Uganda Service Delivery Indicators Final Presentation on Education and Health Author Gayle H. Martin;

8/13/2019 Uganda Service Delivery Indicators Final Presentation on Education and Health Author Gayle H. Martin;

1/23

UGANDAData for Results and Accountability

NOVEMBER 2013

Education and Health Services in


2/23

SOUTH AFRICA

2

SDI: An Africa-wide initiative


3/23

Acknowledgements

Government of Uganda

EPRC SDI Partnership:

World Bank, AERC, AfDB


4/23

Process: Consultation, design and

adaptation of survey materials

Instrument design: Methodology underpinned by state-of-the-art research

Methodology piloted in Tanzania and Senegal

Adaptation of survey instruments to Uganda context through

technical consultations

Consultations held prior to survey in Kampala with

GoU, non-government stakeholders, and sector experts

Survey coverage: representative of health facilities and

schools across the country and for each region

SDI did not include higher level health facilities such as

HC4s and hospitals


5/23

5

Health:

UGX 850 Bil(2011-12, 8% of

budget)

Education:

UGX 1.6 Tr.

(2011-12, 15% of

budget)

Expenditure

Behavior

Inputs

Value for Money,

Quality, and Equity

Maternal mortality

ratio 438/100,000

(UDHS 2011)

6/10 P4 pupils

cannot read

sentence at P2level (Uwezo 2011)

SDI aims to shed light on behavior at servicedelivery units

Outcomes


6/23

6

What does SDI measure?


7/23

EducationFindings


8/23

Input availability

8

Schools do well on infrastructure and equipment

Uganda Public PrivateTeaching equipment 94% 94% 95%School infrastructure 55% 60% 40%Pupil-teacher ratio 39 46 19 14%

3%

11%

Public

Private

Uganda

except for textbooks


9/23

What teachers do

Uganda Public PrivateSchool

absence rate 24% 27% 14%

Classroom

absence rate 53% 57% 40%Classroom

teachingtime

3h19m 2h58m 4h18m

9

Teachers Effort Out of 100 Ugandan pr im aryteachers

Private school:

50% more

instruction

42

29

50

28

52

39

11

9

12

1

2

7

25

34

27

35

24

29

0

2

0

1

4

2

22

26

11

35

18

24

Central

Eastern

Kampala

Northern

Western

Uganda

In classroom teaching In classroom not teaching

In school not teaching Teaching outdoors

Absent from school


10/23

What teachers know

Teachers test scores Minimum Knowledge

. according to the Uganda SDI data,

students performance is strongly enhanced

by teachers knowledge

65%

58%

26%

Maths score English score Pedagogy score

20%

18%

23%

Uganda Rural Urban

Teachers score

much lower on

teaching skills

assessment


11/23

Regional disparities

Students per classTime spent teaching per day (minutes)

20

2932

39

51

58

Kampala Central Western Uganda Eastern Northern

283

237223

197

164

112

Kampala Western Central Uganda Eastern Northern

Northern

classes 3 times

larger than

Kampalas

Northern

students receive

2.5 times less

teaching time


12/23

SDI: Uganda vs Kenya

What teachers do: absenteeismWhat teachers know: minimum

knowledge

24%

53%

16%

42%

Absence from School Absence from Classroom

Uganda Kenya

4%

36%

10%

75%

English Mathematics

Uganda Kenya


13/23

Education summary

Ugandan primary schools do well in terms ofinfrastructure and equipment but textbook use is a

challenge

Teachers absenteeism both from school and classroom

is a concern and is more serious in public schools andrural areas

Only a small share of teachers in public and private

schools alike master the curriculum they are supposed

to teach There are large regional disparities

13


14/23

Health

Findings


15/23

Infrastructure Availability

Electricity Clean water Improved toilet Minimum infrastructure

Uganda 73% 93% 89% 64%

89% 88%

57%

47%

97%

91% 90%

79%

Clean water Sanitation Electricity Minimum

Infrastructure (all

three)

Public Private


16/23

Drugs and equipment availabilityTracer drugs Mothers drugs Children drugs HC2 drugs Equipment

Uganda 79% 35% 49% 58% 83%

81%

29%

43%

57%

81%

74%

44%

58% 60%

85%

Tracer drugs Mothers drugs Children drugs HC2 drugs Equipment

Rural Urban


17/23

What health providers doUganda Private Public

Absence from facility 46% 39% 52%

Absence by location and facility type Reason for absence

44%

53%

46%

39%

HC 2 HC 3

Rural Urban

8%

15%

11%

26%

22%

19%

Sick/maternity

In training/seminar

Official mission

Approved absence

Not approved Absence

Other


18/23

What health providers knowA large gap between diagnostic and treatment

58%

50%

19%

Diagnostic Accuracy

Adherence to clinical

Guidelines

Management of maternal

/neonatal complications

45%

59%

62%

88%

28%

58%

26%

42%

53%

42%

9%

36%

Acute Diarrhea

Pneumonia

Diabetes

Pulmonary TB

Malaria with Anemia

All

Full Treatment Correct Diagnosis

46% gap


19/23

Regional disparities

45%

52%

55%

58%

65%

Northern

Western

Central

Eastern

Kampala

Diagnostic accuracy: competence Infrastructure availability

35%

56%

67%

46%

84%

Northern Western Central Eastern Kampala


20/23

What providers do and knowUGANDA KENYA

48%

38%

35%

33%

73%

75%

50%

48%

Doctors

Clinical Officer

Nurses

Midwives

Correct Diagnosis Full Treatment

54%

47%

46%

28%

86%

81%

72%

82%

Doctors

Clinical Officers

Nurses

Midwives

Correct Diagnostic Full treatment

All Public Private All Public PrivateAbsence

from facility46% 52% 39% 27% 29% 21%

VS


21/23

Health summary

Ugandan health facilities do well in terms ofinfrastructure and equipment but availability of drugs,

especially for mothers, is a challenge

Absenteeism of health providers is a cause for concern,

and is more serious in public facilities 1 out of 10 health providers did not manage to diagnose

any of 5 conditions. A correct diagnosis is no guarantee

for full treatment, the knowledge gap is large

There are large regional disparities in equipment,infrastructure, and providers competence

21


22/23

Conclusion

Uganda has made tremendous progress in access tobasic education and health services but there are

serious quality issues to be addressed

Addressing quality of education and health services is

crucial if Uganda is to build the healthy and educated

workforce necessary to achieve Vision 2040

Improving quality will also ensure value for money by

increasing efficiency and effectiveness of services

Improving quality will require better management, a

focus on providers incentives, and enhanced

accountability

22


23/23

UGANDAData for Results and Accountability

NOVEMBER 2013

Education and Health Services in

Documents

Uganda Service Delivery Indicators Final Presentation on Education and Health Author Gayle H. Martin;