In theory, epidemiological transitions are enhanced by designing of appropriate health
strategies aimed at achieving sustainability in the global healthcare system. Therefore,
approaches towards the achievement of universal access to healthcare by the global population
will reduce mortality rates and improve health in general. This is the core approach adopted by
the World Health Organization through the implementation of MDG #5: improving maternal
health, MDG #4: reducing child mortality and MDG #6 combating malaria and other infectious
diseases. It has been reported that various countries around the globe have recorded diverse
progress towards achieving the principal MDG targets, especially with regard to MDG #6.
However, the achievement of MDG 6; target 6C depends on the commitment of different
countries. It is worth noting that, some countries have recorded remarkable progress towards the
reversal of malaria incidence rate while others have lagged behind owing to historical, cultural,
structural and critical factors. For instance, Uganda is among the countries which have recorded
remarkable progress towards the achievement of MDG 6C target, although it has not met other
target objectives of MDG #6. Therefore, this argumentative paper will provide a comprehensive
evaluation of Uganda's progress in combating malaria, and provide appropriate
Ideally, a comprehensive critical analysis on Uganda's progress towards the achievement
of MDG #6C target can be presented through providing an overview on the current situation in
the country. The history of malaria in Uganda encompass an array of aspects owing to the fact
that the country lies within the tropical region where malaria is known to be endemic. In regard
to the country profile, Uganda is positioned between latitudes 4
North and 1
South of Equator.
On the other hand, the country lies in a high altitude of 1,300-1,500M above the sea level
(Mallinga et al., 2009). As such, Uganda experiences tropical climatic conditions owing to its
geographical location. Ordinarily, the country experiences varied temperatures depending on the
country's geography in which temperatures range from 16
C in the Southwest to 30
C in the
Northeastern region (Adams & Spielberg, 2011). As a result, the country is covered with
savannah woodland, tropical rain forests and semi-desert conditions, and these climatic
conditions influence epidemiological trends of malaria, in which some regions experience more
or less malaria prevalence rates than others.
In regard to the structure of Uganda's healthcare system, the formal healthcare system
comprises of private for-profit sector, private not-for-profit sector and the public sector.
Epidemiological surveys indicate that Uganda's public healthcare sector consists of referral
hospitals which serve an approximation of 2 million people, and parish-level healthcare centers
serving about 5,000 people. In addition, there are community health centers within the country's
public healthcare sectors which are responsible for providing healthcare services to patients at
the community level. As such, community health centers provide mobile healthcare services in
collaboration with community medicine contributors (CMDs) and village health teams.
Ordinarily, these parish-level healthcare centers and referral hospitals provide curative and
preventive healthcare services to patients (Mallinga et al., 2009). However, it is worth noting
that, Uganda has an extensive informal healthcare sector that contributes significantly in
addressing healthcare challenges including combating malaria in the country.
Despite the remarkable advances realized by the Uganda's healthcare system in
combating malaria transmission, malaria has been found to be one of the most challenging
diseases in the country because it causes significant mortality, morbidity and economic loss.
According to epidemiological data, malaria causes its greatest impact on children less than five
years of age and pregnant women. This is attributable to biological factors related to the immune
levels among children and pregnant women. In Uganda, malaria has been found to be causing 9-
14 percent of the total inpatient deaths (Ahaibwe & Kasirye, 2012). On the other hand, malaria
has been found to be responsible for 15-20 percent of hospital admissions, and it accounts for 30-
50 percent of hospital visits (Acton, 2013). This implies that, malaria causes the highest
percentage of the disease burden in the country's healthcare system. Currently, Uganda has been
in the list of the countries with the highest incidence rates for malaria.
In addition, it has been ranked 3
among the leading countries with the highest malaria
deaths, and this implies that, Uganda experiences enormous consequences from malaria
transmission. In reality, malaria transmission in Uganda ranges from 90-95 percent, although
transmission is influenced by epidemiological variations in which over 320 malaria related
deaths occur daily (Kagolo, 2013). In theory, areas of malaria transmission in Uganda can be
divided into three principal epidemiological zones depending on the level of transmission.
According to epidemiological surveys, 70 percent of the country comprises of high transmission
levels in which infective bites per person exceeds 100, annually. The second epidemiological
zone comprises of medium to high transmission levels in which 10-100 infective bites occur
annually, accounting for 20 percent of total malaria transmission in the country. On the other
hand, low transmission areas in which infective bites are less than 10 bites per person accounts
for 10 percent. These are regarded to as stable perennial malaria transmission areas. There are
also areas with unstable malaria transmission in which incidence rates of malaria are relatively
low, especially in the Southwest region of the country that comprises of mountain ranges with
altitudes of above 1,800 meters.
From an analytical perspective, Uganda seems to have realized a remarkable progress
towards the achievement of MDG #6C target because epidemiological surveys show a significant
reduction of malaria cases. Beaudrap et al (2011) reaffirm "malaria is a major public health
problem, especially for children, however, recent reports suggest a decline in the malaria burden"
(p. 132). In practice, the rate of Uganda's progress in combating malaria can be explained
through a comprehensive evaluation of mortality rates of the populations that are at a high risk of
malaria. Therefore, mortality rates of children under the age of 5 years can be used as the
principal indicator of malaria reduction in Uganda. According to a recent epidemiological report
from UNICEF (2013), child mortality related to malaria has been decreasing in the past two
decades, and this is attributable to changes of health policy in Uganda. In this period, malaria
related mortality rates among children aged less than five years seem to have decreased by 75
percent from 178, in 1990 to 69, in 2012. On the other hand, annual rate of malaria related
mortality rates reduction indicates that, 2000-2012 accounted for the highest mortality reduction
rates in the history of Uganda. In this period, Uganda recorded a reduction rate of 6.3%
compared to the rates recorded in 1990-2000 and 1970-1990 periods corresponding to 1.9% and
Malaria Under-5 Mortality Rates
Source: UNICEF (2013)
Excerpt out of 10 pages
- Quote paper
- Patrick Kimuyu (Author), 2018, Malaria. Uganda's Progress in Achieving Millennium Development Goal #6C Target, Munich, GRIN Verlag, https://www.grin.com/document/388293