Fifty years after independence, Uganda has one of the highest population growth rates in the world at 3.3 percent – a rate which puts the country on track to nearly double in population over the next two decades. More than 50 percent of the population is under the age of 18. This large youth cohort will ensure that the country continues to grow for decades to come, even if couples choose – and are able – to have smaller families. And according to the State of Uganda Population Report 2011, “with more than one million people added to the population every year, the quality of [health] service delivery will suffer.”