THE REPUBLIC OF UGANDA UGANDA NUTRITION ACTION PLAN...

THE REPUBLIC OF UGANDA

UGANDA NUTRITION ACTION PLAN 2 0 1 0 - 2 0 1 5

Scaling-up Multi-Sectoral Efforts to Establish a Strong Nutrition Foundation for Uganda’s Development

FINAL DRAFT (20th April 2011)

THE REPUBLIC OF UGANDA

UGANDA NUTRITION ACTION PLAN

Scaling-up Multi-Sectoral Efforts to Establish a Strong Nutrition Foundation for Uganda’s Development

2 0 1 0 - 2 0 1 5

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© Government of Uganda 2011

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Uganda Nutrition Action Plan 2010-2015

Table of ConTenTs

foReWoRD iiiaCKnoWleDGeMenTs vaCRonYMs anD abbReVIaTIons vieXeCUTIVe sUMMaRY viii

PaRT I: oVeRVIeW 11 Introduction 12 Policy Context 53 Situation and Problem Analysis 63.1 Consequences of high malnutrition in Uganda 10

PaRT II: THe sTRaTeGIC DIReCTIon 144 Action Plan Target Groups and Broad Strategies 14 4.1 Target groups 14 4.2 Broad Strategies for Reduction of Malnutrition in the Plan Period (2010-2015) 145 Goal, Objectives, Strategic interventions, and Core Programs 16 5.1 Goal 16 5.2 Objectives, Strategies and Strategic Intervention 17 5.3 Priority Investment areas and core projects 21 5.3.1 Priority Investment areas 21 22PaRT III: IMPleMenTaTIon, fInanCInG, anD MonIToRInG & eValUaTIon fRaMeWoRKs 236 Implementation Framework 23 6.1 Introduction 23 6.1.2 Institutional Arrangements 23 6.1.3 Coordination Arrangements 24 6.1.4 Implementation Strategy 25 6.1.5 Prerequisites for implementation 267 Financing Framework 26 7.1 Government of Uganda 26 7.2 Development partners 27 7.3 Public-Private Partnerships 278 Monitoring and Evaluation framework 28 8.1 Annual Monitoring and Reporting system 29 8.2 Quarterly Monitoring and reporting system 29 8.3 Annual, mid–term and end of term Evaluations and reviews 29

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8.4 Indicators and Targets 29

anneXes 31ANNEX I : Implementation Matrix 31ANNEX II: Cost Implementation Matrix 44ANNEX III: Output Level Monitoring and Evaluation Matrix 50ANNEX IV: Reviewed Documents 54ANNEX V: List of UNAP technical committee members 55

lIsT of fIGURes

Figure 1: The effects of malnutrition on productivity across the life cycle and across generations 2Figure 2: Prevalence of stunting, underweight, and wasting among young children in Uganda, by month of age 3Figure 3: National trends in the prevalence of malnutrition among under-fives 7Figure 4: Young child malnutrition- A conceptual framework for Uganda 9

lIsT of Tables

Table 1: Gap analysis for scaling-up nutrition interventions in Uganda 11Table 2: Key Nutrition Outcome Indicators 16Table 3: Summary of Core Projects 21Table 4: Summary of the five year costed implementation matrix 28Table 5: Annualized Key Outcome Indicators and Targets 29

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foReWoRD

Adequate nutrition is a pre-requisite for human development and socio-economic well being. Government is therefore committed to fulfilling the Constitutional obligation of ensuring food and nutrition security for all Ugandans. This Nutrition Action Plan is thus important as it provides the framework for addressing nutrition issues in the country sequentially to develop strong and quality human capital that will propel socio-economic transformation.

We have made progress in reducing poverty over the years however; malnutrition still ravages our country. Malnutrition affects millions of Ugandans in various ways especially killing women, babies, and children. It also impairs educational achievements and economic productivity costing government and families enormous amounts of money to treat related illnesses. This five year Uganda Nutrition Action Plan (UNAP) has been formulated within the context of the National Development Plan (NDP), which is in line with the overall vision for Uganda; transforming the Ugandan Society from a peasant to a modern and a prosperous Country.

The goal of this plan is to improve the nutrition status of all Ugandan’s with emphasis on women of reproductive age, infants and young children. Different forms of malnutrition affect different groups of people in Uganda. However, the “window of opportunity” is within the 1000 days from conception up until two years of age, where the greatest returns to effective action to prevent malnutrition are obtained.

The plan is intended to reduce the magnitude of malnutrition in Uganda and its impact on the individual, household, community and the nation at large. It will stimulate the nation towards the achievement of acceptable levels of nutrition security especially for women of reproductive age, infants, young children and other vulnerable groups. The plan therefore calls for scaling up multi-sectoral interventions, placing more emphasis on community based initiatives that have proven to yield cost effective results, as well as targeting areas and groups with the highest levels of malnutrition.

Investing in the fight against malnutrition will not only save lives but will also yield high economic returns for Uganda: For every dollar we invest in nutrition results in economic benefits worth six times or more. These gains mainly benefit the poor and most disadvantaged, as they spend less money on treating malnutrition-related disease and increase their productivity, reaping sustainable Socio-economic benefits.

As Ugandans, we all must do whatever is possible in the fight against malnutrition. So, I call upon you all to support the quick enactment of the Food and Nutrition Bill, which will establish a legal institution to coordinate different nutrition partners and ensure accountability in reaching the objectives of both the NDP and the UNAP; increase commitment of resources and expertise to scale up high-impact programs and policies to prevent and control malnutrition.

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I am pleased that the factors, which have led to the persistent and sometimes, worsening malnutrition and poor health of our people have been identified and documented. Malnutrition contributes to poor health, aggravates diseases, and reduces productivity and compounds poverty and it’s after effects. These are inter-related factors, which call for multi-disciplinary approaches to address. Effective intra and inter-sectoral linkages must thus be put in place to promote co-ordination and resource utilization.

I extend my sincere appreciation to all those who contributed to the development of this plan. Members of the nutrition technical committee and forum are commended for a job well done and the donor community is appreciated for its support. I cannot underestimate the role played by the National Planning Authority in coordinating the development of this plan.

I am confident that by now we are all aware that nutrition is a crosscutting issue with economic, socio-cultural, political and biomedical dimensions. In order to achieve the goal and objectives of this plan, it is imperative that all sectors of the economy play their roles. I therefore call upon all the ministries of Agriculture, Health, Trade, Education, Gender, Labour and social development, Ugandans, the public and private sectors, civil society and faith based organizations, and development partners to support the implementation of the action plan and align their programs to it for a united response. We must act now, for the reason that our actions will send a message to the Ugandan Population and the world that Uganda will not look on while its people are ravaged by malnutrition. Truly, the price of malnutrition in Uganda today and in the future is too high to ignore.

For God and My Country

Yoweri Kaguta MuseveniPresident of the Republic of Uganda

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aCKnoWleDGeMenTs

The Ministry of Health and Ministry of Agriculture, Animal Industry and Fisheries acknowledges with great thanks the National Planning Authority (NPA), and various development partners for their valuable contributions to the development of the Uganda Nutrition Action Plan 2010- 2015. We appreciate the technical and financial support that was essential to development of this Plan.

We further thank NPA for spear heading the process of the UNAP, housing the technical committee, coordinating and harmonizing the process. Special appreciation is due to Dr. Wilberforce Kisamba-Mugerwa, Chairperson NPA for his passion for nutrition, leadership role and championing this cause. More thanks are due to the Minister for Foreign Affairs Hon. Sam Kuteesa for the statement made in New York at UN General Assembly, September 2010 committing Uganda to tackle the malnutrition crisis to achieve the MDGs. Your statement gave us more ground to start the process and further showed the strong political-will to address malnutrition in Uganda. Sincere gratitude is due to FANTA-2, WFP, IGAD, USAID, World Vision, CSOs, UNAS, Academia, the private sector and members listed in appendix V for their contribution and development of this document from the time of inception through the final stages. The process was rigorous and the development of the UNAP would not have been possible without the untiring effort of these individuals and organizations.

Finally, we thank all stakeholders not mentioned by name, who in one way or another, either individually or collectively contributed to the finalization of the UNAP 2010-2015: End malnutrition now.

Thank you

……………………………………………Hon. Hope Mwesigye

Minister of agriculture, animal industry and fisheries

…………………………………………Hon. stephen Malinga

Minister of Health

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aCRonYMs anD abbReVIaTIons

ANC Antenatal CareBFW Breast Feeding WeekCAADP Comprehensive Africa Agriculture Development ProgramCSO Civil Society OrganizationEWS Early Warning SystemFCS Food Consumption Survey FHHS Food Handling Hygiene and Sanitation FNC Food and Nutrition CouncilFNS Food and Nutrition Strategy GDP Gross Domestic ProductHC Health Centre HH House Hold HIV Human immune VirusHSSIP Health Sector Strategic and Investment PlanHWD Hand Washing DaysIEC Information, Education and CommunicationLG Local GovernmentLST Labour Saving Technologies MAAIF Ministry of Agriculture, Animal Industry and FisheriesMDAs Ministries Departments and AgenciesMDG Millennium Development GoalsMEMD Ministry of Energy and Mineral DevelopmentMIS Management Information SystemMJCA Ministry of Justice and Constitutional AffairsMOES Ministry of Education and SportsMOFPED Ministry of Finance, Planning and Economic DevelopmentMOGLSD Ministry of Gender, Lab our and Social DevelopmentMOH Ministry of HealthMoICT Minister for Information, Communication and TechnologyMOLG Ministry of Local GovernmentMoPS Ministry of Public ServiceMTTI Ministry of Tourism, Trade and Industry MWE Ministry of Water and environment NDA National drug AuthorityNDP National Development Plan NFND National Food and Nutrition Days NMHCP National Minimum Health Care PackageNMTC National Multi-sectoral Technical CommitteeNNSS National Nutrition Surveillance system NPA National Planning Authority

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OPM Office of the Prime MinisterPNC Postnatal CarePOPSEC Population Secretariat PPP Public Private PartnershipsSP Social ProtectionSUN Scaling Up NutritionUBOS Uganda Bureau of StatisticsUDHS Uganda Demographic and Household SurveyUNAP Uganda Nutrition Action PlanUNBS Uganda National Bureau of StandardsUNCF Uganda Nutrition Coordination ForumUNDAF United Nations Development Agency FundUNHS Uganda National Household SurveyUNIS United Nations Information System

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eXeCUTIVe sUMMaRY

Nutrition plays a crucial role in the socio-economic development of any country. In the world, undernutrition accounts for about 35 per cent of deaths among children below five years. Stunting, severe wasting and intra-uterine growth retardation are the major contributors to child mortality, accounting for about 2 million deaths annually. Under- nutrition is the major cause of morbidity for all age groups accounting for 11 per cent of the disease burden globally. With regard to maternal mortality, iron deficiency is the leading cause contributing 20 per cent of the estimated 536,000 deaths world wide. About 43 per cent of all deaths among under fives occur in Africa. According to the UDHS, 19 per cent of the Ugandan population was undernourished in 2006, and 38 per cent of children under five years were stunted. This prevalence means that about 2.3 million young children in Uganda today are chronically malnourished. Other statistics indicate that 16 per cent of under fives are under weight while 6 per cent are wasted and 12 percent of women are undernourished.

The current levels of malnutrition in Uganda are unacceptable; therefore nutrition warrants greater investment and commitment for Uganda to realize her full development potential. Such an investment is a necessary prerequisite for further progress on the Millennium Development Goals (MDGs) and attainment of the National Development Plan (NDP) objectives. While there has been some reduction in the prevalence of child malnutrition in Uganda over the past 15 years, the change has been slow. Child malnutrition in Uganda remains largely a “hidden problem”. Micronutrient deficiencies are similarly difficult to detect. Malnutrition remains one of Uganda’s most fundamental challenges for human welfare and economic growth.

The ultimate goal of the UNAP is to reduce levels of malnutrition among women of the reproductive age, infants and young children over the next five years (2010-2015). Ensuring that all Ugandans are properly nourished is to enable them live healthy and productive lives. However, it is particularly at the start of the life cycle where we must jointly ensure that all Ugandans are properly nourished. To attain this, women of childbearing age must receive proper nutrition so that when they are pregnant they are able to properly nourish their children from the time of conception until those children are weaned. Interventions to prevent under-nutrition have the greatest benefit during these 1,000 days. Only by doing this will Uganda have in place the nutritional foundation of an intelligent, creative, and healthy population from which to build a better and more prosperous future. This is the reason that the Uganda Nutrition Action Plan (UNAP) focuses on young children and mothers and seeks to scale-up efforts to ensure that all Ugandan children are properly nourished from the day they are conceived.

Improving young child and maternal nutrition in Uganda over the next five years will have the following benefits: reduce the number of maternal deaths by over 6,000 and child deaths by over 16,000 every year; and increase national economic productivity, both physical and intellectual, by an estimated UShs 130 billion (US$ 65 million) per year at present value; and

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provide a strong return on public investment – for every one thousand shillings invested, an estimated six thousand shillings worth of increased productivity will result from reduced child stunting, improved maternal health, enhanced micronutrient intake, and improved nutritional care. Investing in nutrition makes economic sense – the economic benefits far outweigh the investments required for scaling-up nutrition programs.

The sorry state of nutrition in Uganda spells the need for strategic interventions to enable government at various levels to meet its obligations towards the many under-nourished Ugandans. It is in view of comprehensively addressing these problems that the Uganda Nutrition Action Plan has been formulated as a guide for action for the Uganda Food and Nutrition Policy (UFNP) that was approved by government in 2003. The goal of this Action Plan is to improve key nutrition indicators for young children and women of childbearing age over the next five years and beyond. This Uganda Nutrition Action Plan presents the agenda of action that the Government of Uganda will pursue to fulfill legally binding national, regional and international obligations to reduce and eliminate malnutrition.

