CMAP

Permanent URI for this community

https://publication.aercafricalibrary.org/handle/123456789/98

Browse

Browsing CMAP by Author "ATUGONZA, RASHID"

Now showing 1 - 1 of 1
  • Thumbnail Image
    Item
    SOCIAL DETERMINANTS OF HEALTH STATUS IN UGANDA
    (Makerere University, 2019-12-06) ATUGONZA, RASHID
    Health status of individuals of great significance both because of the direct utility that health can provide and the productivity gain as a result of good health. The purpose of the study was to empirically establish the key factors influencing health status in Uganda. Specifically, examining the relationship between health status and socio-demographic, economic, lifestyle and environmental factors. Government of Uganda has been investing in health through acting on key Social Determinants of Health (SDH) such as household income and infrastructure as marked in the HSDP 2015/16-2019/20. However, evidence shows heavy burden of disease. The relationship between health status and the above SDH is not clear. Therefore, this necessitated the need to investigate the SDH. The study used Uganda National Household Survey (UNHS) 2016/17 data. The study was based on the SDH framework to examine SDH Status. Four logistic regressions models were estimated i.e. model I, II, III and IV focusing on individuals aged 0-5, 6-14,15-59 and 60+ years respectively. The study used adjusted Wald test to test for individual Statistical significance of the regression coefficients and Hosmer-Lemeshow (HL) test, to assess the goodness of fit. In reference to demographic factors the study establishes that Females aged 6-14, 15-59 and 60+ years were 1.29, 1.25, and 1.4 times more likely to be in poor health when compared to the males at P< 0.01 respectively. Individuals aged 6-14 from male headed household were 1.2 times more likely to be in poor health at P< 0.01 when compared to those from femaleheaded households. Rural residents aged 0-5, 6-14 and 15-59 were 1.5, 1.52, and 1.3 times more likely to be in poor health when compared to urban residents at P< 0.01 respectively. Likewise, the married aged 15-56 and 60+ years were 1.6 and 1.7 times more likely to be in poor health when compared with individuals not married at P< 0.01 respectively. Concerning economic factors, individuals with no formal education aged 6-14 years were 1.2 times more likely to be in poor health at P< 0.01 when compared to individuals with secondary level of education. Similarly, individuals aged 6-14 whose mothers have no formal education were 1.1 times more likely to be in poor when compared to those whose mothers have attained secondary level of education at P< 0.01. At P< 0.05 the unemployed aged 60+ were 1.6 times more likely to be in poor health when compared to those employed. Regarding lifestyle factors, current and past alcohol consumers aged 15-59 were 1.3 and 1.9 times likely to be in poor health at P< 0.01 when compared to individuals that do not consume alcohol respectively. Current smokers above 15-59 and 60+years were 1.8 and 1.4 times more likely to be in poor health when compared to the non-smokers at P< 0.01 respectively. As for environmental factors, individuals aged 0-5- and 6-14 using water from unimproved sources were 1.3 and 1.2 times more likely to be in poor health when compared to those that use water from improved sources at P< 0.01 and P< 0.05 respectively. Individuals aged 0-5 using poor and intermediate quality toilet facilities were 1.7 and 1.5 times more likely to be in poor health when compared to those that use high quality toilet facilities at P< 0.01 and P< 0.05 respectively. Individuals aged 6-14 residing in mad and poles houses and houses whose floor material made of earth were 1.2 and 1.3 times more likely to be in poor health when compared to those that reside in brick houses and houses whose floor material made of cement at P< 0.01 respectively. The study findings show that females above 6 years are more likely to be in poor health when compared the males. Therefore, considerable emphasis should be put on health interventions for women. Education of girls and employment opportunities for women will also promote gender equality and more broadly improve upon their health. Interventions to prevent people from smoking and alcohol consumption must also be undertaken or strengthened. More efforts should also be put in promoting health lifestyles especially among the young people. Also, policies should be aimed at closing the gap in health conditions between urban and rural inhabitants through balanced economic and social development to increase the level of income, education and decreasing unemployment amongst people living in the rural areas. From the results, children aged 6 to 14 years whose mothers have no formal education are more likely to be in poor health. Therefore, education especially for the girls should be a priority to enable mothers gain knowledge and skills to be able to make better healthy choices. To address the health problem among unemployed individuals aged 60+ years, it is necessary to put in place insurance scheme for the elderly to ease their access to health care. Regarding the environmental factors, there should be establishment of clear institutional responsibility and specific budget lines for water & sanitation, and ensuring that public sector agencies working in health, in water resources and other utility services work together better to enhancing quality infrastructure (piped water to homes, toilets connected to sewers or septic tanks).