NRU :: Browsing by Author "Odokonyero, Tonny"

Browsing by Author "Odokonyero, Tonny"

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Coffee Production in mid-Northern Uganda: Prospects and Challenges
(Economic Policy Research Centre (EPRC), 2014) Mbowa, Swaibu; Odokonyero, Tonny; Munyambonera, Ezra
At the beginning of the 21st Century, the Uganda Coffee Development Authority (UCDA) introduced coffee in the mid-North sub region. This marked the beginning of the sub-region’s transition from dependency on annual crops such as cotton to a perennial crop. While the long-term objective of UCDA was to find ways of sustaining the coffee sector amidst the coffee wilt disease in the traditional coffee growing regions, the opening up of coffee growing opportunities to enhance the incomes of agricultural households in a former war-ravaged Mid-North was a well-conceived strategy. Several studies have demonstrated that coffee sector remains key in Uganda’s poverty reductions efforts as well as pointing to the limited poverty reduction effects among those households who depended mainly on annual crops such as cotton. This policy brief draws from the research paper by Mbowa et al. (2014)1 focusing mainly on the prospects and challenges of the coffee sector in the mid-North of Uganda. There is growing evidence in the sub-region that the systematic coffee planting by the UCDA has yielded positive results in the subregion. On average, there are 16,000 farmers with 10,045 hectares of coffee, and in 2013 coffee output was 154 metric tons and projected to increase to 16,323 metric tons by 2017 with start of harvesting of new planted trees. Apac, Lira, Nwoya and Oyam are among the districts with the highest potential for coffee production. Despite the faster adoption of coffee in the sub-region, there are challenges that need to be addressed if the UCDA’s objectives are to be realized. The major challenges relate to lack of organized marketing and processing infrastructure to support value addition; and inadequate coffee specialized extension support system to narrow the knowledge gap about recommended agronomic practices among farmers.
Floating Fish Cage Farming a Solution to Uganda’s Declining Fishery Stocks
(Economic Policy Research Centre, 2016) Mbowa, Swaibu; Odokonyero, Tonny; Munyaho, Anthony T.
This brief is extracted from a study on cage culture and aquaculture park technologies in Uganda conducted by EPRC and National Fisheries Resources Research Institute (NaFIRRI). The brief demonstrates that favorable and bullish international fish prices have supported steady foreign exchange earnings to Uganda, amidst declining volumes of fish exports. Despite decline in fish export volumes from 39,000 metric tons in 2005, to 17,600 tons in 2014, export earnings increased from 104 million to 135 million in the same period. To enable Uganda take advantage of this opportunity, innovations that overcome supply constraints will play a critical role. Statistics from NaFIRRI suggest that floating cage technology is a more productive system in comparison to capture fishery. A farmer using floating cage technology produces 12 times more tonnage per annum than counterparts practicing capture fishery - 48 metric tons of fish per annum, compared to only 4 metric tons. To increase fish production, therefore, the adoption of floating fish cage farming technology needs to be scaled up as opposed to continued dependence on capture fishery systems that are less productive and cannot meet the increased demand for fish exports. This brief also draws policy lesson from China and Egypt - the most successful and leading aquaculture producing countries – who made deliberate investments in aquaculture technology and support services, which increased fish farming productivity and exports.
Has Foreign Aid Improved Health Outcomes in Uganda? Evidence from Panel Microdata
(Economic Policy Research Centre, 2017) Odokonyero, Tonny; Marty, Robert
The health sector has attracted significant foreign aid; however, evidence on the effectiveness of this support is mixed. We combine household panel data with geographically referenced foreign aid data and use a quasi-experimental approach to investigate the contribution of aid on key health outcomes in Uganda. We find that overall, health aid achieved a significant impact on reducing both disease severity and burden—with the largest impact on disease burden. In addition, we observe aid is more effective if resources are channelled to locations and facilities that are closer to communities in need, given the ease of access to health services. From a policy perspective, aid ought to be channelled as close to intended beneficiaries as possible, thus advancing the Universal Health Coverage strategy of “close to client” health system.