The design of the Action Plan was guided by several concerns. These include vulnerability and gap analyses; attention to human rights and gender differences; decentralization, and the cross-sectoral nature of effective measures that can redress malnutrition. Nutrition issues are cross-cutting and with no strong sectoral advocates responsible for seeing that attention is paid to nutrition, it can easily be ignored or addressed in an uncoordinated manner. Many of the actions that are needed to address malnutrition are already within the mandates of the various sectors, most notably agriculture, health, trade, gender and social development, water and environment, and education among others. It is critical that these sectors undertake the nutrition-related activities for which they are responsible and are held accountable for doing so. The Action Plan seeks to minimize duplication of effort and conflicts of interest which tend to misdirect scarce public and private resources.

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PaRT I: oVeRVIeW

1 Introduction

Malnutrition is a major development concern in Uganda, affecting all regions of the country and most segments of the population. The current levels of malnutrition negatively impact on Uganda’s human, social and economic development. Although the country has made tremendous progress in economic growth and poverty reduction over the past 20 years, its progress in reducing malnutrition remains very slow. The ultimate objective of the UNAP is to ensure that all Ugandans are properly nourished is to enable them to live healthy and productive lives. However, it is particularly at the start of life that we must jointly ensure that all Ugandans are properly nourished.

To attain this, women of childbearing age must receive proper nutrition so that when they are pregnant, they are able to properly nourish their children from the time of conception until those children are weaned. These same women must receive related information and the health services to properly feed and care for their children so that they grow strong, smart, and healthy. Only by doing this will Uganda have in place the nutritional foundation of an intelligent, creative, and healthy population from which to build a better and more prosperous future. It is for this reason that the Uganda Nutrition Action Plan (UNAP) focuses on young children and their mothers, both potential and actual, and seeks to scale-up efforts to ensure that all Ugandan children are properly nourished from the day they are conceived.

The previous three Uganda Demographic Health Surveys (UDHS) show; nutrition indicators for young children and their mothers have not improved much over the past fifteen years; with some indicators showing a worsening trend. For example, forty five percent of children under-five years of age in Uganda were found to be short for their age (stunted) in 1995, and ten years later, the prevalence of stunted under-fives had fallen to only 39 percent (UDHS, 2006). Stunting indicates chronic malnutrition in children – the stunting prevalence rate of 39 percent means that about 2.3 million young children in Uganda today are chronically malnourished. The meager improvements in ensuring the nutritional well-being of Ugandan children stand in stark contrast to the large gains in economic growth and poverty reduction over this period.

Much of the nutritional problems that women and children experience in Uganda are hidden. Micronutrient deficiencies are common among both groups.

• Vitamin A deficiency affects one out of five young children and women of childbearing age, resulting in impaired resistance to infection and consequently higher levels of illness and mortality, as well as potentially severe eye problems.

• Iron-deficiency anemia affects three-quarters of children aged 6 to 59 months and half of women of childbearing age. Anaemia in women leads to chronic fatigue with adverse

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effects on productivity, earnings, and care-giving abilities. Pregnancy complications, premature birth, low birth weight and even maternal mortality, all arise from iron deficiencies in women. In children, anaemia leads to a significant slow-down in cognitive development, decreased physical activity, and reduced resistance to disease.

Figure 1: The effects of malnutrition on productivity across the life cycle and acrossgenerations

• The prevalence of zinc deficiency has been estimated to range between 20 to 70 percent in young children and 20 to 30 percent in adults, resulting in poor growth, reduced resistance to infectious diseases, and increased incidence of stillbirths.

This nutrition insecurity among Uganda’s young children and mothers has significant economic costs for the malnourished individuals, their households and communities, and the nation as a whole – those dealing with an increased disease burden and other physical and mental problems related to malnutrition and the enormous reductions in human potential and economic productivity throughout life are caused by hunger and malnutrition. As shown in Figure 1, malnourished children suffer from irreparable intellectual impairment and stunted physical growth. Hungry children make poor students and are prone to drop out of the educational system. Hungry and malnourished adults are unable to be fully productive workers and are more likely to be ill, increasing the burden on often over-stretched health systems. Undernourished women give birth to low birth weight babies, transferring the broad economic disadvantages of malnutrition in their own lives to the next generation. The aggregate costs of nutrition insecurity at the national level impose a heavy burden on efforts to foster sustained economic growth and

Figure 1: The burden of malnutrition through the life cycle and across generations.

OLDER PEOPLE

Malnourished

BABY Low

Birthweight

CHILD Stunted

ADOLESCENT Stunted

WOMAN Malnourished

PREGNANCY Low weight gain

Inadequate food, health, &

care

Reduced capacity to care for child

Higher mortality

rate

Impaired mental

development Increased risk of adult chronic disease

Inadequate catch-up

growth

Untimely / inadequate feeding

Frequent infections

Inadequate food, health, & care

Reduced mental capacity



Higher maternal mortality

Inadequate fetal nutrition

Inadequate infant nutrition

Reduced physical labor capacity,

lower educational attainment,

restricted economic potential,

shortened life expectancy

Reduced physical labor capacity,

lower educational attainment

Source: modified from ACC/SCN-IFPRI, 2000 .



improved general welfare.

The principal points of intervention to stop this cycle of malnutrition across the life cycle from occurring and recurring are first, in addressing the nutritional needs of the young child in the period from conception through to about 24 months of age and; secondly, assuring the nutritional well-being of the mother of the child even before she is pregnant.

For young child nutrition, the period from conception to two years of age is characterized as the 1,000 days of opportunity to effectively and sustainably address undernutrition. Interventions to prevent undernutrition have the greatest benefit during these 1,000 days. Interventions after the second birthday can make a difference, but often cannot undo the damage that was done by undernutrition during the first 1,000 days. This is seen in Figure 2, which shows that the percentage of young children in Uganda who are stunted increases sharply with each added month of age up to 2 years, with a particularly steep rise from the ages of 6 to 18 months. Relatively little change, positive or negative, is seen in the general nutritional condition of children after age two years. For these reasons, the objective of the UNAP is to stop the rapid rise in levels of chronic malnutrition among children that occurs in their first two years of life.

Figure2: Prevalenceofstunting,underweight,andwastingamongyoungchildreninUganda,by month of age

Beyond the young child, action also is needed to address maternal nutrition needs so that children are properly nourished from conception. Healthy, well nourished mothers are considerably more likely to give birth to and be able to nurture and raise healthy children. While women who are pregnant or caring for an infant must receive a range of nutrition-related services and information, adolescent girls will also be targeted under the UNAP. Efforts to ensure the proper nutrition of these future mothers will result, when they eventually do bear children, in their

Percent60

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Age (months)

Stunted

Note: Includes childrfen below -2SD from the WHO Child Growth Standards UDHS 2006

Wasted Underweight

The window of opportunity outside the womb



experiencing easier pregnancies and deliveries and giving birth to healthier babies who have a good birth weight. Hence, the focus of the UNAP on young children and their mothers includes both the children and mothers of today and those of the future.

The Government of Uganda is committed to achieving its development objectives set out in the NDP, which are also consistent with the international Millennium Development Goals. In the NDP, the commitment was made to significantly reduce the levels of malnutrition in the Ugandan population in the next five years and beyond. The NDP’s theme of Growth, Employment and Socio-Economic Transformation for Prosperity cannot be achieved if the population is unhealthy and if children and women continue to face problems that arise from malnutrition. In addition, Uganda cannot achieve its objectives of reducing the high rates of infant, child and maternal mortality. Most of the deaths are directly attributed to preventable diseases such as pneumonia, diarrhea and malaria. Malnutrition is the underlying cause of death in nearly 60 percent and 25 percent of infant and maternal deaths, respectively.

Over the next five years, the Goal of the UNAP is to focus public resources and national effort to bring about sharp improvements in nutrition among young children and women of childbearing age by scaling-up the implementation of a package of proven and cost-effective interventions. The Uganda Nutrition Action Plan focuses on young children and their mothers in order to operationalize the nutrition component of the NDP, as well as the Uganda Food and Nutrition Policy (UFNP), and the draft Uganda Food and Nutrition Strategy (UFNS). The UNAP will also foster action to address sectoral priorities, such as those laid out in the Health Sector Strategic and Investment Plan (HSSIP) and the Agricultural Sector Development Strategy and Investment Plan (ASDIP).

Improving young child and maternal nutrition in Uganda over the next five years will have the following benefits:

a) reduce the number of maternal deaths by over 6,000 and child deaths by over 16,000 every year; and

b) increase national economic productivity, both physical and intellectual, by an estimated UShs 130 billion (US$ 65 million) per year at present value;

c) provide a strong return on public investment – for every one thousand shillings invested, an estimated six thousand shillings worth of increased productivity will result from reduced child stunting, improved maternal health, enhanced micronutrient intake, and improved nutritional care. Investing in nutrition makes economic sense – the economic benefits far outweigh the investments required for scaling-up nutrition programs.

Factors leading to high levels of malnutrition in Uganda cut across many sectors. To guide public action to address maternal and young child malnutrition in Uganda, the UNAP recognizes that cross-sectoral, inter-agency collaboration is necessary. This action plan prioritizes multi-sectoral interventions that will have the quickest impact on improving key nutritional indicators. The interventions are grouped under five thematic objectives:

a) Improve maternal, infant, and young child nutrition and health to increase the likelihood of healthy pregnancy and infancy and proper physical and mental growth.



b) Increase the levels of consumption of diverse nutritious foods among the target populations through increasing the production of and access to foods that are rich in micronutrients at household and community level.

c) Mitigate and respond to the impacts of acute malnutrition by providing nutrition care for children and mothers who are ill and nutrition services in emergencies.

d) Strengthen the legal and institutional framework and the capacity to effectively plan and implement nutrition programs in the country.

e) Advocate for increased resources for scaling-up nutrition interventions to address the needs of young children and mothers and to create awareness among the general population of the human, social, and economic costs of malnutrition.

2 Policy Context

The Uganda Nutrition Action Plan to address the nutritional needs of young children and women of childbearing age in Uganda was developed within the context of a specific set of policy and legal frameworks. The Constitution of the Republic of Uganda establishes among the duties of the state to encourage and promote good nutrition in order to build a healthy Uganda. It further mandates the Ministry of Health (MOH) and the Ministry of Agriculture, Animal Industries and Fisheries (MAAIF) to set minimum standards and to develop relevant policies to ensure provision of quality food and nutrition services in the country.

The master development framework for Uganda, the National Development Plan (2010-2015), has incorporated nutrition as a cross-cutting issue that requires multi-sectoral action in at least four key sectors – health, agriculture, education, and gender, labour, and social development. This is a clear testimony to Uganda’s understanding that tackling nutrition problems will contribute to the attainment of Uganda’s broader development goals. As such, given the historical challenges to cross-sectoral nutrition programming in Uganda, the UNAP has been designed with the full participation of all stakeholders involved in nutrition. Likewise, implementation and monitoring and evaluation of the Action Plan will follow a similar approach.

Under the joint leadership of MoH and MAAIF in exercising their constitutional mandate, the Uganda Food and Nutrition Policy (UFNP) was developed in 2003. Thereafter, a National Food and Nutrition Strategy was drafted, as was a Food and Nutrition Bill (2008) to put in place statutory regulations and institutions for the implementation of the UFNP, in particular the Uganda Food and Nutrition Council. The UNAP draws much of its content from these documents in seeking to operationalize efforts to effectively implement the UFNP.

At sectoral level, the Health Sector Strategy and Investment Plan identifies nutrition as part of the National Minimum Health Care Package for Uganda, while the Agricultural Sector Development Strategic and Investment Plan and the draft National Agriculture Policy recognize food and nutrition security as key factors for the social and economic development of the country. Also, nutrition and food security are central components in the draft School Health Policy, the draft School Feeding Policy Guidelines, and the National Orphans and Other Vulnerable Children Policy.



The UNAP also builds upon several international undertakings to which Uganda is a signatory. These include:

• International Conference on Nutrition, 1992;• World Food Summits, 1996;• Declaration on the Millennium Development Goals, 2000, and the follow-up summit in

2010;• Scaling-up Nutrition Initiative;• International Covenant on Economic, Social and Cultural Rights;• Convention on Elimination of All Forms of Discrimination Against Women; and• International Health Partnerships and related Initiatives (IHP+).

At the regional level, Uganda adopted the African Regional Nutrition Strategy of the African Union. The main focus of this strategy is to advocate for renewed commitment to nutrition, intensify efforts to sustainably address malnutrition by member states in the wake of the worsening nutrition status of vulnerable groups across Africa, and stimulate actions at national and regional levels that result in improved nutrition outcomes. In light of the above, at the 2010 summit of heads of state of the African Union hosted by Uganda, member states approved the establishment of an Africa Food and Nutrition Day to be commemorated each year on 31 October to serve as a reminder for Africa of the constant need to address its nutrition problems.

Uganda has also adopted the Comprehensive Africa Agriculture Development Program (CAADP), an African Union-driven initiative for substantially improving agricultural production. CAADP is being implemented along four pillars. CAADP pillar three focuses on nutrition and food security.

3 SituationandProblemAnalysis

Uganda has made progress in reducing HIV, malaria, and tuberculosis; produces sufficient food nationally to meet the needs of the population; and has experienced a significant reduction in poverty levels from 39 percent of the population being poor in 2002 to 23 percent in 2009/10. However, the levels of malnutrition among women and young children have improved only minimally and some indicators, like micronutrient deficiency, have even worsened over the past two decades. While there has been some reduction in the prevalence of child malnutrition in Uganda over the past 15 years (Figure 3), the change is slow. Moreover, child malnutrition in Uganda remains largely a “hidden problem” since most children affected are moderately malnourished, and identifying malnutrition in these children without regular assessment is difficult. Micronutrient deficiencies are similarly difficult to detect.



source: UDHs 1995, 2001 and 2006

Figure3: Nationaltrendsintheprevalenceofmalnutritionamongunder-fives

In regard to the nutrition of women of childbearing age, in 2006 over 12 percent were found to be underweight with a Body Mass Index (BMI) of less than 18.5 kg/m2. Uganda is also faced with a double burden of malnutrition – the increasing co-existence of obesity and undernutrition in communities across the country. The 2006 UDHS showed high levels of overweight among women living in urban centers, as well as in many rural areas of Western and Central regions. Iron-deficiency anaemia remains the most serious micronutrient deficiency faced by Ugandan women.

