of standards (unbs) act which sets standards on ugandan commodities hasn't any standards on native liquor (commonly called "enguli"). on september 26, 2016, a new alcohol control bill was drafted by a small committee and presented to the parliament of uganda. this bill is aimed at banning small alcohol packaging, alcohol advertising and regulating alcohol consumption time. additionally it includes raising legal age for alcohol consumption from 18 to 21 years and an imposition of a 5% tax on all alcohol beverages. the impact and policy changes plus law enforcement will help regulate alcohol consumption in uganda and save the lives of many youth and children. oral health there is inadequate data on the current oral health situation in uganda. a rapid assessment conducted through a community survey and key informant interviews in ugandan districts in 2004/2005 estimated that 51% of the community had experienced an oral health problem six months prior to the survey. of the population that had experienced an oral health problem, only 35% had received treatment. the most prevalent conditions as reported by key informants included; results of an oral health community survey 2004/2005 oral conditions prevalence (%) tooth decay 93.1 pain 82.1 tooth loss 79.3 early childhood caries 75.9 bleeding gums 71.4 loose teeth 48.3 bad breath 42.9 oral hiv lesions 28.6 tooth bud extractions 17.2 orofacial trauma (without fractures) 13.8 jaw fractures 13.8 oral cancer 10.3 mouth sores 10.3 fluorosis 6.9 benign oral tumors 3.4 according to a study carried out among school children in mbarara in 2007, the oral hygiene of school children was generally poor showing a lack of well-established oral hygiene practices. the mean decayed, missed, filled permanent teeth (dmft) was 1.5 (±0.8sd) with females having a higher dmft than males of 1.6 (±0.8sd) and 1.3 (±0.8sd) respectively. children in private schools were more likely to have more caries in both permanent teeth and milk teeth. calculus was more prevalent in males, government schools and among day scholars. caries experience is generally higher in kampala as compared to the rural districts. overall dmft score was 0.9 for children and 3.4 for adults. according to the global disease burden, oral diseases in uganda contribute 0.38% of total dalys. this is lower than its neighboring countries in the east african community and much lower than the other bank regions world bank regions, i.e., east asia and the pacific, europe and central asia, latin america and the caribbean and parts of south asia. uganda is unique as it trains different cadres of oral health workers, dental surgeons, public health dental officers, oral and maxillofacial surgeons and dental laboratory technologists. the dental surgeons in uganda are regulated by the uganda medical and dental practitioners' council (umdpc) and a professional body, uganda dental association (uda) the number of registered dental surgeons across the country has increased from 72 dental surgeons in 2006 to about 396 dental surgeons in 2021 serving a ugandan population of more than 42 million. of these, 372 are general dental practitioners, 12 oral and maxillofacial surgeons, 3 orthodontists, 2 prosthodontists and 7 restorative dentists across the entire country as of 2021. all the dental specialties except for oral and maxillofacial surgery are trained outside the country. the national oral health policy has been running since 2007 through 2009 and has not yet been updated since. the ministry of health operates at a very low budgetary proportion covering less than 0.1% on oral health care which is suboptimal for adequate oral service delivery. the basic oral services are at a free cost at government facilities while second and tertiary care is received at a cost. most dental care services in uganda are out-of-pocket payments (oops) due to shortage of materials, supplies, equipment and manpower at most government health care units hence patients are forced to seek oral care at private facilities. infant oral mutilation (iom) infant oral mutilation is very common to most african countries in sub- saharan africa, uganda inclusive. among the bantu-speaking tribes in uganda, it's commonly known as "ebinyo". the un-erupted tooth is gouged out usually as a cure for high fevers and diarrhea in infants by un-trained personnel. the practice involves identifying raised areas on the infants' gums and using sharp instruments to extract the soft non-mineralized tooth considering it the "offending worm." the common tooth buds removed are the primary canines. infant oral mutilation (iom) was first reported in uganda in 1969 among 16.1% of children from the acholi tribe in the northern part of uganda. these were all missing canines due to iom. a recent study published in 2019 among 3-5-year-old children in the western part of uganda revealed 8.1% were missing primary canines due to iom. this practice is more common among the rural populations versus the urban populations, with more prevalence in children under a caretaker other than a parent. the commonest groups reported to carry out iom are culturally respected people in uganda and these include; traditional healers, traditional midwives, school teachers and local priests. this practice is carried out at an age where the child's antibodies from breast milk and pregnancy are decreasing hence increased susceptibility to infections manifesting as fevers, diarrhea and vomiting that iom is performed to treat. this leads to neglection of the primary cause of infections and instead exacerbates it through use of unsterile instruments leading to high morbidity and mortality among children. the main cause of iom is poor oral literacy among majority of the ugandan population. health in the northern region northern uganda is one of the four major administrative regions in uganda. the region was devastated by a protracted civil war between the government of uganda and the lords resistance army as well as the cattle rustling conflict that lasted for 20 years. since the war ended in 2006, the internally displaced person camps have been destroyed and people have resettled back to their former homesteads. the region, however, still has many health challenges, such as poor health care infrastructure and inadequate staffing at all levels (2008 published report); lack of access to the national electricity grid (2007 published report); an inability to attract and retain qualified staff; frequent stock outs in the hospitals and health facilities; emerging and re-emerging diseases such as ebola, nodding