MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION

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MULTIDIMENSIONAL CHILD POVERTY ANDDEPRIVATION IN UGANDA: VOLUME 1THE EXTENT AND NATURE OFMULTIDIMENSIONAL CHILD POVERTYAND DEPRIVATION

MARCH 2019

MULTIDIMENSIONAL CHILD POVERTY ANDDEPRIVATION IN UGANDA: VOLUME 1THE EXTENT AND NATURE OFMULTIDIMENSIONAL CHILD POVERTYAND DEPRIVATION

ACKNOWLEDGEMENTSThe research and drafting of this report was led by David Gordon, Şebnem Eroğlu, Eldin Fahmy,Viliami Konifelenisi Fifita, Shailen Nandy, Acomo Oloya, Marco Pomati and Helen Andersonfrom the University of Bristol and the University of Cardiff, in close collaboration with theUganda Bureau of Statistics (UBOS) and UNICEF Uganda. This pioneering work to betterunderstand multidimensional child poverty and deprivation in Uganda would not have beenpossible without the vision, oversight and support of James Muwonge, Vincent Ssennono,Bylon Twesigye and Stephen Baryahirwa from UBOS, and Diego Angemi, Sarah Kabaija, ArthurMuteesasira and Amna Silim from UNICEF Uganda.Frances Ellery provided significant editorial inputs, while Rachel Kanyana designed the report.Above all, we are very grateful to all enumerators, field researchers and participants whovolunteered their time to take part in the UNHS 2016/17 and focus group discussions. Wehope these reports do justice to their contributions.iMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION

FOREWORDAs enshrined in the UN Convention on the Rights of the Child, children have the right to anadequate standard of living, and to be free from any form of health, education, nutrition, careor protection related deprivation. Whereas income poverty provides a vital measure of childpoverty and vulnerability, it does not sufficiently capture the extent and depth of deprivationssuffered by children. Put differently, children can experience poverty even when householdincome is above the poverty line.Like development, the nature of poverty is multidimensional. This important recognition makesit particularly important to broaden common perceptions and measures of poverty beyondtraditional household consumption-based monetary approaches. Notably, this sentimentwas emphatically reaffirmed in the global transition from the Millennium Development Goals(MDGs) to the Sustainable Development Goals (SDGs), placing a stark commitment to tacklingpoverty in all its dimensions, and in particular to addressing child poverty.Child poverty hampers children’s development, educational outcomes, job prospects, healthand behaviour, often resulting in the chronic intergenerational transmission of poverty. In thisrespect, with close to 57% of the population below 18 years of age, and over 78% belowthe age of 35 years, Uganda’s vision of becoming a middle-income country by 2040 remainshighly contingent on Government’s ability to safeguard children’s right to contribute to nationaldevelopment. A healthy, educated and empowered young population will enable Uganda toreap an unprecedented demographic dividend.This report represents the successful integration of multidimensional child poverty measuresin national statistics. In doing so it provides a better understanding of child poverty in Ugandaby augmenting Uganda’s rich tradition of poverty analysis with a more deprivation-centredanalytical tool.Capitalising on this methodological innovation, reflected in the quantitative and qualitativeanalysis presented in Volumes 1 and 2, an additional objective of this analysis is to supportGovernment’s efforts to transition from child poverty measurement to action by identifyingspecific areas of deprivation suffered by children to strengthen the delivery of basic services,and ultimately improve the implementation of national programmes affecting children.Imelda Atai Musana Doreen MulengaAg. Executive Director Country RepresentativeUganda Bureau of Statistics UNICEF UgandaMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATIONii

EXECUTIVE SUMMARYiiiMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION

The Government of Uganda (GoU) has made significant progress in reducing levels of extremepoverty, meeting the Millennium Development Goal target of a 25% reduction five yearsahead of the 2015 deadline. Since then, the GoU has committed itself to achieving the moreambitious Sustainable Development Goals (SDGs). These include ‘reducing by at least halfthe proportion of men, women and children of all ages living in poverty in all its dimensionsaccording to national definitions’ by 2030 and ultimately ending poverty in all its forms duringthe 21st century.Based on the country’s national poverty line, slightly less than a quarter (23%) of children inUganda are identified as ‘poor’. However, this figure is based on monetary poverty which,although providing a clear account of household resources, does not capture the extent anddepth of deprivations children experience. Children have both material and social needs –including health care and education, a social and family life, clean and safe drinking water,housing that is not squalid and overcrowded, adequate clothing, and regular meals withsufficient and nutritious food. These items are termed ‘socially perceived necessities’.MULTIDIMENSIONAL POVERTYUsing an indicator of multidimensional poverty fully integrated in the 2016/17 Uganda NationalHousehold Survey (UNHS), which takes these socially perceived necessities into account, overhalf (56%) of Uganda’s children experience multidimensional deprivations and a low standardof living. They live in households with insufficient financial resources, and are deprived of six ormore possessions or activities the majority of Ugandans consider necessary for an adequatestandard of living.Using this indicator of multidimensional poverty for the first time, the Uganda NationalHousehold Survey 2016/17 found that:56%MORE THANEXPERIENCE MULTIDIMENSIONALDEPRIVATIONS and a low standardin households with three or more childrenOF UGANDA’S CHILDRENof living.THE HIGHEST RATESOF MULTIDIMENSIONAL POVERTYARE IN RURAL AREAS84%of children inKaramoja live inmultidimensional poverty60% OF CHILDRENlive in multidimensional poverty.In Kampala, around fivetimes more children areliving in multidimensionalpoverty (15%) thanmonetary poverty (3%).MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATIONiv

MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATIONS:KEY FINDINGSHOUSEHOLD DEPRIVATIONS74%66%59%42%of children do nothave their own bedof children lacktheir own blanketof children live in ahousehold unable to affordto put money aside foremergenciesof children live in a householdsthat cannot afford to replacebroken pots and pans forcookingEDUCATIONMULTIDIMENSIONALLYPOOR CHILDREN are betweenTWO AND FOUR TIMESmore likely to be educationdeprived than non-poor children.43%of all children areunable to read orwrite.Lack books in the home.75%Non- Poor90%Multidimensionally Poor ChildrenCannot afford school uniforms.57%Non- Poor73%Multidimensionally Poor ChildrenLack educational toys or games orsomewhere to study in their homes.77%Non- Poor89%Multidimensionally Poor ChildrenADEQUATE CLOTHINGMULTIDIMENSIONALLY POOR CHILDREN:NOTABLY9 in 10do not have twopairs of shoes8 in 10have no newclothes1 in 4do not have twosets of clothes58%OF NON-POOR CHILDRENwere also deprived of oneor more clothing items.WORKING CHILDRENRURAL CHILDREN ARE MORE THAN TWICEas likely as urban children to be working, butURBAN CHILDREN WORK LONGERAND ARE OFTEN ENGAGED IN HARMFUL AND EXPLOITATIVE WORK.v18%RURALMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION7%URBAN

BIRTH AND REGISTRATION4%WEST NILEKARAMOJAONLY 11%1%OF CHILDREN IN UGANDAHAVE A BIRTH CERTIFICATEThe lowest rates are in Karamoja,West Nile, Bukedi and Busoga.5%BUKEDIBUSOGA5%WATER AND SANITATION78%HOWEVER25%rural areas24%are severely deprived,having to travel longdistances or wait in longqueues for safe water.OVER THREE QUARTERSof children areusing water from animproved source9%16%nationallyurban areasPERCENTAGE OF CHILDRENDEPRIVED OF ADEQUATESANITATIONCHILDREN LIVING IN HOMESWITH HANDWASHINGFACILITIES NEAR THE TOILET.RATES OF SEVERE SANITATION DEPRIVATION ARE FIVE TIMES HIGHERAMONG POOR HOUSEHOLDS THAN AMONG NON-POOR HOUSEHOLDS.HEALTHChildren in rural areas have higher ratesof health deprivation than those in urban areas96%West NileBukedi88%Karamoja87%55%children are fullyimmunisedUNDER FIVE MORTALITY IN 2012 [PER 1,000 LIVE BIRTHS]77% of120multidimensionallypoor childrenare unable to go to a healthfacility or afford prescribedmedicines when laKaramojaFOOD SECURITY48%OF ALL CHILDRENand two-thirds (66%) ofpoor children do not getthree meals a day due toa lack of Around 3%MILD-TO-MODERATEWASTING1%62%under-fives sleep under aninsecticide-treated bed net.Wasting rates areTHREE TIMESthe national average inWest Nile and Karamoja10%WEST NILE9%KARAMOJASEVERE WASTINGMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATIONvi

INFORMATION DEPRIVATION75%of all children and 91% of urban children livein households with access to either a landlinetelephone or a cellular/mobile phone.Around 1 in 5CHILDREN LACK ANY SOURCEOF INFORMATION AT HOMEand so are considered severelyinformation deprived.54%85%97%more than half donot have a radiomore than halfdo not have a tvmore than half donot have a computerCRIMEMore than 1 in 4CHILDREN (27%)HAD BEEN EXPOSED TO A CRIMEin the 12 months before the 2016/17 UNHS.This may have been theft, housebreaking,malicious property damage, defrauding,burglary, a child-related crime or murder.THE PUBLIC’S VIEWBased on the socially perceived necessities used for the UNHS indicators, participants in60 focus groups across the country were asked to identify what they believe to be itemsand activities necessary for a decent standard of living in Uganda today. While there wereregional differences and differences between household size and those classified as ‘poor’and ‘not poor’, there was a high level of consensus. With regard to items viewed as essentialfor children, these included:80%A visit to a healthfacility when ill68%All school fees,uniform and requiredequipment70%Money to take children to amedical facility when sick63%Money to payschool fees forchildren68%Toiletries to be ableto wash every day62%Own blanket62%Three mealsa day67%Two setsof clothing58%Own room forchildren over 10 ofdifferent sexes*Figures represent share of Ugandans that consider these items viewed as esential for childrenviiMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION

