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Uganda faces a growing double burden of disease. Communicable diseases still account for the largest share of morbidity, while non-communicable diseases (NCDs) are rising rapidly and now contribute approximately one-third of total deaths. Yet the consequences of this dual crisis on labour market outcomes remain relatively underexplored. This study analyses the socio-economic impacts of illnesses on employment in Uganda, using data from the 2019/20 Uganda National Household Survey (UNHS). It identifies key drivers of both communicable and non-communicable diseases (NCDs) and assesses their effects on employment, earnings, and labour supply among the working-age population.
The findings reveal a substantial prevalence of illnesses, with 16.3 percent of individuals aged 14-64 reporting a communicable disease in the month prior to the survey, compared to 4.6 percent for NCDs. Women bear a disproportionate share of illness, accounting for 60 percent of reported cases, and prevalence is higher in rural areas. Significant regional disparities are observed, particularly for communicable diseases in Teso, Elgon, and West Nile, and for NCDs in Elgon, Busoga, and Bukedi.
The study employs logistic regression to identify drivers of illness and a Heckman selection model to estimate the labour market effects of illness. Notably, the most significant predictors of poor health at the individual worker level are wealth quintile and gender. NCDs are more common among wealthier individuals, likely due to both higher exposure to lifestyle-related risks and better access to diagnosis. However, environmental and demographic factors such as sanitation and hygiene, also play an important role. Poor sanitation conditions such as using shared toilets and unsafe waste disposal, increase the likelihood of communicable illness, while access to handwashing facilities reduces it.
Regression analysis shows that illness adversely affects labour market outcomes, with more pronounced impacts for noncommunicable diseases (NCDs) than for communicable conditions. NCDs are associated with an estimated 30 percent reduction in monthly earnings, compared to a 23 percent decline for communicable diseases, largely driven by increased worker absenteeism. These effects are especially strong for women, likely reflecting additional constraints such as caregiving responsibilities and more limited workplace support.
Further, the study finds that individuals in poor health are more likely to be unemployed, work fewer hours, and be concentrated in informal employment characterized by low job security and limited access to social protection. These findings underscore the urgent need for government ministries, including Water and Environment and Health, and other stakeholders such as NGOs, to strengthen Water, Sanitation, and Hygiene (WASH) initiatives and promote targeted behavioral interventions, such as handwashing, to prevent communicable illnesses.
Equally important is the establishment of a social protection scheme such as health insurance that includes informal workers to improve access to healthcare, reduce the disease burden, and enhance productivity. Finally, region-specific interventions are needed to address unique health challenges in high-burden areas, such as Teso and Elgon, which are particularly affected by malaria and NCDs.
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- Published Jun 12, 2026