syndrome, onchocerciasis, and tuberculosis; proneness to malaria epidemics, the leading cause of death in the country; reintegration of former abducted child soldiers who returned home (2007 study); lack of safe drinking water as most boreholes were destroyed during the war; the hiv/aids epidemic (2004 published report); poor education standards with high failure rates in primary and secondary school national examinations (2015 published report); and poverty (2013 published report). refugees uganda has been hosting refugees and asylum seekers since achieving its independence in 1962. in fact, the 2016 united nations summit for refugees declared uganda's refugee policy a model. the 2006 refugee act and 2010 refugee regulations allow for integration of refugees within host communities with refugees having access to the same public services as nationals. they have freedom of movement and are free to pursue livelihood opportunities, including access to the labour market and to establish businesses. uganda is currently hosting 1,252,470 refugees and asylum seekers making it the largest refugee hosting country in africa and the third largest in the world (gou and unhcr, 2017) undp. this has placed a huge burden on the country that has a gdp per capita of just 710 dollars, yet the aid received per person is very small. "aid received per person against income" cost disaggregated by sector sectorvalue (us$)percentage distribution education795,4190.25 health5,201,0261.61 security3,045,8580.94 land29,746,2099.21 ecosystem loss90,682,16928.07 energy and water145,881,76145.16 other costs2,406,8140.75 estimated tax exemption to un agencies45,254,12514.01 total323,013,382100.00 there are regular outbreaks of diseases such as cholera, ebola and marburg. 2017 uganda marburg virus outbreak. the policy of allowing refugees to freely move within the country increases the risk of spreading these outbreaks beyond refugee camp borders. health indicators according to the 2015 uganda bureau of statistics (ubos) report: the region has one of the highest hiv prevalence rates of 8 percent in the country, second only to kampala. the region leads in poverty with 80 percent of households living below poverty line compared to only 20 percent of the country in general living in poverty. the region has the lowest per capita house hold expenditure of ush.21,000/= compared to ush.30,000/= of the general population. up to 26 percent of people are chronically poor the region leads in illiteracy with only 60 percent of the population aged 10 years and above being literate compared to 71 percent of the general country population. most districts in the region lack clean piped water supply with the exception of a few urban centers like gulu, lira, arua, and soroti. the pit latrine coverage ranges from 4 to 84 percent in some districts, the worst in the country. the region has the lowest numbers of health facilities compared to other regions of the country. of the total 5,229 health facilities in uganda (2,867 operated by the government, 874 operated by non-governmental organizations (ngos), and 1,488 private facilities), there are only 788 health facilities in the northern region (664 operated by government, 122 operated by ngos, and 2 private facilities). health facility deliveries range from 7 percent in amudat, to 81 percent in gulu. the region has the highest total fertility rate of 7.9 children per woman compared to the nationwide 6.1 rate. the karamoja sub-region has high maternal mortality ratios. according to the 2001 uganda demographic and health survey, the northern region was the worst in infant child mortality indicators (under age five mortality: 178 deaths per 1000 live births) (under age one mortality: 105 deaths per 1000 live births) (neonatal mortality: 42 deaths within the first month of life per 1000 live births). for purposes of the 2011 uganda demographic and health survey, the northern region was subdivided into west nile, north, and karamoja, with the other three regions having seven subdivisions, for a total of ten subdivisions nationwide. karamoja's under age five mortality rate (153 deaths per 1000 live births) was the worst in the country, with west nile's rate (125) the third worst and the north's rate (105) the fourth best. west nile's under age one mortality rate (88) was the worst in the country, with karamoja's rate (87) the second worst and the north's rate (66) the fifth best. west nile's under one month mortality rate (38) was the second worst in the country, with the north's rate (31) tied for fourth worst and karamoja's rate (29) being the fourth best. nodding syndrome hit the region during the early to mid-2000s, although the international community did not become aware of it until 2009 when the who and the us centers for disease control and prevention first investigated it. the disease affected children aged 5–15 years, mainly in the acholi sub-region and a few in the lango sub-region. over 3,000 confirmed cases were documented as of 2012, with uganda having the highest number of cases in the world. the disease has profound health effects on children, families, and communities. the children who were previously healthy and growing well are observed by the parents to nod mainly at meal times initially, progressing to head nod when it is cold, etc. these children eventually develop various forms of epileptic seizures as well as disabilities such as severe malnutrition, burns, contractures, severe kyphosis, cognitive impairment, and wandering away from homes. since the interventions began in 2012, there have been no new cases reported in the region. the exact cause of this disease has not been found, although there is strong association with onchocerciasis. communities believe their children could have been exposed to chemicals during the war, particularly when they were displaced into internally displaced persons camps because they observed that their children became sick only when in the camps. sub countynodding snodding sepilepsyepilepsy malefemalemalefemale awere230188231198 atanga1441299584 lapul34322322 agagura1191087064 laguti172164115110 acholi bur03041823 puranga1312148146 pader13112116 total728648721663 environmental pollution in uganda air pollution air pollution is one of the critical risk factor for non-communicable diseases in uganda. globally, air pollution is responsible for about 18% of all adult deaths from stroke, 27% from heart disease, 20% from chronic obstructive pulmonary disease (copd), 27% are due to pneumonia and 8% from lung cancer, who estimates show. a total of