Aid needs to go where it will help most

Development aid often fails to address the root causes of poverty in poorer nations. A recently proposed program to further sexual and reproductive health in Uganda provides a welcome example of a more focused and effective approach.

by Kelvin Thomson

When I began full time work 45 years ago, I started paying a monthly sponsorship for an African child through World Vision. I wanted to do my bit to help people who were less fortunate, and to tackle world poverty. I have maintained my sponsorship ever since, though I have become increasingly convinced that it hasn’t made any real difference, and that global hunger and poverty are every bit as problematic as they were 45 years ago.

But there is a much larger problem with our national aid budgets. When I was Australia’s Parliamentary Secretary for Trade, because the Trade Department was linked to the Department of Foreign Affairs and AusAid, I got to see a lot about how our aid program works. In reality a lot of aid money actually goes to Australian companies, to undertake projects in poorer countries. This gets justified on the basis that simply handing over money to foreign governments has a corruption risk, and leads to inefficiency and maladministration.

Nevertheless, surely it would be better if the money was going to local people, rather than boosting the bottom line of Australian companies. You might expect Australian civil society aid organisations to complain about this, but I learned that they had their hands up for money out of the aid budget as well. If they think there is something wrong with the system, they have very little to say about it.

It is well said that an ounce of prevention is worth a pound of cure. Surely spending money on family planning and reducing unwanted pregnancies does a lot more good than dealing with the often devastating consequences of overpopulation? Surely our national aid budgets should focus on preventing overpopulation?

The objection to this is that it is people in rich white countries telling poor people in non-white countries what to do. Not so in Uganda. I have received a proposal from Dr Jotham Musinguzi, Director General of Uganda’s National Population Council, for a 5-year project to help Uganda harness its demographic dividend through youth empowerment. The National Population Council is a government agency.

Uganda’s population has grown from 4.9 million people in 1948 to about 45 million currently. It is projected to rise to 103 million by 2050, if unchecked. The coronavirus pandemic has set back progress in reducing child mortality and getting and keeping girls in school. The head of UNICEF in Uganda has reported that the coronavirus pandemic has led to 15 million children not attending school for almost 2 years. UNICEF has reported a 22.5% increase in pregnancies among girls and women aged 10 to 24, from March 2020 to June 2021. It has been reported that many of the fathers are older men taking advantage of boredom and economic desperation to pressure underage girls into sex or marriage.

The National Population Council project seeks to avoid a 100 million population for Uganda, and harness the potential of its young people. It seeks to tackle the high number of early marriages and teenage pregnancies that drive high fertility and a population age structure that is not conducive for development.

The National Population Council project proposal says that the country’s high fertility, coupled with high but declining mortality, has produced rapid population growth of 3% annually, causing a large youthful population and dependency rate. It says that a growing body of evidence shows that there are serious gaps in Adolescent Sexual Reproductive Health in Uganda. One in four girls aged 15-19 is either pregnant or has given birth. Among this age group, more than 60% have an unmet need for modern contraception, meaning that they either don’t use any contraceptive method, or use a traditional method of contraception. Approximately half of all pregnancies among girls aged 15-19 in Uganda are unintended.

Some of the key activities of the project would be to –

• Develop a comprehensive Adolescent Sexual Reproductive Health community (peer) model for the provision of information and services for adolescents and youth
• Establish Regional Child Marriages and Teenage Pregnancy Prevention Committees across the proposed project regions
• Engage different communication channels including both mass and social media to enhance Adolescent Sexual Reproductive Health information and services, and
• Provide call centres with telehealth for Adolescent Sexual Reproductive Health.

The project would cost around $US 24 million over a 5-year period. It would be implemented by the National Population Council, in partnership with the National Planning Authority and Private Sector Foundation Uganda.

I encourage people in the richer countries to urge their governments, and political leaders to support aid programs that genuinely address the urgent needs of poorer nations. In particular we need to stop population growth undoing all our well-intentioned efforts to lift education, health, employment and life expectancy outcomes in those countries.

And if and when you get told, “this is not what they want,” tell them about Uganda’s National Population Council. It is trying to do the right thing by its people, both now and for the future, and deserves our support.