Healthcare coverage and equity – Towards Universal Health Care in Uganda
(Economic Policy Research Centre, 2017) Odokonyero, Tonny; Mwesigye, Francis
Universal Health Coverage (UHC) is a popular global health policy agenda and particularly in Uganda, the health ambition is now aligned to the UHC target. This brief provides an understanding of UHC progress in Uganda, by examining healthcare coverage and equity based on reproductive, maternal, new-born, and child health (RMCH) intervention areas. Evidence shows that coverage improved marginally over the reviewed period, although the Composite Coverage Index remained low, and regional and socio-economic disparities in coverage remained. Improving healthcare coverage is important since it corresponds to better health outcomes. To scale up healthcare coverage; interventions should aim at maintaining immunization successes and addressing existing gaps in lagging intervention areas as well as addressing inequity in coverage. Accelerating UHC is feasible if the country institutes and effectively implements a coherent set of health sector policy reforms, regarding health financing, for instance, while drawing lessons from observed successful policy efforts. The brief is from the paper “Universal health coverage in Uganda: The critical health infrastructure, healthcare coverage and equity”. It demonstrates Uganda’s progress towards UHC and equity in coverage, based on healthcare intervention areas of Reproductive, Maternal, and Child (RMC) healthcare. Composite Coverage Index (CCI) and Coverage Gap Scores (CGS) were computed using the Demographic & Health Survey data, and country comparison was conducted to draw policy lessons.
Is Uganda’s middle class strong enough to deliver national aspirations?
(Economic Policy Research Centre, 2020) Odokonyero, Tonny; Guloba, Madina M.; Kakuru, Medard
Uganda envisioned to become a lower middle-income status by 2020 as a foundation for achieving vision 2040. Policies, including the National Development Plan (NDP), were instituted to drive the aspiration. However, the target was not achieved during NDPII (2015-2020). Building a strong middle class is a crucial strategy for achieving the target, as we advance into NDPIII (2020-2025). This brief provides insights into the size and strength or ability of the middle class, to drive the middle-income agenda and prerequisites for building or driving transition into a strong and stable lower middle-income status country. Using the 2016/17 Uganda National Household Survey, the analysis shows that the size of the middle class (without those in floating category) is about 8.3 million, which is 22% of the population. This is a more than two-fold increase from 2012/13. Considering those in floating middle-class category, the size of the middle class becomes 21 million, indicating that majority (61%) of Uganda’s middle class (over 13 million) are floating and susceptible to becoming poor incase of any negative economic shock occurring. The analysis further reveals that transition into the middle class is driven by urbanization, household size, economic activity, and education as a tool for human capital development. In conclusion, Uganda’s middle class is highly fragile. Therefore, the middle class in Uganda is a weak one, incapable of driving the economy to achieve and sustain the middle-income status goal.
Limited health insurance coverage amidst upsurge of non-communicable diseases in Uganda
(Economic Policy Research Centre, 2019) Mpuuga, Dablin; Mbowa, Swaibu; Odokonyero, Tonny
This brief uses the 2016/17 Uganda National Household Survey (UNHS) and the World Development Indicators (WDI) to show the extent of health insurance coverage for non-communicable diseases (NCDs) such as diabetes, high blood pressure and heart diseases among others. Results indicate that: (i) NDCs affect people of all socio-economic groups; (ii) more Ugandans suffering from NCDs are willing to pay for health insurance, but very few are holders of insurance policies in this regard; (iii) other diseases like malaria are more easily insured compared to NCDs, an indication that the providers of health insurance services are not keen to insure sufferers of NCDs; (iv) there are regional differences in health insurance coverage as well as prevalence of NCDs, with the burden of NCDs more intense in the Bukedi, Busoga and Teso sub-regions, whereas NCDs are least prevalent in Kigezi and Ankole sub-regionsand (v) NCDs are likely to erode gains in poverty reduction at household level, because it is equally high among poor households with the least capacity to afford health insurance. We there by, recommend establishing special screening centres for NCDs in public health facilities especially health center II’s and III’s. This will promote early detection and early treatment hence curbing expensive costs for treating severe and chronic NCDs. Preventive measures need to be emphasized as well. These include regular body exercises and monitored nutrition which all lower the risk of NCDs. We further suggest incorporating and prioritizing NCDs into the proposed national health insurance scheme.
