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Despite sustained macroeconomic growth and impressive income poverty reduction in Uganda, the country's total child nutrition status remains poor. More so, wide within country disparities in stunting and underweight rates exist across the country. This study explored the determinants of child nutrition status and in Uganda using three rounds of the Uganda demographic and health surveys undertaken during 1995-2006. The surveys are nationally representative and capture anthropometric indicators for children aged below 5 years. The study investigated the determinants of health inequalities focusing on child health status through a combination of decomposition and regression analysis. Our results show that household welfare status remains a key determinant of child health status and inequalities in health. Furthermore, the results show that individual maternal education matters more in enhancing child health than does community knowledge about health.

We are grateful to David Sahn and Peter Glick for comments. This research is supported by SAGA, a cooperative agreement between USAID and Cornell and Clark-Atlanta Universities. See www.saga.cornell.edu. AbstractUnusually for an African economy, Uganda's growth has been rapid and sustained for an extended period of time. Further, this growth has clearly translated into substantial declines in poverty for all socio-economic groups and in all regions of the country. Despite this, there is concern in the country that other indicators of well-being are not improving at the same rate as incomes. This paper studies one such indicator, infant mortality. We use three rounds of the Uganda Demographic and Health Surveys to construct a national time series for infant mortality over a long period of time, 1974-1999. We also use these survey data to model the determinants of infant mortality and, based on those results, to examine the likelihood that Uganda will meet the Millennium Development Goal of halving infant mortality by 2015.Key results of the paper include:• household incomes and infant mortality are significantly negatively correlated, but the correlation is small, so that even if Uganda's rapid growth were to continue for another decade the impact on IMRs will be small up to 2015; • after controlling for individual, household, and community determinants, there is no discernable time trend (up or down) in infant mortality in Uganda; • observed improvements in mothers' primary school graduation rates will have a significant impact on IMRs. Plausibly attainable improvements in mothers' secondary graduation rates will have a lesser impact, largely because the improvements in graduation rates are not as great as at the primary level; • improvements in vaccinations for childhood diseases and in general health care services can also cause significant reductions in IMRs; • nevertheless, even under optimistic assumptions about improvements in health care and education, Uganda will not achieve the MDG for infant mortality.

Background Out of pocket (OOP) payments for healthcare remain a significant health financing challenge in sub-Saharan Africa (SSA). Understanding the drivers and impacts of this financial health burden is both an economic and a public health priority. Objective This study examines how the burden of OOP health expenditures varies with different thresholds for financial catastrophe. Methods The analysis is based on Livings Standards Measurement Surveys (LSMS)-Integrated Surveys on Agriculture (ISA) for five SSA countries-Ethiopia, Malawi, Nigeria, Tanzania, and Uganda. We estimate the degree by which OOP payments as share of total household non-food expenditures exceed either the 15 or 25% threshold. Results For the countries considered, the severity of OOP payments is substantial-the average positive overshoot (beyond the 25% threshold) is above 10%, except for Nigeria. This reflects a higher percentage of OOP in total household health expenditures-compared to taxes and contributions-especially among the poor in these specific countries. Regarding sensitivity of distribution of catastrophic health expenditures, we find that households with low non-food expenditures are more likely to incur catastrophic payments with the exception for Uganda where catastrophic payments increase with the increase of non-food household expenditures. Conclusion The burden of catastrophic health expenditures remains large. In order to reduce this burden, public health expenditures need to be expanded as an alternative. This calls for renewed attention to expand public revenues as the most sustainable methods of financing health expenditures in Africa.