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UGANDAData for Results and Accountability
NOVEMBER 2013
Education and Health Services in
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SOUTH AFRICA
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SDI: An Africa-wide initiative
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Acknowledgements
Government of Uganda
EPRC SDI Partnership:
World Bank, AERC, AfDB
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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
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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
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What does SDI measure?
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EducationFindings
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Input availability
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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
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What teachers do
Uganda Public PrivateSchool
absence rate 24% 27% 14%
Classroom
absence rate 53% 57% 40%Classroom
teachingtime
3h19m 2h58m 4h18m
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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
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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
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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
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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
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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
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Health
Findings
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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
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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
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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
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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
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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
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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
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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
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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
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UGANDAData for Results and Accountability
NOVEMBER 2013
Education and Health Services in