Limited health insurance coverage amidst upsurge of non-communicable diseases in Uganda
(Economic Policy Research Centre, 2019) Mpuuga, Dablin; Mbowa, Swaibu; Odokonyero, Tonny
This brief uses the 2016/17 Uganda National Household Survey (UNHS) and the World Development Indicators (WDI) to show the extent of health insurance coverage for non-communicable diseases (NCDs) such as diabetes, high blood pressure and heart diseases among others. Results indicate that: (i) NDCs affect people of all socio-economic groups; (ii) more Ugandans suffering from NCDs are willing to pay for health insurance, but very few are holders of insurance policies in this regard; (iii) other diseases like malaria are more easily insured compared to NCDs, an indication that the providers of health insurance services are not keen to insure sufferers of NCDs; (iv) there are regional differences in health insurance coverage as well as prevalence of NCDs, with the burden of NCDs more intense in the Bukedi, Busoga and Teso sub-regions, whereas NCDs are least prevalent in Kigezi and Ankole sub-regionsand (v) NCDs are likely to erode gains in poverty reduction at household level, because it is equally high among poor households with the least capacity to afford health insurance. We there by, recommend establishing special screening centres for NCDs in public health facilities especially health center II’s and III’s. This will promote early detection and early treatment hence curbing expensive costs for treating severe and chronic NCDs. Preventive measures need to be emphasized as well. These include regular body exercises and monitored nutrition which all lower the risk of NCDs. We further suggest incorporating and prioritizing NCDs into the proposed national health insurance scheme.
A Review of Health Infrastructure and Workforce Critical for Delivering Universal health Coverage in Uganda
(Economic Policy Research Centre, 2017) Mwesigye, Francis; Odokonyero, Tonny
Universal health coverage (UHC) - defined as the availability of quality and affordable health services for all when needed without financial hardships- can be a vehicle for improving equity in healthcare. However, access to basic healthcare is still limited, and the quality remains low in Uganda. This is mainly caused by poor health infrastructure, sub-optimal operation of health facilities, and staff absenteeism, among others. This brief summarizes the findings of a study on infrastructure and human resource gaps that impede Uganda from realizing UHC1. The study results show fundamental challenges with the health infrastructure needed to deliver UHC. Spatial inequality exists in health facility population coverage and private sector health infrastructure investments. Low health workforce density is widespread; and even if the staffing level is raised to 100% as per the set staffing norms for critical cadres, the health workforce density will still fall short of the recommended standards. The low health workforce density implies that the existing health workforce is deficient and unable to expand population-based healthcare services. Accelerating progress towards UHC requires; increased investments in health infrastructure and strengthening Public Private Partnership arrangements to establish health infrastructure in disadvantaged regions; and improvement in health workforce density by reviewing current staffing norms for critical cadres as well as increased deliberate investments in human resources for health.
Supply of Improved Rice Seed in Eastern Uganda: The Gap and Required Investment
(Economic Policy Research Centre, 2016) Odokonyero, Tonny; Barungi, Mildred; Mbowa, Swaibu
This brief explains the challenges limiting use of improved rice seed in three Eastern Uganda major rice growing districts. Insufficient supply of improved seed is a core constraint to intensification in rice production. There are only four rice seed producers in the three study districts, which renders rice seed to be the hardest input to access by farmers compared to fertilizer, herbicides, and fungicides. Rice seed inaccessibility is further compounded by producers having contractual obligations with external seed companies. The volume of seed required by farmers exceeds the supply capabilities of the four seed producers, creating a gap in the rice seed supply chain. Furthermore, the seed producers rarely multiply the varieties grown by farmers, but rather those demanded by seed companies outside the region. The estimated seed supply gap is about 90 percent of what farmers would require. Therefore, in order to meet local farmer’s requirement for improved rice seed, at least 40 new seed production enterprises should be established and this is estimated to cost slightly over one billion Uganda shillings (US $ 300,000).