There are several interacting causes of child malnutrition in Uganda as seen in Figure 4, ranging from policy issues to immediate household conditions to underlying community and cultural situations. The immediate causes of child malnutrition in Uganda are two-fold: i) inadequate dietary intake resulting from suboptimal maternal and infant feeding practices; and ii) the high disease burden resulting from malaria, diarrhoeal disease and acute respiratory infections. There are three broad underlying causes of inadequate dietary intake and the high disease burden.

1. Inadequate dietary intake is partly caused by household food insecurity, mainly related to poor access to the range of foods needed for a diversified diet. An added element of this is that the kinds of foods that are frequently consumed by households are relatively deficient in micronutrients. Seasonality in food production, variable food prices, and seasonal earning patterns exacerbate the instability and the poor quality of the diet consumed by the household through the year.

2. The second underlying cause is inadequate maternal and child care. Care-related constraints lead to both inadequate dietary intake and a high disease burden in young children. These constraints include the high daily workload that women as primary

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Stunting

Underweigh

t

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er-fi

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1995

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caregivers in the household must shoulder. Women do both farm and household chores and may engage in small business activities, while also being responsible for the continual care of the children and other dependents within the household. Frequent births limit the ability of a woman to properly care for her infant and other young children, while also regaining her own health. Social dislocation in many households and communities in Uganda has led to changes in traditional gender roles and increased family breakups. These changes tend to adversely affect the quality of nutritional and health care women and young children receive.

3. The last set of underlying causes, particularly linked to the health of the young child, has to do with whether the child lives in a healthy environment with good access to toilets and other sanitation services, a reliable safe water supply, and effective health facilities and services, including nutritional services such as micronutrient supplementation and nutrition education.



Figure4: Youngchildmalnutrition-AconceptualframeworkforUganda

Malnourished young child

Inadequate dietary intake

Poor feeding frequency Poor feeding practices

Frequent illness

Malaria, diarrhoea, infections Too early & improper weaning

Household food insecurity

Poor access to diversi�ied foods Low nutrient content of foods;

low use of forti�ied foods Seasonal �luctuation in food

supply and diet quality

Inadequate maternal & child care

High daily workload for women Teenage pregnancy and too

frequent births

Access to health care & healthy environment

Improper sanitation and hygiene; unsafe water sources

Poor food safety Poor access to health care &

Livelihoods

Limited off-farm work opportunities; capital to develop businesses scarce

Poor access to land, information, & inputs to improve farm production

Ineffective farming support services

Culture, education, awareness

Maternal education often limited Traditional practices may adversely

affect maternal & child feeding and health & reproductive care

Insuf�icient access to household

Policies

Limited policy guidance to facilitate private sector investment in nutrition

Policies and legal instruments lacking for nutrition planning structures and �inancing

Mechanisms absent for national and

Financing

Earmarked budget allocations across sectors to scale-up high impact nutrition actions are rare

Administrative and budgetary positioning of nutrition in the different sectors at national and district levels generally unclear

Support to sectoral activities to improve

Policy & leadership commitment to improved nutrition

Low awareness of the role of nutrition in the national development agenda

Poor appreciation of evidence of what need to be done to reduce malnutrition

Immediate

Underlying

Basic causes:



The nature of the underlying causes of child malnutrition is dependent to a considerable degree on how available resources are distributed within Uganda. The availability of nutrition resources at the household level is linked to a set of basic causes.

The basic/root causes are a function of how society is organized and operates in terms of livelihood opportunities and economic structure, the availability of knowledge both through cultural institutions and formal and informal education, political expectations and policies, the priorities guiding the allocation of public funding and other resources, and the quality of social and political leadership. It is principally in this area of the basic causes that action to address child malnutrition moves from the realm of the individual and household to the political arena, and where policy, public administration and expenditure, and governance issues come to the fore.

An important driver of the continued high levels of young child undernutrition in Uganda is the overall low conceptualization of nutrition issues as being a central and necessary element for economic development of the country and in addressing childhood and maternal mortality. The inadequate political commitment and low prioritization of nutrition in the allocation of public resources has limited the development of the necessary policies and legislation to create the environment for increased investment in nutrition. More still, the lack of political support has hindered the establishment of the necessary structures for coordinating action to address young child and maternal undernutrition, the development of a monitoring and evaluation framework to improve these efforts, and the building of human capacity for nutrition analysis and nutrition program design and implementation in Uganda.

3.1 ConsequencesofhighmalnutritioninUganda

A. MalnutritionkillsmanyUgandanseachyear• Low birth weight is rampant in Uganda and over 16,000 children born with low-birth

weight in 2009 died. Other forms of malnutrition were associated with more than 67,500 child deaths in 2009.

• Anaemia affects 49 percent of women; without any intervention 15,000 mothers will die of anaemia related causes between 2006 and 2015. One in three of these deaths could be prevented if we doubled our coverage of iron supplementation among pregnant women.

B Malnutritionsignificantlyreducesagriculturalproductivity• Malnutrition affects productivity in the agricultural sector, Uganda’s main employer. In

2009 alone, over US$ 34 million worth of productivity was lost due to iron deficiency anaemia in the adult population. Other losses to agriculture occurred as a result of time lost due to illnesses associated with malnutrition or time lost while taking care of the sick or attending to family deaths associated with malnutrition.

C MalnutritioncontributestopovertyinUganda• Uganda loses US$310 million worth of productivity per year due to the high levels of



stunting, iodine deficiency disorders, iron deficiency and low birth weight.• Malnutrition also contributes to the high cost of treating disease associated with

malnutrition and treating severe acute malnutrition. For instance, treating severe acute malnutrition costs more than US$120/ per child.

• Malnutrition contributes to a loss of about 4.1% of the GDP per year.

D Malnutritionaffectseducationandintellectualpotentialofthoseinschool• Between 2006 and 2015 iodine deficiency disorder will cause 19,300 children to be born

as cretins and 543,000 children to be born with mild or moderate mental disabilities.• Stunting causes late entry in school because children look too small for their age. • One in four children aged seven years had not started school in 2006, even with the

Universal Primary Education program. Stunting will also be a cause of absenteeism and repetition of school years.

As the causes and consequences of malnutrition are multi-dimensional, effectively addressing the problem requires an integrated approach with broad cross-sectoral political support. While cross-sectoral coordination increases the challenges in implementing effective programs, these challenges are not insuperable, particularly if effective leadership is brought to the issue. Table 1 below, provides the gap analysis for scaling up public nutrition action in Uganda that was developed through stakeholder consultations. This exercise involved comparing recent performance in Uganda in addressing young child and maternal undernutrition with potential and desired performance.

Table1: Gapanalysisforscaling-upnutritioninterventionsinUganda

Gap Current performance Opportunitiesforimprovement

Weak advocacy for nutrition at all levels

Limited recognition of the •centrality of improved nutrition for development by government and the general population.Low prioritization of nutrition by •government & implementers.Weak leadership for nutrition •across all sectors.Limited advocacy skills among •nutrition stakeholders.Lack of a national nutrition •agenda. No communication strategy for •nutrition.Inadequate number of nutrition •activists.

Emerging commitment for improving •nutrition in the country.Food and Nutrition Bill available, awaits •enactment by Parliament to empower the UFNC.Nutrition is integrated in various policy •documents including the Constitution of Uganda and the NDP.Government staff structure allows for •human capacity strengthening. For example, nutritionists recruited in health system; agricultural extension and community development officers at sub-county levels.Increasing commitment to nutrition •from development partners




Weak infrastructure to support quality nutrition programming at all levels, including lack of equipment and skilled human resources

Nutrition inadequately •mainstreamed into existing sectoral programs. Poor appreciation of centrality of •nutrition for development.Low recruitment, poor •professional growth opportunities, and poor retention due to low prioritization of nutritionists as cadres of the civil service.Lack of a comprehensive •nutrition curriculum and training plan for in-service capacity building of personnel not specialized in nutrition.Lack of incentives for nutrition •personnel in all sectors.

Nutrition forms part of the curricula at •all levels.In-service training curriculum is now •being reviewed.Nutrition officer posts established at •district levels.Agriculture, education and gender have •wide-reaching structural frameworks that can be utilized to fill gaps in nutritional expertise.Increasing appreciation of the role •of nutrition as a preventative health mechanism.Training and Information, Education •and Communication (IEC) materials on nutrition in Uganda available for local adaptation.Development partners supportive of •capacity strengthening in nutrition.

Weak coordination and inadequate implementation of policy guidelines

Lack of coordination structure •to link sectors on nutrition programming.Lack of a national nutrition •agenda to act as a reference point for implementers.Existing Food and Nutrition •Policy and other guidelines not adequately implemented and disseminated.

Presence of National Planning Authority •(NPA) to coordinate multi-sectoral efforts on nutrition programming and M&E. National coordination forum for •nutrition stakeholders meets regularly.Several stakeholders strongly •committed to support nutrition initiatives.Some nutrition policies & guidelines •in place for implementation, including infant and young child feeding, HIV, food fortification, and micronutrient supplementation.

Weak system for information management and limited research conducted on changing innovations in nutrition

Lack of a national nutrition •database and information system. Lack of standardized data collection and analytical tools.Low demand for nutrition •information.Weak coordination, information •sharing, and adaptation of promising practices.Lack of a national nutrition •research agenda.

Existing and forthcoming survey data •sets with nutrition content.Development partners supportive.•National nutrition indicators •established.Some surveillance systems for nutrition •and food security established.




Low involvement of communities in nutrition

Curative health services seen •as more important than preventative.Nutrition activities often do •not promote community involvement. Few good models for community engagement.Inadequate public knowledge on •importance of good nutrition.Few community organizations •involved in nutrition. No regular incentives in place for •community nutrition volunteers.

Development partners and government •interested in integrating nutrition in community development models.Role of community appreciated.•Communities willing to participate.•Support for operational research •available

Low coverage of nutrition services at all levels, particularly in private sector

High dependence on •development partners.Inadequate knowledge about •food supplementation.Limited data on nutritional •needs.

Local production of enriched foods is •growing.Commitment by government and •development partners.Increasing interest among the private •sector.



PaRT II: THe sTRaTeGIC DIReCTIon

4 ActionPlanTargetGroupsandBroadStrategies

4.1 Target groups

As discussed in the previous chapter of the action plan, different forms of malnutrition affect different groups of Ugandans. However, the “window of opportunity” is within the 1000 days from conception through the nine months of pregnancy up until two years of a child’s age. It is during this period that malnutrition develops in children. The greatest returns to effective action to prevent malnutrition are obtained during this period.

As such, the UNAP, while seeking to address in a substantive manner the entire scope of the malnutrition problem in Uganda, will focus on infants and young children, as well as on their mothers, both those now in their childbearing years and adolescent girls who in coming years will become mothers.

In Uganda there is an estimated 2.7 million children under age two, 7.1 million women of childbearing age (15-49 years), and 2 million adolescent girls (10-14 years). These demographic groups account for about 37 percent of Uganda’s total population.

Effectively addressing the nutritional needs of infants and young children will arrest a lifetime of problems malnourished children face later in life and reduce the burdens they impose on the household, community, and nation. The nutritional condition of the women who bear these children is an equally important element as the health and nutritional well-being of the child is determined by the health and nutritional well-being of its mother. However, these two target groups cannot be served in isolation. Most causes of malnutrition are linked to practices or access to resources at household or community levels. As such, the implementation of the UNAP will directly and indirectly address the nutritional needs of all Ugandans, particularly the most vulnerable, and lead to a sustained decline in the numbers of malnourished Ugandans.

4.2 BroadStrategiesforReductionofMalnutritioninthePlanPeriod(2010-2015)

To effectively deliver the nutritional needs of the selected target groups, the Action Plan recognizes and will seek to address the following issues:

a) Addressing the multiple causes of malnutrition among young children in Uganda. This will be done by building linkages between key sectors in both the public and the private arenas. Intra- and inter-sectoral linkages, public-private partnerships, coordination and collaboration will be strengthened to facilitate adequate nutrition advocacy, programming,



and monitoring and evaluation. b) Implementing proven high impact interventions in reducing young child and maternal

malnutrition both nationally and internationally. Most interventions will be in the areas of nutritious food production, nutrition care within the household, and public health, as well as livelihood support.

c) Identifying and implementing cost effective nutrition program models that are scalable at both district and national levels. Such models will involve behavior change and social marketing, fortification of common staple foods, use of bio-fortified produce, and micronutrient supplementation programs, among others.

d) Building and strengthening local institutions to provide leadership and capacity in nutrition policy and programming. This will include the legal establishment of the Uganda Food and Nutrition Council and its secretariat. The ability of key public sectors to finance nutrition programs and research with local or external resources will be strengthened. Policies and incentives will be established to enable the private sector and local governments to increase their investments in nutrition.

e) Planning nutrition programs appropriately. Whenever possible, the programs will be planned, managed, and implemented at community and local government levels in a cross-sectoral manner. Those geographic areas which are very vulnerable with young child and maternal malnutrition will be specifically targeted under the UNAP.

The Uganda Nutrition Action Plan will therefore focus on the following four broad action areas:1) Promote key maternal, infant and young child feeding and nutrition practices to improve

awareness and increase targeted healthy feeding behaviors. These include breastfeeding, appropriate complementary feeding during weaning, dietary diversification, and increased coverage of micronutrient supplementation programs.

2) Support households and communities to increase access to and consumption of diversified foods throughout the year through both own food production or procured food sources. Complementary programs will focus on reducing post-harvest losses and spoilage and addressing issues of women’s workload within the household.

3) Provide care and support to individuals identified with severe acute malnutrition (SAM).4) Community mobilization to promote the adoption of healthy nutrition behaviors,

community-based growth monitoring and promotion, and two-way referral of malnourished cases for care at either the community or the health facility level, and increased public awareness of the centrality of improved nutrition to community and national development.

