood, and a lifelong risk of chronic respiratory diseases, such as asthma, heart disease, stroke and cancer.

“A polluted environment is a deadly one – particularly for young children,” Dr Chan says in a statement this morning. “Their developing organs and immune systems, and smaller bodies and airways, make them especially vulnerable to dirty air and water.”

A companion report, don’t pollute my future! The Impact of the Environment on Children’s Health, shows that up to 570 000 children under 5 years die from respiratory infections, such as pneumonia, attributable to air pollution, and second-hand smoke. Another 361,000 die due to diarrhea, as a result of poor access to clean water, sanitation, and hygiene.

The report adds that 270,000 children die during their first month of life from conditions, including prematurity and 200 000 deaths of children die from malaria which could also be prevented through reducing breeding sites of mosquitoes or covering drinking-water storage. A similar number of children die from poisoning, falls, and drowning.

According to the reports, children are equally facing emerging environmental hazards, such as electronic and electrical waste (like old mobile phones) that is improperly recycled, exposing them to toxins which can lead to reduced intelligence, attention deficits, lung damage, and cancer.

There are also increasing rates of asthma in children due to climate change and rising levels of temperatures and carbon dioxide. Children are also exposed to harmful chemicals through food, water, air and products around them.

“A polluted environment results in a heavy toll on the health of our children,” Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health says adding that  improving water quality or using cleaner fuels will result in massive health benefits.