In describing their own and others’ experiences of poverty and deprivation, Ugandan citizensspoke not only of the physiological effects of, for example, poor nutrition, health care andeducation, but of the social and psychological effects – the stigma attached to not havingdecent clothes or shoes to wear, the impact on children’s development and learning of nothaving an adequate diet or not being able to afford school uniform, and the isolation of thoseunable to participate in social activities and occasions.Achieving an adequate standard of living for Ugandan children is their right, and is important inrelation to their wellbeing, happiness, comfort and parental care. It is also vital with regard totheir longer-term access to opportunities, life chances and livelihoods. Participants’ accountsemphasise the importance of adequate living standards in ensuring children’s successfultransition out of poverty and into adulthood.DEMOGRAPHIC DIVIDENDDemographers believe that the average fertility rate will continue to fall in Uganda and that inthe next decade the number of working-age adults in the population will begin to exceed thenumber of children. As the number of working-age adults rises, Uganda has the potential toreap a ‘demographic dividend’, i.e. rapid economic growth that will enable it to attain uppermiddle-income country status by 2040.However, realising a demographic dividend will require a healthy and well-educated populationthat is engaged in productive work. This can only be achieved by strengthened implementationof the National Social Protection Policy and a substantial investment in health care, educationand other social services aimed at improving the lives and skills of poor children.POLICY RECOMMENDATIONSThe integration of multidimensional child poverty in the Uganda National Household Surveyseries reaffirms the GoU’s firm commitment to achieve the SDG target of reducing by at leasthalf the proportion of men, women and children of all ages living in poverty in all its dimensionsaccording to national definitions by 2030. Ending poverty in all its dimensions during the 21stcentury will require deliberate efforts to move from measurement to action by integratingmultidimensional child poverty targets in the National Development Plan, and ultimately revisitthe balance between economic and social sector public investments to improve the quality ofbasic services.The analysis presented in this report supports the GoU’s efforts to transition from outputoriented budgeting (OOB) towards programme-based budgeting (PBB). This important policyreform represents a necessary, precondition to embrace a more comprehensive and strategicapproach to prioritise public investments on the basis of thematic areas of intervention. Toelaborate further, alleviating the burden of multiple deprivations on children requires a healthy,and carefully calibrated, mix of interventions aimed at addressing both social and economicexclusion, while protecting children from violence and exploitation. Nested within the GoU’sstrengthened implementation of the National Social Protection Policy, the analysis presentedin this report identifies the following key areas of thematic, programme-based financing toaddress some of the most prominent areas of deprivation:MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATIONviii

Reduce maternal and child morbidity and mortality through: improving the health andnutritional status of mothers and children; increasing access to and utilisation of safewater; promoting sanitation and hygiene; controlling and minimising environmentalconditions that negatively affect health-related outcomes; and harnessing nonhealth sector interventions that have an impact on maternal, newborn and childvulnerability and deaths so that children are healthy and can grow up in safe andclean environments, Provide equitable access to high-quality and child-friendly integrated early childhooddevelopment and education programmes and services to all children, supportedby trained caregivers and teachers, to enable children to achieve appropriatedevelopmental milestones. Ensure that all children are protected from different forms of abuse and thatcaregivers, teachers and other adults within the home and other institutions upholdchildren’s rights, including the right to participate. Foster the socioeconomic empowerment of families and communities so that theycan better support children’s development.The policy recommendations articulated above can be further strengthened through theeffective national and sub-national roll out and implementation of the GoU’s Key Family CarePractices (KFCPs), a set of 22 high-impact strategies and interventions directed at parents andcarers to promote better parenting and encourage early childhood development.ixMULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION

MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATION IN UGANDA VOLUME 1: THE EXTENT AND NATURE OF MULTIDIMENSIONAL CHILD POVERTY AND DEPRIVATIONx

CONTENTSACKNOWLEDGEMENTS .IFOREWORD . IIEXECUTIVE SUMMARY. IIIABBREVIATIONS.XIVO1 INTRODUCTION 1O2 METHODOLOGY 112.12.22.32.42.52.6The Relationship between Child Poverty and Children’s Rights . 12Rights and Child Poverty in Uganda. 15Definitions of Poverty . 16Low Income and Deprivation Groups . 18Consensual Non-monetary Poverty Measures . 20Measuring Consensual Deprivation . 21O3 PERCEPTIONS OF CHILD POVERTY IN UGANDA 253.13.2Consensus in Uganda . 26Household Deprivation . 31O4 CHILD POVERTY IN UGANDA 354.14.24.34.44.54.64.74.84.94.104.11Monetary and Multidimensional Poverty among Children . 36Education Deprivation among Children . 40Health Deprivation among Children . 47Working Children . 53Exposure to Crime . 58Birth Registration. 61Food Security. 64Decent Shelter. 69Access to Water and Sanitation.

This report represents the successful integration of multidimensional child poverty measures in national statistics. In doing so it provides a better understanding of child poverty in Uganda by augmenting Uganda’s rich tradition of poverty analysis with a more deprivation-centred analytical tool.

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