Appropriate materials and tools will be employed to:• facilitate behavior change, using information, education and communication (IEC) and

nutrition education materials;• provide nutrition care and support; and• collect information on the nutritional condition of the target groups and all Ugandans

through time, to analyze this information, and to use it for programming.

To support priority nutrition areas and their complementary activities, key structural functions will be invested in institutions that will be established or strengthened at national, district, sub-



county, and community levels in both government and private arenas, as provided for in the Food and Nutrition Policy and the draft Food and Nutrition Bill. Strengthened links between different levels of nutrition actors to enable informed and appropriate decisions for coordinated nutrition programming across Uganda will also be an element of the implementation of the UNAP.

5Goal,Objectives,Strategicinterventions,andCorePrograms

5.1 Goal

The goal of the Uganda Nutrition Action Plan is to reduce malnutrition levels among women of reproductive age, infants and young children over the next five years 2010-2015 and beyondThe key indicators on which the UNAP will focus are the following:

Table2:KeyNutritionOutcomeIndicators

outcome indicatorbaseline

(UDHS,2006)UnaP target

2015

1 Stunting – prevalence in under-fives 38% 32%

2 Underweight – prevalence in under-fives 16% 10%

3 Underweight women – non-pregnant women 15-49 years with BMI less than 18.5 kg/m2

12% 8%

4 Iron deficiency anemia – prevalence in under-fives 73% 50%

5 Iron deficiency anemia – prevalence among women aged 15-49 years

49% 30%

6 Vitamin A deficiency – prevalence in under-fives 19% 13%

7 Vitamin A deficiency – prevalence among women aged 15-49 years

20% 12%

8 Low birth weight - newborns less than 2.5 kg 13% 9%

9 Exclusive breastfeeding to 6 months, percent of infants 60% 75%

10 Dietary diversification index, percent calories consumed from foods other than cereals & starchy roots

57% 75%

11 Calorie consumption (avg. daily energy intake per capita) 2,220 Kcal 2,500 Kcal

These indicators have been chosen to cover the two principal target groups of the UNAP, young children and women of childbearing age and to consider both calorie and micronutrient consumption levels, principally by looking at deficiencies in consumption as evidenced by stunted growth in children and underweight in children and women. Attention is also paid to the nutrition in pregnancy (as indicated by the birth weight of the infant), to breastfeeding, and to the diversity of foods in the diet.



5.2 Objectives,StrategiesandStrategicIntervention

To achieve the above goal and to improve the nutrition status indictors, the following five strategic objectives will be pursued over the five year period.

Objective1:Improveaccesstoandutilizationofmaternal,infantandyoungchildnutritionrelated services

Strategy1.1:Promoteaccessandutilizationofnutritionhealthrelatedservicestoallwomenofreproductiveage,infantsandyoungchildren.

Intervention1) Promote and support health and nutrition education to increase the level of awareness

on good nutrition. 2) Promote integration of nutrition services in all routine and outreach health services and

programs targeting children and mothers. 3) Undertake nutrition management of sick children, pregnant and lactating mothers,

including other women of reproductive age. 4) Integrate the management of severe and acute malnutrition into routine health

services.5) Promote utilization of antenatal and post natal care services among all pregnant and

lactating mothers to monitor child growth, health and nutrition status of both the mother and the child.

6) Promote and support breastfeeding policies, programs and initiatives. 7) Promote and support appropriate complementary feeding practices. 8) Support and scale up community based nutrition initiatives. 9) Promote proper food handling, hygiene and sanitation through increased knowledge,

use of safe water and hand washing practices at household level.

Strategy1.2:AddressGenderandSocio-culturalissuesthataffectmaternal,infantandyoungchildnutrition.

Intervention1) Promote male involvement in family health services, food security and nutrition

programs. 2) Advocate for and seek solutions for reducing workload for all women especially the

pregnant and lactating mothers. 3) Address negative food taboos and norms that affect nutrition of women, infants and

young children.

Objective2:Enhanceconsumptionofdiversediets

Strategy2.1:Increaseaccessanduseofdiversenutritiousfoodsathouseholdlevel



Intervention1) Promote production and consumption of diversified nutritious foods at household and

community levels. 2) Advocate and support integration of nutrition in agricultural programs at national and

local government levels.3) Increase consumption of both raw and processed nutritious foods. 4) Promote and support local food processing and value addition at household and

community level. 5) Promote and support the utilization of safe labour saving technologies at household and

community level. 6) Support on farm enterprise mix to promote stable diversified food production. 7) Promote production and consumption of local indigenous foods to enhance diet

diversification. 8) Promote positive indigenous dietary practices.

Strategy 2.2: Enhance post-harvest handling, storage and utilization of nutritious foods athousehold and farm level.

Intervention1) Promote and support adoption of post-harvest handling and storage technologies at

household and community level. 2) Provide an enabling environment to the private sector to manufacture, market and

distribute appropriate post-harvest handling and storage technologies.

Strategy2.3:Promotetheconsumptionofnutrientenhancedfoods.

Intervention1) Promote production of fortified common staples by local manufactures. 2) Promote production of bio-fortified varieties. 3) Promote utilization of nutrient enhanced foods through increased awareness on the

benefits of consuming fortified and bio-fortified foods including their adoption.4) Support local production of ready to use therapeutic and complementary food.

Objective3:Protecthouseholdsfromtheimpactofshocksandothervulnerabilitiesthataffecttheirnutritionalstatus

Strategy3.1:Developpreparednessplansforshocks Intervention

1) Strengthen and scale up Early Warning Systems (EWS) on food and nutrition information from community to national levels.

2) Support and promote urban farming to cater for the most vulnerable households in urban areas.

3) Develop, promote and timely implement a comprehensive package of nutritional services



and food items to provide during emergencies and recovery periods. 4) Mandatory integration of nutrition in all disaster management programs.5) Promote and support diversified production of drought-resistant crops, vegetables and

animals tolerant to heat stress at households and community level. 6) Carry out sensitization programs for communities to raise their level of awareness on

prevention, mitigation and response to risks of malnutrition during shocks.

Strategy3.2:Promotesocialprotectioninterventionsforimprovednutrition

Intervention1) Provide social transfers and support livelihoods to the most vulnerable households and

communities.2) Develop and implement special social assistance and livelihood promoting and protection

programs in areas with high levels of malnutrition. 3) Advocate and promote school feeding programs. 4) Manage cases of severe acute malnutrition by integrating care into routine health

services and follow up support and monitoring at household and community levels. 5) Promote social protection interventions for improved nutrition.

Objective4:StrengthenthePolicy,Legal,Institutionalframework,andCapacitytoeffectivelyplan,implement,monitorandevaluatenutritionprograms

Strategy 4.1: Strengthen the policy and legal framework for coordinating, planning andmonitoringnutritionactivities

Intervention1) Fast track the enactment of the Food and Nutrition Bill, which will provide the statutory

mechanism for establishing the Uganda Food and Nutrition Council (FNC) and its secretariat.

2) Revitalize and legalize the functionality of the Uganda Food and Nutrition Council and establish its secretariat/coordinating unit.

3) Review the Food and Nutrition Policy to integrate emerging issues.4) Revise the draft Uganda Food and Nutrition Strategy to align it with the prevailing national,

regional and global nutrition agenda and disseminate the Strategy widely.5) Advocate for the enactment of by-laws and ordinances that promote nutrition and food

security at District and Sub-County Levels.6) Integrate nutrition issues into plans and budgets at all levels of governments by

mainstreaming nutrition and creating vote functions for nutrition. 7) Support the development of nutrition curricula for all levels of education and training. 8) Advocate for establishment of lower and middle cadre nutrition courses in the education

structure.9) Review and integrate nutrition issues in the existing curricula of formal and non-formal

education and pre and in- service training.



Strategy4.2:Strengthenandharmonizetheinstitutionalframeworkfornutritionfromlocalto central government levels.

Intervention1) Review the current institutional framework for nutrition in the country and implement a

suitable framework. 2) Establish an interim multi-sectoral coordination mechanism for nutrition programming,

monitoring and evaluation.3) Strengthen human resource capacity for nutrition programming at all levels in all

sectors.

strategy 4.3: strengthen human resource capacity to plan, implement, monitor and evaluate foodandnutritionprogramsinthecountry.

Intervention1) Design and implement a capacity building plan for nutrition programming at national,

local government and community levels. 2) Establish a food and nutrition monitoring and evaluation system for tracking performance

of nutrition indicators and for timely decision making..3) Conduct a national food and nutrition baseline survey to establish up-to date nutrition

baseline monitoring indicators.4) Conduct periodic district level food and nutrition surveys in the geographically and

demographically vulnerable communities.5) Undertake mid-term and end of term impact evaluation of the action plan.6) Strengthen district level food and nutrition surveillance systems.

Strategy4.4:Enhanceoperationalresearchfornutrition

Intervention1) Undertake formative research studies on best practices of nutrition.2) Undertake research, document and disseminate findings on positive indigenous dietary

practices.3) Compile food composition data for all foods consumed in Uganda.4) Identify and undertake research relevant to scaling –up food and nutrition

interventions. 5) Collate and share research findings and best practices for scaling-up food and nutrition

in Uganda.

Objective5:Createawarenessandmaintainnationalinterestandcommitmenttoimprovingandsupportingnutritionprogramsinthecountry

Strategy5.1:Increaselevelsofawarenessandcommitmenttoaddressingnutritionissuesinthe country



Intervention1) Develop and implement a Nutrition Communication strategy2) Produce annual policy statements and periodic policy briefs on the food and nutrition

situation at national level.3) Commemorate events and take advantage of other opportunities presented to raise the

profile of nutrition.

Strategy5.2:Advocateforincreasedcommitmenttoimprovingnutritionoutcomes

Intervention1) Develop and implement a comprehensive and sustainable nutrition advocacy plan.2) Produce and publish an annual report on the state of the food and nutrition situation in

the country.

5.3 Priority Investment areas and core projects

5.3.1 Priority Investment areas

1. Scaling –up community based cost effective initiatives that emphasize prevention and control of malnutrition. Key areas of focus will include; Growth Monitoring and Promotion; Community based Management of Acute Malnutrition; Food fortification and bio-fortification among others.

2. Creating an enabling legal environment and building strong institutional capacity and mechanisms to implement the UNAP at all levels. Critical areas of focus will include; Fast tracking the Food and Nutrition Bill, human resource capacity development and establishment of institutional structures for nutrition implementation and coordination at national and decentralized levels.

3. Strengthen food and nutrition security safety nets at both national and decentralized levels.

4. Operational Research in Nutrition to inform implementation and UNAP progress.

Table 3: summary of Core Projects

Core Project AnnualizedCostEstimates

2011/12UGX 106

2012/13UGX 106

2013/14 UGX 106

2014/15UGX 106

Total project CostsUGX 106

lead agency

1. Growth Monitoring and Promotion

1,500 3,000 4,500 6,000 15,200 MOH

2. Community based Management of Acute and severe Malnutrition

1,047 1,332 1,879 1,596 5,854 MOH and MGLSD

3. Baby Friendly Hospital and Community Initiatives

500 1,500 2,000 1,000 5,100 MOH and MGLSD



4. Production of fortified common staples by local manufacturers

625 750 875 1,000 3,250 MOH and MTTI

5. Production of bio-fortified varieties.

350 500 650 800 2,300 MAAIF

6. Nutrition Human resource capacity building project

400, 600 800 400 2,200 FNC/ NPA

7. National Food and Nutrition Information System (NNIS)

15 250 300 350 1,050 FNS/NPA

8. Nutrition operational Research project

400 500 500 500 1,900 FNC

9. Community & household level local food processing and value addition project

450 500 550 600 2,100 MAAIF and MTTI

10. Post-harvest handling & storage technologies at household & community level.

500 600 700 800 2,600 MAAIF and MTTI

11. “Home grown” school meals project

40 40 40 40 160 MOES, MAAIF and MGLSD

12. Demonstration centres for labour saving technologies at community level

2,000 3,000 4,000 5,000 14,000 MAAIF and MoGLSD



PaRT III: IMPleMenTaTIon, fInanCInG, anD MonIToRInG & eValUaTIon fRaMeWoRKs

6 ImplementationFramework

6.1 Introduction

This chapter provides an overview of how the UNAP will be implemented and coordinated at both national and local government levels to achieve the intended goal and objectives. This implementation framework is aimed at supporting nutrition stakeholders at all levels in the country to successfully operationalize the Action plan. Nutrition is a multi-sectoral issue that should be best addressed through a well coordinated multi-sectoral approach.

The lack of an institutionalized coordinating mechanism for nutrition has been one of the main contributors to the non-effectiveness of past interventions. Inadequate coordination of the planning and implementation of nutrition programs and projects often resulted in unnecessary duplication of services and programs without proper equitable distribution and convergence of resources. Nutrition interventions have been implemented mostly as vertical projects with little human capacity, technical competence development and numbers in the public sector.

The UNAP seeks to address this gap and emphasizes the need to establish and strengthen the existing and new institutional arrangements to adequately provide policy direction, coordinate and harmonize nutrition programming, monitoring and evaluation in the country.

6.1.2 InstitutionalArrangements

The UNAP specifically recognizes the urgent need to establish and strengthen the national level coordination institutional structure, by legally establishing the Food and Nutrition Council and its Secretariat in the office of the Prime Minister as proposed in the Draft Food and Nutrition Bill. In its role as a Council, assisted by its secretariat, it will be responsible for provision of policy direction, guidance and oversight as well as effective national coordination of the implementation, monitoring and evaluation of the UNAP and other nutrition programs in the country. Specifically the council assisted by its secretariat will undertake the following functions;

• Coordinate joint planning and review with other ministries and departments as well as development partners, civil society, private sector and academia.

• Monitor and evaluate national nutrition response in the country• Mobilize resources and support for nutrition response• Provide national standards and norms for nutrition



• Lobby and advocate for both the development of nutrition structures and adequate resource allocation.

• Lobby for the establishment of nutrition consolidated fund from development partners• Facilitate cross-sector collaboration and work with higher level committees (Cabinet and

Parliament) and the Multi-sectoral Technical Committee on Nutrition.

