UGANDA Data for Results and Accountability NOVEMBER 2013 Education and Health Services in.
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Transcript of UGANDA Data for Results and Accountability NOVEMBER 2013 Education and Health Services in.
UGANDAData for Results and Accountability
NOVEMBER 2013
Education and Health Services in
SOUTH AFRICA
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SDI: An Africa-wide initiative
Acknowledgements
Government of Uganda
EPRC
SDI Partnership: World Bank, AERC, AfDB
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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Expenditure
Behavior
Value for Money, Quality, and Equity
Maternal mortality ratio 438/100,000 (UDHS 2011)
6/10 P4 pupils cannot read
sentence at P2 level (Uwezo
2011)
Maternal mortality ratio 438/100,000 (UDHS 2011)
6/10 P4 pupils cannot read
sentence at P2 level (Uwezo
2011)
SDI aims to shed light on behavior at service delivery units
Outcomes
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What does SDI measure?
Education Findings
Input availability
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Schools do well on infrastructure and equipment…
Uganda Public Private
Teaching equipment 94% 94% 95%
School infrastructure 55% 60% 40%
Pupil-teacher ratio 39 46 19
…except for textbooks
What teachers do
Uganda Public PrivateSchool absence rate 24% 27% 14%
Classroom absence rate 53% 57% 40%
Classroom teaching time
3h19m 2h58m 4h18m
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Teachers’ Effort Out of 100 Ugandan primary teachers …
Private school: 50% more instruction
Private school: 50% more instruction
What teachers know
• Teachers’ test scores • Minimum Knowledge
…. according to the Uganda SDI data, students performance is strongly enhanced
by teacher’s knowledge
Teachers score much lower on teaching skills
assessment
Teachers score much lower on teaching skills
assessment
Regional disparitiesStudents per class
Time spent teaching per day (minutes)
Northern classes 3 times
larger than Kampala’s
Northern classes 3 times
larger than Kampala’s
Northern students receive
2.5 times less teaching time
Northern students receive
2.5 times less teaching time
SDI: Uganda vs Kenya
What teachers do: absenteeism What teachers know: minimum knowledge
Education summary
• Ugandan primary schools do well in terms of infrastructure and equipment … but textbook use is a challenge
• Teacher’s absenteeism both from school and classroom is a concern and is more serious in public schools and rural 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
Infrastructure Availability
Electricity Clean water Improved toilet Minimum infrastructureUganda 73% 93% 89% 64%
Drugs and equipment availabilityTracer drugs Mothers drugs Children drugs HC2 drugs Equipment
Uganda 79% 35% 49% 58% 83%
What health providers doUganda Private Public
Absence from facility 46% 39% 52%
Absence by location and facility type Reason for absence
What health providers knowA large gap between diagnostic and treatment
Regional disparities
Diagnostic accuracy: competence Infrastructure availability
What providers do and knowUGANDA KENYA
All Public Private All Public PrivateAbsence from facility 46% 52% 39% 27% 29% 21%
VS
Health summary
• Ugandan health facilities do well in terms of infrastructure 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 to basic 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