Vital statistics has received considerably low priority in the policy agenda of sub-Saharan Africa, in general and Uganda in specific, despite the urgent need for reliable information to measure progress towards the Millennium Development Goals. Policy decisions and effective planning of resources entirely depend on reliable information; unfortunately this may be inadequate in most poor countries. This paper therefore asks; should we bother about counting the dead and what they have died from and do we need to know about those being born! For any country to efficiently and effectively plan for the health of its population, it's fundamental that quality data on births, deaths and cause of death is collected, to provide guidance for policy and planning of limited health resources. Significant amounts of development aid have been invested in Uganda, to improve the health system and certainly the health status of the population, and the financers of these initiatives require accountability, both in terms of money spent and progress attained, but all these may not be possible, unless the country commits significant amount of resources to strengthen routine systems of data collection.