6.1.3 CoordinationArrangements

The UNAP further recognizes the need to establish, strengthen and support nutrition coordination structures at both national and local government levels, as well as strengthening of sector specific capacity at all levels in order to achieve effective implementation of nutrition programs.

A.NationalLevelcoordination

1. PolicylevelCoordinationPolicy Coordination will be at three fronts; one will be a sub-committee of Cabinet which will meet bi-annually to review progress on key nutrition indicators in the country and provide policy direction. The second policy committee will be the Food and Nutrition Council, on which the key Line Ministers and Permanent Secretaries will be members; and the third will be the Parliamentary Sub-Committee on Nutrition.

This Council will meet quarterly to review progress on performance of key nutrition indicators, analyze budget performance of nutrition programs, analyze the constraints to implementation and provide strategic direction. Recommendations from the above two committees will then be fed into the third policy level committee, the Parliamentary Sub-Committee on Nutrition to pass the key policy and financial decisions and then back to the technical committee for implementation of decisions.

2. TechnicalLevelcoordination:NutritionMulti-sectoralTechnicalCommittee(NMTC)National level coordination of nutrition will be undertaken through the Nutrition Multi-sectoral Technical Committee (NMTC), whose establishment and terms of reference will be defined during the plan period. This committee will comprise of key technical experts from government, development partners group, private sector, academia and the civil society. The committee will be chaired by the Chair of the Food and Nutrition Council and coordinated by the head of the established secretariat.

In the absence of the legally established Food and Nutrition Council and its secretariat, the National Planning Authority (NPA), in line with its mandate to coordinate and harmonize national development planning, monitoring and evaluation, will undertake this role until the Council and its secretariat are in place. NPA will as well work with other stakeholders to ensure that the proposed institutional structures are established as soon as possible.

3. NutritionDevelopmentPartnersCommittee:This committee will be composed of representatives of nutrition development partners and will



feed into the policy and technical level committees above. This committee will be responsible for promoting and identifying funding resources for the nutrition agenda in Uganda, promoting joint resource mobilization, allocation and support, responding to the proposed consolidated development partner’s nutrition fund and provide policy guidance on alignment of nutrition programs to MDGs, UNDAF, and other international commitments on nutrition.

4. TheUgandaNutritionCoordinationForumThe Uganda Nutrition Coordination Forum (UNCF) will be inaugurated in the plan period, and will be composed of all key nutrition stakeholders at both national and local levels. This forum will meet bi-annually to review implementation of the UNAP and to provide advice and advocate for nutrition. This forum will be chaired by the National Planning Authority. UNCF membership will be comprised of the heads of the principal government departments and agencies and representatives of the private sector and non-governmental and civil society organizations involved in the implementation of programs under the UNAP.

B. Decentralizedlevelcoordination

1. SectorallevelCoordinationcommitteesAt the sector level, the various MDAs will form committees that will coordinate nutrition programs and support implementation of central government departments, local governments, private sector, academia and civil society. These committees will also ensure joint planning and budgeting for nutrition activities within the sector, prepare quarterly monitoring reports and submit to the Secretariat or NPA in the interim and provide technical guidance to stakeholders and service providers within the sector. Nutrition focal persons in each sector will be responsible for coordinating nutrition activities within their area of responsibility.

2. DistrictLevelCoordinationcommitteesDistrict level coordination of nutrition activities will be through the District Nutrition Coordination Committee. It will be composed of representatives from key sector departments, civil society organizations, private sector and academia. This committee will provide technical advice to the District technical planning committees and subsequently to the District Council. The committee will further undertake monitoring and evaluation of nutrition activities, carrying out reviews and providing technical advice to the lower local government levels. Nutrition focal persons/officers in local government and at community level will be responsible for coordinating nutrition activities within their area of responsibility.

6.1.4 ImplementationStrategy

Implementation of the UNAP will be along five main dimensions which are interrelated and mutually reinforcing for successful implementation of the Action Plan. These include; i. Focusing on prevention and control of malnutrition by targeting and investing in

interventions that cause an impact within the window of opportunity (1000 days) period from inception of pregnancy to two years after birth.

ii. Scaling –up community based initiatives that have proven to have a high impact and yet



cost effective. iii. Focusing on management of cases of malnutrition to especially reduce cases of acute

malnutrition. iv. Focusing on food based approaches that have been proven to be sustainable and with

wide linkages to a larger part of the national economy. v. Focus on creating an enabling legal environment and building strong institutional

structures and mechanisms and capacity at all levels.

6.1.5 Prerequisitesforimplementation

Successful implementation of the UNAP will require the following:• Ownership of the action plan by the key government ministries of: Health; Agriculture,

Animal Industries and Fisheries; Education and Sports; Water and Environment; Local Government; Gender, Labour and Social Development; Tourism, Trade & Industry; and support from MoFPED; OPM and NPA.

• Political will at both national and local government levels and financial commitment.• Behavior change at national, local and household levels to promote good nutrition.• Routine and effective monitoring and evaluation of the implementation of the UNAP to

ensure that the plan is on track.• Effective coordination and networking of implementing agencies and development

partners.The implementation of the UNAP will be a shared responsibility of the public sector, the private sector, development partners, non-governmental and civil society organizations, and the research institutions and academia.

7 FinancingFramework

The budget is the sum of all budget estimates from the programs/activities under each objective, representing a snapshot of the current nutrition priorities for Uganda. The total cost of the five year Uganda Nutrition Action Plan is 155,514 billion Uganda shillings (Table 4 and Annex II). Financing the Uganda Nutrition Action Plan will require concerted effort from the Government of the Republic of Uganda, development partners, civil society organizations and the private sector. However, the major investor in these nutrition priorities will be the Government of the Republic of Uganda.

7.1 Government of Uganda

The government, both central and local governments, in alliance with other agencies and development partners, will finance the Uganda Nutrition Action Plan through focused resource reallocation within existing budgets as well as mainstreaming nutrition in various sector programs to increase resource availability. This calls for high prioritization of food security and nutrition in national programs – specifically in sectors such as health, agriculture, social Development, finance, education, trade and tourism and local development. For successful resource mobilization, a strong advocacy strategy will be employed to demonstrate to sectors and development partners, the cost-effectiveness of improved investment in nutrition compared to the adverse effects of



failure to do so. Addition financing is expected through earmarked expenditure on nutrition-specific activities under various sectors.

7.2 Development partners

The Government appreciates the fact that the current domestic budgets will not be able to independently finance the Uganda Nutrition Action Plan to the desired level of investment required to sustainably impact the nutrition indicators. Whereas in the long term, Government will seek to fund this action plan from domestic revenues, it will continue to depend on external resources in the short to medium term, while progressively reducing this reliance for increasing investment in nutrition. Opportunities for initial resources mobilization will be through existing forums such as the Local Development Partners (LDP) group meeting which assembles on a monthly basis. The government will further take advantage of existing and new global and regional initiatives including the Feed the Future Initiatives, Scale Up Nutrition (SUN), CAADP among others to identify potential sources for financing the nutrition programs. Various advocacy approaches will be utilized to demonstrate the cost effectiveness for increasing investment in nutrition.

The current support for nutrition programs is fragmented with minimal impact on the nutrition indicators. Thus, at national level, advocacy for basket funding for nutrition programs from the national nutrition development partners to maximize nutrition investments will be adopted. This will facilitate a more holistic approach to nutrition programming and implementation, since the tendency is to implement only those activities that would have received funding, even when these are limited in scope and potential impact, i.e., micronutrient programs have received a lot of funding and yet macro nutrient problems remain largely not addressed.

Some development partners provide support direct to civil society organizations, NGOs and to some districts outside the Government budget. Whereas this arrangement is not being discouraged, it will be appropriate to share information on the level of support and the activities of the action plan being funded in order to have a fairly accurate assessment of the effects on the nutrition indicators.

7.3 Public-PrivatePartnerships

Experience shows that co-operation between the public and private sectors in form of public-private sector partnerships (PPP) can be a powerful incentive for improving the quality and efficiency of public services, and a means of public infrastructure financing. There will be strategic exploration of PPPs with the highest cost effectiveness in sustainably addressing malnutrition in Uganda especially in the value chain, energy and labour saving technologies.

There is need to effectively coordinate existing and available resources for nutrition within national budget, private sector and from development partners to maximize on impact. The government envisages instigation of community ownership in addressing nutrition problems. Increased awareness will be created such that communities affected take ownership of their nutritional problems: appreciate how these are affecting their development and that they can do



something by participating in the identification of strategies to address their nutrition problems, then community contribution to nutrition interventions would increase and thus activities will remain sustained through community effort.

Table4:Summaryofthefiveyearcostedimplementationmatrix

obJeCTIVe 2010-11 2011-12 2012-13 2013-14 2014-15 ToTal Percentage

UGX 106 UGX 106 UGX 106 UGX 106 UGX 106 UGX 106 Us$ 103

1. Improve access to and utilization of maternal, infant and young child nutrition related services

4,987 5,699 7,892 10,399 11,606 45,683 22,841 29.4

2. Enhance consumption of diverse diets

1,227 3,777 4,817 5,127 6,777 21,727 10,863 14.0

3. Protect households from the impact of shocks and other vulnerabilities that affect their nutritional status

920 6,920 9,960 13,030 15,080 45,910 22,955 29.4

4. Strengthen the policy, legal, institutional framework, and capacity to effectively plan, implement, monitor and evaluate nutrition programs

3,855 6,292 7,729 8,836 6,343 33,055 16,528 21.3

5. Create a awareness and maintain national interest and commitment to improve and support nutrition programs in the country

1,595 1,732 1,835 1,937 2,040 9,140 4,570 5.9

ToTal 12,584 24,420 32,233 39,329 41,846 155,514 777,572 100

8 MonitoringandEvaluationframework

The current monitoring and evaluation system for nutrition and food security indicators is weak with minimal and fragmented systems among sectors and development partners. To effectively track progress on the implementation of the action plan and performance of the target outcome and output indicators, a comprehensive and integrated multi-sectoral monitoring system for nutrition will be developed.



8.1 AnnualMonitoringandReportingsystem

An annual multi-sectoral monitoring and reporting system will be established with a lead coordinating agency which will be NPA in the interim and later the Food and Nutrition Council when legally established. All implementing agencies will submit annual reports on the status of implementation and performance of the target indicators to the coordinating agency. The agency will then compile and produce an annual report and annual review meeting held for the implementing agencies as well as other nutrition stakeholders.

8.2 QuarterlyMonitoringandreportingsystem

All implementing agencies will submit quarterly reports in their thematic areas to the coordinating agency which will compile and produce a quarterly report and quarterly meetings will be held to discuss the reports and come up with appropriate measures if implementation is slow or not on track.

8.3 Annual,mid–termandendoftermEvaluationsandreviews

To evaluate the effectiveness and impact of the various programs, interventions and the overall performance of the Nutrition Action Plan, evaluations and reviews will be undertaken at an annual, mid-term (two and a half years) and end of term (five years) basis.

8.4 Indicators and Targets

The Table 5 below indicates the key outcome level indicators and targets that will be monitored during the five year plan period.

Table5:AnnualizedKeyOutcomeIndicatorsandTargets

no outcome indicator baseline1,2 2010/11 2012 2013 20142015/16

UnaP TaRGeT

1 Stunting – prevalence in under-fives1 38% 37% 35% 34% 33% 32%

2 Underweight – prevalence in under-fives 16% 15% 14% 12% 11% 10%3 Underweight women – non-pregnant

women 15-49 years with BMI less than 18.5 kg/m2

12% 11% 10% 10% 9% 8%

4 Iron deficiency anemia – prevalence in under-fives

73% 68% 64% 59% 54% 50%

5 Iron deficiency anemia – prevalence among women aged 15-49 years

49% 45% 41% 38% 34% 30%

6 Vitamin A deficiency – prevalence in under-fives

19% 18% 17% 15% 14% 13%

7 Vitamin A deficiency – prevalence among women aged 15-49 years

20% 18% 17% 15% 14% 12%

8 Low birth weight - newborns less than 2.5 kg

13% 12% 11% 11% 10% 10%



9 Exclusive breastfeeding to 6 months, percent of infants

60% 63% 66% 69% 72% 75%

10 Dietary diversification index, percent calories consumed from foods other than cereals & starchy roots

57% 61% 64% 69% 71% 75%

11 Calorie consumption (avg. daily energy intake per capita)2

2,220Kcal 2,276 Kcal

2,332Kcal

2,388 Kcal

2,444 Kcal

2,500 Kcal

1 UDHS, 2006 and 2 SOFI, 2008,

31EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

ANANNEX

I:Implem

entation

Matrix

Goa

l:ToRed

uceMalnu

trition

levelsamon

gwom

enofrep

rodu

ctiveage,infan

tsand

you

ngchildrenov

erth

ene

xtfiveyea

rs201

0-20

15.

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Objective1:

Impr

ove

ac-

cess

to a

nd

utiliz

ation

of

mat

erna

l, in

fant

and

yo

ung

child

nu

triti

on

rela

ted

ser-

vice

s

1.1

Prom

ote

acce

ss

anduti

lizati

onof

nutrition

hea

lth

rela

ted

serv

ices

to

all

wom

en o

f reprod

uctiveage,

infa

nts

& y

oung

ch

ildre

n

Prom

ote

and

supp

ort

•he

alth

and

nut

ritio

n ed

ucati

on (I

EC m

ater

ials

, m

edia

)

Incr

ease

d le

vel o

f aw

aren

ess

on

•go

od n

utri

tion

Incr

ease

d ac

cess

and

util

izati

on

•of

IEC

mat

eria

ls &

mes

sage

s to

ta

rget

ben

efici

arie

s.

MO

HLG

s ,M

oGLS

D, M

AA

IF, M

OES

, D

evel

opm

ent P

artn

ers,

CSO

s,

MFP

ED

Prom

ote

inte

grati

on o

f •

nutr

ition

ser

vice

s in

all

routi

ne &

out

reac

h he

alth

se

rvic

es a

nd p

rogr

ams

targ

eting

chi

ldre

n an

d m

othe

rs.