Universal Health Coverage in Uganda: The Critical Health Infrastructure, Healthcare Coverage and Equity
(SPEED Initiative, 2017) Odokonyero, Tonny; Mwesigye, Francis; Adong, Annet; Mbowa, Swaibu
Universal Health Coverage (UHC) has gained popularity within the global health policy and academic circles as countries strive to meet the UHC target established under the Sustainable Development Goal agenda. To accomplish this goal, developing countries such as Rwanda, Ghana and others have pursued bold policy initiatives including the introduction of health insurance schemes. In addition to financing, presence of critical health infrastructure and Human Resources for Health (HRH) are crucial to achieving UHC. Using administrative data from IntraHealth Uganda Country Programme (as well as document review) and the Demographic & Health Survey data, this paper analysed Uganda’s critical health infrastructure (including HRH) needed to attain sustained progress towards UHC. It also reviewed UHC progress and analysed equity by computing Composite Coverage Index (CCI) and Coverage Gap Scores. Results show fundamental challenges with the health infrastructure needed to deliver UHC in Uganda. Spatial inequality exists in health facility population coverage and private sector health infrastructure investments. Low health workforce density imply that the existing health workforce is deficient and unable to expand populationbased healthcare services. Progress towards UHC [considering reproductive, maternal, new-born, and child health (RMCH) interventions] has improved marginally over the reviewed period, although the CCI remained low, and regional and socio-economic disparities in coverage remained. Findings also demonstrate that improved healthcare coverage corresponds to better health outcomes. Accelerating progress towards UHC require; increased investments in health infrastructure and strengthening Public Private Partnership arrangements to establish health infrastructure in disadvantaged regions; and improvement in health workforce density by reviewing current staffing norms for critical cadres as well as increased deliberate investments in HRH using similar initiatives like the HRH programme model of Rwanda. To scale up healthcare coverage for RMCH, interventions should aim to maintain successes obtained for immunization and address existing gaps in lagging intervention areas. These objectives can only be achieved if the country institutes and effectively implements a coherent set of health sector policy reforms, regarding health financing, for instance, while drawing lessons from the successful policy efforts observed in the Rwandan case scenario.
Why Strong Farmer Groups are Ideal in the Marketing of Rice in Eastern Uganda
(Economic Policy Research Centre, 2016) Barungi, Mildred; Odokonyero, Tonny; Mbowa, Swaibu
Avenues for marketing rice in three districts of Butaleja, Tororo, and Bugiri in Eastern Uganda are studied based on data collected from a community and market survey. Survey results reveal that majority of farmers sell their rice to traders and middlemen, followed by processors and individual consumers. Consistently, relatively high prices are earned when rice marketing is undertaken in groups across all the three districts, and premium prices are realised from improved rice varieties like WITA9 grown by only 26 percent of the farmers. This demonstrates proof that there are income benefits from economies of scale in rice marketing that accrue to farmers that opt to market their rice as a group. However, the majority (over 79%) of farmers still operate as individuals. The study establishes that there are overriding considerations at community level (like urgent need to offset personal needs, lack of information, and limited group storage infrastructure) that weaken farmer groups for bulk marketing, hence sending farmers to operate as individuals. This leads to loss of farm income, and keeps farmers perpetually in poverty; and makes the case stronger to expedite the implementation of government projects such as the “produce storage facilities development project”, spelt out in the Second National Development Plan (NDP II) in the predominately rice growing Eastern Uganda. The findings further strengthen the case for reviving farmers’ cooperative societies in the country.

Browsing by Author "Odokonyero, Tonny"

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