Gro

wth

mon

itori

ng a

nd p

rom

o-•

tion

and

othe

r nu

triti

on s

ervi

ces

inte

grat

ed in

all

routi

ne &

out

-re

ach

heal

th s

ervi

ces

Incr

ease

d ac

cess

and

util

izati

on

•to

nut

ritio

n se

rvic

es

MO

HLG

s, M

oGLS

D, M

AA

IF, M

OES

, D

evel

opm

ent P

artn

ers,

CSO

s,

MFP

ED

Nut

ritio

n m

anag

emen

t of

•si

ck c

hild

ren,

pre

gnan

t &

lact

ating

mot

hers

& w

om-

en o

f rep

rodu

ctive

age

Incr

ease

d ac

cess

& in

take

of

•nu

triti

ous

food

s by

sic

k ch

ildre

n an

d pr

egna

nt, l

acta

ting

mot

hers

&

wom

en o

f rep

rodu

ctive

age

MO

HLG

s, M

oGLS

D, M

AA

IF, M

OES

, M

FPED

Dev

elop

men

t Par

tner

s,

CSO

s,

32EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Inte

grat

e m

anag

emen

t of

•ca

ses

of s

ever

e &

acu

te

mal

nutr

ition

into

routi

ne

heal

th s

ervi

ces

Capa

city

for

man

agem

ent o

f •

acut

e &

sev

ere

mal

nutr

ition

en

hanc

ed

Cent

res

of m

anag

emen

t of a

cute

•

& s

ever

e m

alnu

triti

on in

crea

sed

with

in e

xisti

ng h

ealth

faci

lities

co

untr

y w

ide

Case

s of

acu

te a

nd s

ever

e m

al-

•nu

triti

on m

onito

red

& fo

llow

ed-

up

MO

HM

GLS

D, L

Gs,

MO

ES, M

AA

IF,

MFP

ED, P

riva

te s

ecto

r, D

evel

opm

ent P

artn

ers,

CSO

s

Prom

ote

utiliz

ation

of a

n-•

tena

tal a

nd p

ost n

atal

car

e se

rvic

es b

y al

l pre

gnan

t an

d la

ctati

ng m

othe

rs.

Incr

ease

d nu

mbe

r of

mot

hers

•

atten

ding

AN

C &

PN

C se

rvic

esM

OH

LGs,

MoG

LSD

, MA

AIF

, MO

ES,

MFP

ED D

evel

opm

ent P

artn

ers,

CS

Os,

PO

PSEC

.

Prom

ote

and

sup

port

•

brea

stfee

ding

pol

icie

s,

prog

ram

s an

d in

itiati

ves

Incr

ease

d nu

mbe

r of

cas

es o

f •

excl

usiv

ely

brea

stfed

bab

ies

Incr

ease

d nu

mbe

r of

bab

y •

frie

ndly

wor

kpla

ces,

com

mun

i-tie

s &

hea

lth fa

ciliti

es b

oth

pub-

lic &

pri

vate

In

crea

sed

num

ber

of e

mpl

oyer

s,

•in

stitu

tions

/age

ncie

s im

plem

ent-

ing

the

mat

erni

ty &

pat

erni

ty

law

MO

HLG

s, M

oGLS

D, M

AA

IF, M

OES

, D

evel

opm

ent P

artn

ers,

CSO

s

Prom

ote

& s

uppo

rt a

p-•

prop

riat

e co

mpl

emen

tary

fe

edin

g pr

actic

es

Incr

ease

d us

e of

div

ersi

fied

loca

l •

food

s fo

r w

eani

ngIn

crea

sed

freq

uenc

y of

com

ple-

•m

enta

ry m

eals

at H

/Hs.

Incr

ease

d le

vel o

f kno

wle

dge

of

•m

othe

rs o

n ap

prop

riat

e co

mpl

e-m

enta

ry fe

edin

g pr

actic

es

Incr

ease

in n

umbe

r of

app

ropr

i-•

ate

com

plem

enta

ry fe

edin

g pr

ac-

tices

/ini

tiativ

es s

uppo

rted

.

MO

HLG

s, M

oGLS

D, M

AA

IF, M

OES

, M

FPED

Dev

elop

men

t Par

tner

s,

CSO

s, M

oICT

33EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Supp

ort a

nd s

cale

up

com

-•

mun

ity b

ased

nut

ritio

nin

itiati

ves

Incr

ease

in c

omm

unity

bas

ed

•nu

triti

on in

itiati

ves

supp

orte

dIn

crea

sed

leve

l of c

over

age

of

•co

mm

unity

bas

ed n

utri

tion

ini-

tiativ

esIn

crea

sed

leve

l of c

omm

unity

•

parti

cipa

tion

&in

volv

emen

t in

co

mm

unity

bas

ed n

utri

tion

pro-

gram

s

MO

H/M

GLS

D/

MA

AIF

/MO

ESLG

s, M

AA

IF, M

OES

, MFP

ED,

Dev

elop

men

t Par

tner

s, C

SOs,

M

oICT

Prom

ote

pro

per

food

•

hand

ling

hygi

ene

and

sani

-ta

tion

(FH

HS)

.

Incr

ease

d kn

owle

dge

on p

rope

r •

FHH

SIn

crea

se in

use

of s

afe

wat

er a

t •

HH

leve

l.In

crea

se in

han

d w

ashi

ng p

rac-

•tic

es a

t hou

seho

ld le

vel.

MO

HLG

s, M

WE,

MO

ES, D

evel

opm

ent

Part

ners

, CSO

s, M

FPED

, MoI

CT

1.2:

Add

ress

Gen

der

& s

ocio

-cul

tura

l is

sues

that

af-

fect

mat

erna

l, in

fant

and

yo

ung

child

nu

triti

on

Prom

ote

mal

e in

volv

e-•

men

t in

fam

ily h

ealth

se

rvic

es, f

ood

secu

rity

and

nu

triti

on p

rogr

ams

Incr

ease

d le

vel o

f kno

wle

dge

•am

ong

men

on

fam

ily h

ealth

&

nutr

ition

issu

esIn

crea

sed

leve

l of m

ale

invo

lve-

•m

ent i

n fa

mily

hea

lth, f

ood

se-

curi

ty a

nd n

utri

tion

serv

ices

and

pr

ogra

ms.

MG

LSD

/MO

H/

MA

AIF

MO

H, M

AA

IF, L

Gs,

MFP

ED

Dev

elop

men

t Par

tner

s, C

SOs.

Adv

ocat

e a

nd s

eek

solu

-•

tions

for

redu

cing

wor

k-lo

ad fo

r al

l wom

en e

spe-

cial

ly th

e pr

egna

nt a

nd

lact

ating

mot

hers

Incr

ease

d le

vel o

f aw

aren

ess

•am

ong

mal

e sp

ouse

s an

d ot

her

fam

ily m

embe

rs o

n be

nefit

s of

re

duce

d w

orkl

oad

on w

omen

.In

crea

se in

sha

ring

of f

arm

& H

H

•w

ork

amon

g H

H m

embe

rs.

Incr

ease

d up

take

of l

abou

r •

savi

ng te

chno

logi

es a

t far

m &

ho

useh

old

leve

ls

MG

LSD

/M

AA

IFM

OH

, LG

s, M

FPED

D

evel

opm

ent P

artn

ers,

CSO

s.

34EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Add

ress

neg

ative

food

ta

boos

& n

orm

s th

at a

f-fe

ct n

utri

tion

of w

omen

, in

fant

s &

you

ng c

hild

ren

Incr

ease

d kn

owle

dge

on th

e im

-•

pact

s of

neg

ative

food

tabo

os &

no

rms

that

affe

ct n

utri

tion

chan

ge o

f neg

ative

atti

tude

s,

•be

liefs

and

pra

ctice

sIn

crea

sed

inta

ke o

f cul

tura

lly

•pr

ohib

ited

food

s

MA

AIF

/ M

GLS

DM

OH

, LG

s, D

evel

opm

ent

Part

ners

, CSO

s

Objective2:

enha

nce

con-

sum

ption

of

dive

rse

diet

s

Stra

tegy

2.1

: In

crea

se a

cces

s to

di

vers

e nu

triti

ous

food

s an

d us

e at

ho

useh

old

leve

l

Prom

ote

prod

uctio

n an

d •

cons

umpti

on o

f div

ersi

-fie

d nu

triti

ous

food

s at

ho

useh

old

and

com

mu-

nity

leve

ls

Incr

ease

d pr

oduc

tion

of d

iver

si-

•fie

d n

utri

tious

food

sIn

crea

sed

cons

umpti

on o

f div

er-

•si

fied

nutr

itiou

s fo

ods

Incr

ease

d pr

ovis

ion

of a

ppro

pri-

•at

e ag

ricu

ltura

l inp

uts

& s

ervi

ces

at h

ouse

hold

and

com

mun

ity

leve

l

MA

AIF

MO

H, L

Gs,

MG

LSD

, MFP

ED

Priv

ate

Sect

or, D

evel

opm

ent

Part

ners

, CSO

s.

Adv

ocat

e &

sup

port

•

inte

grati

on o

f nut

ritio

n an

d H

ome

econ

omic

s in

A

gric

ultu

ral p

rogr

ams

Incr

ease

d in

tegr

ation

of n

utri

-•

tion

and

Hom

e ec

onom

ics

is

-su

es i

n ag

ricu

ltura

l pro

gram

s

MA

AIF

/ N

PAPr

ivat

e Se

ctor

, Dev

elop

men

t Pa

rtne

rs, C

SOs,

MFP

ED

Incr

ease

con

sum

ption

of

•bo

th ra

w a

nd p

roce

ssed

nu

triti

ous

food

s

Incr

ease

d co

nsum

ption

of r

aw

•ve

geta

bles

and

frui

tsIn

crea

sed

cons

umpti

on o

f en-

•ri

ched

pro

cess

ed fo

ods

Incr

ease

d co

nsum

ption

of f

orti-

•fie

d fo

ods

MA

AIF

/ M

OH

MTT

I, M

FPED

Pri

vate

Sec

tor,

Dev

elop

men

t Par

tner

s.

Prom

ote

and

supp

ort l

ocal

•

food

pro

cess

ing

and

valu

e ad

ditio

n at

hou

seho

ld a

nd

com

mun

ity le

vel

Incr

ease

d p

roce

ssin

g of

nut

ri-

•tio

us fo

ods

at h

ouse

hold

& c

om-

mun

ity le

vels

Div

ersi

fied

proc

esse

d fo

od p

rod-

•uc

ts a

t HH

& c

omm

unity

leve

l.

MA

AIF

/MTT

IPr

ivat

e Se

ctor

, Dev

elop

men

t Pa

rtne

rs, M

OH

, MG

LSD

, MFP

ED

Prom

ote

and

supp

ort

the

•uti

lizati

on o

f sa

fe la

bour

sa

ving

tech

nolo

gies

at

hous

ehol

d le

vel

Incr

ease

d ty

pes

of L

ST a

t HH

&

•co

mm

unity

leve

lIn

crea

sed

utiliz

ation

of L

ST a

t HH

•

& c

omm

unity

leve

l

MA

AIF

/MTT

I/M

GLS

D, M

WE,

MEM

D, L

Gs,

Pr

ivat

e Se

ctor

, Dev

elop

men

t Pa

rtne

rs, C

SOs

35EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Supp

ort o

n fa

rm e

nter

-•

pris

e m

ix to

pro

mot

e st

able

div

ersi

fied

food

pr

oduc

tion

Incr

ease

d H

Hs

& c

omm

uniti

es

•w

ith s

tabl

e di

vers

ified

food

sup

-pl

ies

& in

com

es

MA

AIF

LGs,

MG

LSD

, MTT

I, M

FPED

, Pr

ivat

e Se

ctor

, Dev

elop

men

t Pa

rtne

rs, C

SOs

Pro

mot

e pr

oduc

tion

&

•co

nsum

ption

of l

ocal

in

dige

nous

food

s to

en-

hanc

e di

et d

iver

sific

ation

.

Incr

ease

d pr

oduc

tion

& c

on-

•su

mpti

on o

f ind

igen

ous

food

sIn

crea

sed

awar

enes

s on

the

nu-

•tr

itiou

s va

lue

of in

dige

nous

food

sIn

crea

sed

expl

oita

tion

and

utili-

•za

tion

of fo

ods

from

non

con

ven-

tiona

l sou

rces

Indi

geno

us fo

od d

ieta

ry p

racti

ces

•em

phas

ized

in th

e sc

hool

cur

ri-

cula

& n

ation

al e

xam

inati

on.

Incr

ease

d ap

plic

ation

of i

ndig

-•

enou

s di

etar

y pr

actic

es a

t hou

se-

hold

& c

omm

unity

leve

ls.

MA

AIF

MO

H,M

OES

, MW

E,M

GLS

D,

Dev

elop

men

t Par

tner

s, C

SOs

Stra

tegy

2.2

: En

hanc

e po

st-

harv

est h

andl

ing,

st

orag

e &

uti

liza-

tion

of n

utri

tiou

s fo

ods

at h

ouse

-ho

ld &

farm

leve

l

Prom

ote

& s

uppo

rt

•ad

optio

n of

pos

t-ha

rves

t ha

ndlin

g &

sto

rage

tech

-no

logi

es a

t hou

seho

ld &

co

mm

unity

leve

l.

Incr

ease

d aw

aren

ess

& a

dopti

on

•of

app

ropr

iate

pos

t-ha

rves

t han

-dl

ing

& s

tora

ge te

chno

logi

es

MA

AIF

/MO

ESM

OH

, MTT

I, M

GLS

D,

Dev

elop

men

t Par

tner

s, C

SOs

Prov

ide

an e

nabl

ing

en-

•vi

ronm

ent t

o th

e pr

ivat

e se

ctor

to m

anuf

actu

re,

&

dist

ribu

te a

ppro

pria

te

post

-har

vest

han

dlin

g &

st

orag

e te

chno

logi

es

Clea

r po

licy

deve

lope

d to

gui

de

•&

pro

vide

ince

ntive

s to

sm

all

& m

ediu

m s

cale

pri

vate

sec

tor

play

ers

Priv

ate

play

ers

supp

orte

d to

ac-

•qu

ire e

quip

men

t, fi

nanc

ial s

up-

port

& in

fras

truc

ture

Incr

ease

in P

PPs

for

food

pro

-•

cess

ing

& s

tora

geA

ffirm

ative

acti

on p

rovi

ded

for

geog

raph

ical

ly m

argi

naliz

ed a

reas

MTT

I/ M

TTI

MA

AIF

, MO

ES, D

evel

opm

ent

Part

ners

, Pri

vate

Sec

tor

36EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Stra

tegy

2.3

: Pr

omot

e th

e co

nsum

ption

of

nutr

ient

enh

ance

d fo

ods

Prom

ote

prod

uctio

n of

•

forti

fied

com

mon

sta

ples

by

loca

l man

ufac

ture

rs

A P

olic

y pr

omoti

ng fo

rtific

ation

•

in p

lace

PPPs

for

food

forti

ficati

on in

-•

crea

sed

& s

tren

gthe

ned

Incr

ease

d va

riet

y o

f for

tified

•

food

s In

dust

ries

forti

fyin

g fo

ods

scal

ed

•up

cou

ntry

wid

e

MO

H/M

TTI

UN

BS, N

DA

, LG

s, P

riva

te S

ecto

r, D

evel

opm

ent p

artn

ers,

CSO

s

Prom

ote

prod

uctio

n of

•

bio-

forti

fied

vari

eties

Po

licy

prom

oting

bio

- for

tifica

-•

tion

in p

lace

Incr

ease

d va

riet

y o

f bio

-for

tified

•

food

sBi

o-fo

rtific

ation

of f

oods

sca

led

•up

cou

ntry

wid

ePP

Ps fo

r fo

od b

io-f

ortifi

catio

n •

incr

ease

d &

str

engt

hene

d

MA

AIF

/MTT

IM

OH

, LG

s, P

riva

te S

ecto

r, D

evel

opm

ent p

artn

ers,

CSO

s

Prom

ote

utiliz

ation

of n

u-tr

ient

enh

ance

d fo

ods

Incr

ease

d aw

aren

ess

on th

e be

n-•

efits

of n

utri

ent e

nhan

ced

food

sIn

crea

sed

cons

umpti

on o

f for

ti-•

fied

food

sIn

crea

sed

adop

tion

& c

onsu

mp-

•tio

n of

bio

-for

tified

food

s

MA

AIF

/MO

H/

MTT

IPr

ivat

e se

ctor

, Dev

elop

men

t pa

rtne

rs, L

Gs

Supp

ort

loca

l pro

ducti

on

•of

read

y to

use

ther

apeu

-tic

and

com

plem

enta

ry

food

s

Polic

y pr

omoti

ng th

erap

eutic

&

•co

mpl

emen

tary

food

s in

pla

ceTh

erap

eutic

food

s in

clud

ed o

n •

the

esse

ntial

dru

gs li

stLo

cal I

ndus

trie

s pr

oduc

ing

ther

a-•

peuti

c &

com

plem

enta

ry fo

ods

scal

ed u

p co

untr

y w

ide

PPPs

for

ther

apeu

tic &

com

ple-

•m

enta

ry fo

ods

stre

ngth

ened

MO

H/M

TTI

MA

AIF

, LG

s, M

JCA

, Pri

vate

Se

ctor

, Dev

elop

men

t Par

tner

s,

CSO

s, U

NBS

.

37EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Obj

ecti

ve 3

: P

rote

ct

hous

ehol

ds

from

the

impa

ct o

f sh

ocks

&

othe

r vu

l-ne

rabi

lities

th

at a

f-fe

ct t

heir

nu

triti

onal

st

atus

Stra

tegy

3.1

:D

evel

op p

repa

red-

ness

pla

ns fo

r sh

ocks

Stre

ngth

en a

nd s

cale

up

•ea

rly

war

ning

sys

tem

s on

fo

od a

nd n

utri

tion

info

r-m

ation

from

com

mun

ity

to n

ation

al le

vels

EWS

in M

AA

IF

•st

reng

then

ed(c

apac

ity &

equ

ip-

men

t)N

utri

tion

info

rmati

on s

yste

m in

•

MO

H s

tren

gthe

ned

Nati

onal

Nut

ritio

n su

rvei

llanc

e •

syst

em e

stab

lishe

d

MO

H/M

AA

IF/

FNC

OPM

, LG

s, P

riva

te S

ecto

r, D

evel

opm

ent P

artn

ers,

CSO

s,

Aca

dem

ia

Dev

elop

, pro

mot

e &

•

timel

y im

plem

ent a

com

-pr

ehen

sive

pac

kage

of n

u-tr

ition

al s

ervi

ces

and

food

ite

ms

to p

rovi

de d

urin

g em

erge

ncie

s &

reco

very

pe

riod

s.

Com

preh

ensi

ve p

acka

ge o

f nut

ri-

•tio

n se

rvic

es &

requ

irem

ents

for

emer

genc

ies

deve

lope

d Co

mpr

ehen

sive

nut

ritio

n se

r-•

vice

s tim

ely

impl

emen

ted

in

emer

genc

ies.

MO

H/O

PMO

PM, M

AA

IF, P

riva

te S

ecto

r, D

evel

opm

ent p

artn

ers,

CSO

s

Inte

grat

e nu

triti

on in

•

disa

ster

man

agem

ent p

ro-

gram

s.

Capa

city

of l

ocal

gov

ernm

ents

•

to p

rovi

de n

utri

tion

serv

ices

in

emer

genc

ies

built

.N

utri

tion

Pack

age

inte

grat

ed in

•

all d

isas

ter

man

agem

ent p

ro-

gram

s

MO

H/O

PM/

MA

AIF

/MO

LGLG

s, M

GLS

D, M

AA

IF, P

riva

te

Sect

or, D

evel

opm

ent P

artn

ers,

CS

Os

Prom

ote

and

supp

ort

•di

vers

ified

pro

ducti

on o

f dr

ough

t-re

sist

ant c

rops

, ve

geta

bles

and

ani

mal

s to

lera

nt to

hea

t str

ess.

Incr

ease

d pr

oduc

tion

of d

roug

ht

•re

sist

ant c

rops

, veg

etab

les

& a

ni-

mal

s to

lera

nt to

hea

t str

ess

MA

AIF

MW

E, L

Gs,

MG

LSD

, Pr

ivat

e Se

ctor

, Dev

elop

men

t Par

tner

s,

CSO

s

Sens

itiza

tion

prog

ram

s fo

r •

com

mun

ities

to p

reve

nt,

miti

gate

and

resp

ond

to

risk

s of

mal

nutr

ition

dur

-in

g sh

ocks

Incr

ease

d le

vel o

f aw

aren

ess

on

•pr

oper

nut

ritio

n du

ring

sho

cks

OPM

/MO

H/

MA

AIF

MO

H, M

WE,

MA

AIF

, M

GLS

D, L

Gs,

Pri

vate

Sec

tor,

Dev

elop

men

t Par

tner

s, C

SOs

38EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Stra

tegy

3.2

: Pr

omot

e so

cial

pr

otec

tion

inte

r-ve

ntion

s fo

r im

-pr

oved

nut

riti

on

Prov

ide

soci

al tr

ansf

ers

•(c

ash,

food

s, a

gric

ultu

ral

inpu

ts) a

nd s

uppo

rt li

ve-

lihoo

ds fo

r vu

lner

able

ho

useh

olds

and

com

mun

i-tie

s.

Incr

ease

in v

ulne

rabl

e H

Hs

•re

ceiv

ing

soci

al tr

ansf

ers(

cash

, fo

ods,

agr

icul

tura

l inp

uts)

MG

LSD

/M

AA

IF/

OPM

MFP

ED, L

Gs,

OPM

, Pri

vate

Se

ctor

, Dev

elop

men

t Par

tner

s,

CSO

s

Dev

elop

& Im

plem

ent

•sp

ecia

l soc

ial a

ssis

tanc

e an

d liv

elih

ood

prom

oting

an

d pr

otec

tion

prog

ram

s in

are

as w

ith h

igh

leve

ls o

f m

alnu

triti

on

Spec

ial f

ood

base

d pr

ogra

ms

for

vuln

erab

le g

roup

s in

are

as w

ith

high

mal

nutr

ition

leve

ls d

esig

ned

&

impl

emen

ted.

Incr

ease

d co

vera

ge in

live

lihoo

d pr

ogra

ms.

MG

LSD

/ M

AA

IFLG

s, O

PM, M

OH

, Pri

vate

Sec

tor,

Dev

elop

men

t Par

tner

s, C

SOs

Adv

ocat

e an

d pr

omot

e •

scho

ol m

eals

pro

gram

sIn

crea

sed

awar

enes

s on

the

ben-

•efi

ts o

f nut

ritio

us s

choo

l mea

ls

on le

arni

ng o

utco

mes

“Hom

e gr

own”

sch

ool m

eals

pro

-•

vide

dSc

hool

s su

ppor

ted

to p

rovi

de

•sc

hool

mea

ls

MO

ES/M

AA

IF/

MG

LSD

MA

AIF

,MO

H, L

Gs,

Dev

elop

men

t Pa

rtne

rs, C

SOs,

Pri

vate

Sec

tor,

MFP

ED

Prom

ote

soci

al p

rote

c-•

tion

inte

rven

tions

for

im-

prov

ed n

utri

tion

Incr

ease

d So

cial

pro

tecti

on in

ter-

•ve

ntion

s fo

r im

prov

ed n

utri

tion.

MG

LSD

MO

H, M

AA

IF, D

evel

opm

ent

Part

ners

Supp

ort a

nd p

rom

ote

ur-

•ba

n fa

rmin

g fo

r vu

lner

able

ho

useh

olds

Urb

an fa

rmin

g po

licy

deve

lope

d •

and

oper

ation

alis

edSu

per

mar

ket l

inke

d Va

lue

chai

ns

•de

velo

ped

for

high

val

ue e

nter

-pr

ise

in u

rban

and

per

i-urb

an

area

s

MA

AIF

/MTT

IM

OH

, LG

s, D

evel

opm

ent p

art-

ners

, CSO

s, P

riva

te s

ecto

r

39EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Objective4:

Stre

ngth

en

the

polic

y,

lega

l, in

-sti

tuti

onal

fr

amew

ork,

an

d ca

-pa

city

to

effec

tive

ly

plan

, im

ple-

men

t, m

oni-

tor

and

eval

uate

nu

triti

on

prog

ram

s

4.1

: Str

engt

hen

the

polic

y an

d le

gal f

ram

ewor

k fo

r co

ordi

nati

ng,

plan

ning

and

m

onit

orin

g nu

tri-

tion

acti

viti

es

Fast

trac

k th

e en

actm

ent

•of

the

Food

and

Nut

ritio

n Bi

ll.

Food

and

nut

ritio

n Bi

ll en

acte

d •

NPA

/MA

AIF

MO

H,M

JCA

, Dev

elop

men

t Pa

rtne

rs

Revi

taliz

e th

e fu

nctio

nalit

y •

of th

e U

gand

a Fo

od a

nd

Nut

ritio

n Co

unci

l and

es-

tabl

ish

its s

ecre

tari

at

FNC

func

tiona

l•

FNC

secr

etar

iat e

stab

lishe

d•

OPM

NPA

Revi

ew o

f the

Foo

d &

•

Nut

ritio

n Po

licy

Revi

sed

Food

and

Nut

ritio

n •

Polic

y FN

CM

OH

,MA

AIF

,NPA

,MO

GLS

D,

MTT

I Pri

vate

Sec

tor,

Dev

elop

men

t Par

tner

s, C

SOs

Revi

se th

e dr

aft U

gand

a •

Food

and

Nut

ritio

n St

rate

gy.

Food

& N

utri

tion

stra

tegy

re-

•vi

sed

FNC

secr

e-ta

riat

NPA

, MTT

I, LG

s, P

riva

te S

ecto

r, D

evel

opm

ent P

artn

ers,

CSO

s

Adv

ocat

e fo

r en

actm

ent

•of

by-

law

s an

d or

dina

nces

th

at p

rom

ote

nutr

ition

an

d fo

od s

ecur

ity

By-la

ws

and

ordi

nanc

es th

at p

ro-

•m

ote

nutr

ition

& fo

od s

ecur

ity

deve

lope

d &

ena

cted

FNC/

MoL

GLG

s, M

OH

, MA

AIF

, MTT

I, M

OES

, CS

Os,

Dev

elop

men

t Par

tner

s,

MFP

ED

Inte

grat

e nu

triti

on is

sues

•

into

pla

ns a

nd b

udge

ts a

t al

l lev

els

of g

over

nmen

ts.

Vote

func

tions

for

nutr

ition

es-

•ta

blis

hed

Nut

ritio

n m

ains

trea

med

into

•

sect

ors

and

dist

rict

dev

elop

men

t pl

ans

NPA

/ M

FPED

MO

H, M

AA

IF, M

TTI,

MO

ES,

MG

LSD

, MW

E, M

OLG

, PO

PSEC

, D

evel

opm

ent P

artn

ers

40EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Supp

ort t

he d

evel

opm

ent

•of

nut

ritio

n cu

rric

ula

for

all l

evel

s of

edu

catio

n &

tr

aini

ng

Nut

ritio

n cu

rric

ula

in p

lace

at a

ll •

leve

ls o

f edu

catio

nM

oES

Aca

dem

ia, M

OH

, MA

AIF

Adv

ocat

e fo

r es

tabl

ish-

•m

ent o

f low

er &

mid

dle

cadr

e nu

triti

on c

ours

es in

th

e ed

ucati

on s

truc

ture

.

Low

er &

mid

dle

cadr

e nu

triti

on

•co

urse

s es

tabl

ishe

d.M

oES

MO

H, M

AA

IF, A

cade

mia

Revi

ew &

in

tegr

ate

nutr

i-•

tion

issu

es in

the

exis

ting

curr

icul

a of

form

al &

non

-fo

rmal

edu

catio

n &

pre

&

in-s

ervi

ce tr

aini

ng

Nut

ritio

n is

sues

inte

grat

ed in

•

curr

icul

a.M

OES

MO

H, M

AA

IF, A

cade

mia

Stra

tegy

4.2

: St

reng

then

and

ha

rmon

ize

the

in

stitu

tion

al

fram

ewor

k fo

r

nutr

ition

from

lo-

cal

to c

entr

al g

ov-

ernm

ent

leve

ls

Revi

ew th

e cu

rren

t ins

titu-

•tio

nal f

ram

ewor

k fo

r nu

tri-

tion

in th

e co

untr

y an

d im

plem

ent a

n ap

prop

riat

e fr

amew

ork.

A re

view

of t

he c

urre

nt in

stitu

-•

tiona

l fra

mew

ork

unde

rtak

enKe

y re

com

men

datio

ns o

f the

•

repo

rt Im

plem

ente

d

NPA

OPM

MO

H, M

AA

IF, M

TTI,

MO

ES,

MG

LSD

, MW

E, M

OLG

, PO

PSEC

, D

evel

opm

ent P

artn

ers

Esta

blis

h an

inte

rim

mul

ti-•

sect

oral

coo

rdin

ation

m

echa

nism

for

nut

ritio

n pr

ogra

mm

ing,

Foo

d an

d m

onito

ring

and

eva

luati

on

Mul

ti-se

ctor

al c

oord

inati

on

•m

echa

nism

in p

lace

NPA

MO

H, M

AA

IF, M

TTI,

MO

ES,

MG

LSD

, MW

E, M

OLG

, PO

PSEC

, D

evel

opm

ent P

artn

ers,

CSO

s,

Stre

ngth

en in

stitu

tiona

l •

capa

city

for

nutr

ition

pro

-gr

amm

ing

at a

ll le

vels

Nut

ritio

n fo

cal p

erso

ns a

p-•

poin

ted

or a

ssig

ned

in k

ey M

DA

s &

LG

sN

utri

tion

coor

dina

tion

stru

ctur

es

•&

com

mitt

ees

at n

ation

al &

loca

l go

vern

men

t lev

el e

stab

lishe

d

FNC

secr

e-ta

riat

,O

PM

MO

H, M

WE,

MA

AIF

, MO

ES,

MG

LSD

41EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

4.3

: Str

engt

hen

hu

man

res

ourc

e ca

paci

ty to

pla

n,

impl

emen

t an

d m

onit

or a

nd

eval

uate

foo

d an

d nu

triti

on p

ro-

gram

s

Des

ign

& im

plem

ent a

•

capa

city

bui

ldin

g pl

an fo

r nu

triti

on p

rogr

amm

ing

at

natio

nal,

LG &

com

mun

ity

leve

l.

Nut

ritio

n ca

paci

ty b

uild

ing

plan

•

deve

lope

dCa

paci

ty in

nut

ritio

n po

licy

anal

-•

ysis

, pla

nnin

g, im

plem

enta

tion,

su

rvei

llanc

e, M

&E

built

.N

utri

tion

Capa

city

of c

omm

unity

•

base

d re

sour

ce p

erso

ns b

uilt

FNC

Secr

etar

iat

MO

H, M

AA

IF, M

TTI,

MO

ES,

MG

LSD

, MW

E, M

OLG

, PO

PSEC

, D

evel

opm

ent P

artn

ers

4.4:

Mon

itor

and

ev

alua

te th

e fo

od

andnu

trition

situati

onto

inform

po

licy

and

prog

ram-

min

g

Esta

blis

h fo

od a

nd n

utri

-•

tion

M&

E sy

stem

for

time-

ly d

ecis

ion

mak

ing.

Nati

onal

food

and

nut

ritio

n in

-•

form

ation

sys

tem

est

ablis

hed

Inte

grat

ed n

utri

tion

M&

E sy

stem

•

esta

blis

hed

Peri

odic

Pro

gres

s re

porti

ng o

n •

impl

emen

tatio

n &

per

form

ance

of

UN

AP

FNC

Secr

etar

iat

MO

H,M

AA

IF,M

FPED

, MTT

I, LG

s,

Dev

elop

men

t Par

tner

s, M

oICT

, A

cade

mia

Cond

uct a

nati

onal

food

•

and

nutr

ition

nut

ritio

n ba

selin

e su

rvey

Base

line

food

and

nut

ritio

n su

r-•

vey

cond

ucte

dFN

C Se

cret

aria

tM

OH

,MA

AIF

,MFP

ED, M

TTI,

LGs,

D

evel

opm

ent P

artn

ers,

MoI

CT,

Aca

dem

iaCo

nduc

t sel

ecte

d di

stri

ct

•le

vel s

urve

ys b

ased

on

high

pre

vale

nce

of m

alnu

-tr

ition

Dis

tric

t spe

cific

sur

veys

con

-•

duct

ed.

FNC

Secr

etar

iat

/LG

s

MO

H,M

AA

IF,M

FPED

, MTT

I, LG

s,

Dev

elop

men

t Par

tner

s, M

oICT

, A

cade

mia

End

of U

NA

P im

pact

as-

•se

ssm

ent s

urve

y

UN

AP

impa

ct a

sses

smen

t sur

vey

•co

nduc

ted.

FNC

Secr

etar

iat

MO

H,M

AA

IF,M

FPED

, MTT

I, LG

s,

Dev

elop

men

t Par

tner

s, M

oICT

, A

cade

mia

Stre

ngth

en d

istr

ict-

leve

l •

food

and

nut

ritio

n su

rvei

l-la

nce

syst

ems

Dis

tric

t foo

d &

nut

ritio

n su

rvei

l-•

lanc

e sy

stem

s es

tabl

ishe

d a

nd

capa

city

bui

lt

FNC

Secr

etar

iat/

M

OH

, MA

AIF

LGs,

MO

ES, M

TTI,

Dev

elop

men

t Pa

rtne

rs, C

SOs

stra

tegy

4.5

: en

hanc

e op

era-

tion

alre

searchfo

rnu

trition

Form

ative

rese

arch

on

the

•be

st p

racti

ces

For

mati

ve re

sear

ch s

tudi

es u

n-•

dert

aken

MA

AIF

/MO

HN

PA, A

cade

mia

, LG

s,

Dev

elop

men

t Par

tner

s, C

SOs,

M

FPED

Rese

arch

on

posi

tive

•in

dige

nous

die

tary

pra

c-tic

es

Doc

umen

tatio

n &

dis

sem

inati

on

•of

pos

itive

indi

geno

us d

ieta

ry

prac

tices

MA

AIF

Dev

elop

men

t Par

tner

s,

Aca

dem

ia

42EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Com

pile

food

com

posi

-•

tion

data

for

all f

oods

co

nsum

ed in

Uga

nda

Dat

abas

e on

Foo

d Co

nsum

ption

•M

AA

IFD

evel

opm

ent P

artn

ers,

A

cade

mia

Iden

tify

and

unde

rtak

e •

rese

arch

re

leva

nt to

sca

l-in

g-up

food

and

nut

ritio

n.in

terv

entio

ns.

Rese

arch

on

scal

ing-

up fo

od a

nd

•nu

triti

on i

nter

venti

ons

unde

r-ta

ken

Aca

dem

ia s

uppo

rted

to u

nder

-•

take

app

lied

food

and

nut

ritio

n re

sear

ch

MO

H/M

AA

IFN

PA, A

cade

mia

, LG

s,

Dev

elop

men

t Par

tner

s

Colla

te a

nd s

hare

rese

arch

•

findi

ngs

and

best

pra

ctice

s fo

r sc

alin

g-up

nut

ritio

n in

U

gand

a.

Best

pra

ctice

s do

cum

ente

d, d

is-

•se

min

ated

and

sca

led-

upN

PAM

OH

,MA

AIF

, LG

s, M

OLG

, M

GLS

D, M

OES

, MTT

I, D

evel

opm

ent P

artn

ers,

CSO

s,

Aca

dem

iaO

bjec

tive

5:

Crea

te a

aw

aren

ess

and

mai

n-ta

in n

ation

-al

inte

rest

an

d co

m-

mit

men

t to

impr

ove

and

supp

ort

nutr

ition

pr

ogra

ms

in

the

coun

try

5.1:

Incr

ease

leve

ls

of a

war

enes

s an

d co

mm

itm

ent t

o ad

dres

sing

nut

ri-

tion

issu

es in

the

coun

try

Dev

elop

& im

plem

ent a

•

Nut

ritio

n co

mm

unic

ation

st

rate

gy

Nut

ritio

n co

mm

unic

ation

str

at-

•eg

y de

velo

ped

Dev

elop

men

tPa

rtne

rs

MO

H/M

AA

IF/C

wSO

s

Prod

uce

annu

al p

olic

y •

stat

emen

ts a

nd p

erio

dic

polic

y br

iefs

on

stat

us

of n

utri

tion

at n

ation

al

leve

ls

Ann

ual p

olic

y st

atem

ents

pro

-•

duce

dQ

uart

erly

pol

icy

brie

fs•

MA

AIF

/MO

HN

PA, L

Gs,

MO

LG, M

GLS

D, M

OES

, M

TTI,

Dev

elop

men

t Par

tner

s,

CSO

s

43EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objectives

stra

tegi

esInterven

tion

sex

pect

edo

utpu

tle

ad

age

ncy

oth

er

Com

mem

orat

e ev

ents

•

that

rais

e th

e pr

ofile

of

nutr

ition

and

nut

ritio

n be

st p

racti

ces.

(NFN

D,

BFW

, HW

D) a

nd ta

ke a

d-va

ntag

e of

oth

er a

dvoc

acy

even

ts.

Nati

onal

, reg

iona

l and

inte

rna-

•tio

nal f

ood

and

nutr

ition

eve

nts

com

mem

orat

ed.

MO

H/M

AA

IFLG

s, M

OLG

, MG

LSD

, MO

ES,

MTT

I, D

evel

opm

ent P

artn

ers,

CS

Os,

MoI

CT

5.2:

adv

ocat

e fo

r in

crea

sed

com-

mit

men

t to

im-

prov

ingnu

trition

ou

tcom

es

Dev

elop

and

impl

emen

t a

•su

stai

nabl

e nu

triti

on a

d-vo

cacy

pla

n

A c

ompr

ehen

sive

Nut

ritio

n ad

vo-

•ca

cy p

lan

deve

lope

d an

d im

ple-

men

ted.

FNC

MO

H, M

AA

IF

Prod

uce

an a

nnua

l sta

te

•of

the

food

and

nut

ritio

n si

tuati

on i

n th

e co

untr

y

Ann

ual s

tate

of f

ood

and

nutr

i-•

tion

repo

rtN

PAM

OH

,MA

AIF

, LG

s, M

OLG

, M

GLS

D, M

OES

, MTT

I, D

evel

opm

ent P

artn

ers,

CSO

s

44EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

ANNEX

II:C

ostImplem

entation

Matrix

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lObjective1:I

mpr

ove

acce

ss to

and

uti

lizati

on o

f mat

erna

l, in

fant

and

you

ng c

hild

nut

riti

on r

elat

ed s

ervi

ces

Stra

tegy

1.1

: Pro

mot

e ac

cess

and

util

izati

on o

f nu

triti

on h

ealth

rela

ted

serv

ices

to a

ll w

omen

of r

epro

ducti

ve a

ge, i

nfan

ts a

nd y

oung

chi

ldre

nPr

omot

e an

d su

ppor

t hea

lth a

nd n

utri

tion

educ

ation

14

0,00

0,00

016

0,00

0,00

018

0,00

0,00

020

0,00

0,00

025

0,00

0,00

093

0,00

0,00

0

Prom

ote

inte

grati

on o

f nut

ritio

n se

rvic

es in

all

routi

ne h

ealth

ser

vice

s an

d pr

ogra

ms

targ

eting

ch

ildre

n (G

row

th m

onito

ring

) an

d w

omen

of

repr

oduc

tive

age

200,

000,

000

1,50

0,00

0,00

03,

000,

000,

000

4,50

0,00

0,00

06,

000,

000,

000

15,2

00,0

00,0

00

Nut

ritio

n m

anag

emen

t of

sick

chi

ldre

n, p

regn

ant

wom

en a

nd la

ctati

ng m

othe

r an

d w

omen

of

repr

oduc

tive

age

1,20

0,00

0,00

0 1

,000

,000

,000

1,0

00,0

00,0

00 1

,000

,000

,000

1,0

00,0

00,0

001,

200,

000,

000

Inte

grat

e m

anag

emen

t of c

ases

of s

ever

e &

acu

te

mal

nutr

ition

into

routi

ne h

ealth

ser

vice

s96

7,29

1,42

81,

046,

730,

000

1,33

2,33

0,00

01,

878,

900,

000

1,59

5,59

0,00

06,

820,

841,

428

Prom

ote

utiliz

ation

of a

nten

atal

and

pos

t nat

al c

are

serv

ices

by

all p

regn

ant a

nd la

ctati

ng m

othe

rs.

400,

000,

000

500,

000,

000

600,

000,

000

700,

000,

000

800,

000,

000

3,00

0,00

0,00

0

Prom

ote

and

sup

port

bre

astf

eedi

ng p

olic

ies,

pr

ogra

ms

and

initi

ative

s10

0,00

0,00

011

2,00

0,00

010

0,00

0,00

010

0,00

0,00

010

0,00

,000

412,

000,

000

Prom

ote

Excl

usiv

e br

east

feed

ing

100,

000,

000

500,

000,

000

1,50

0,00

0,00

02,

000,

000,

000

1,00

0,00

0,00

05,

100,

000,

000

Prom

ote

& s

uppo

rt a

ppro

pria

te c

ompl

emen

tary

fe

edin

g pr

actic

es80

,000

,000

120,

000,

000

100,

000,

000

100,

000,

000

100,

000,

000

500,

000,

000

Supp

ort a

nd s

cale

up

com

mun

ity b

ased

nut

ritio

n pr

ogra

ms

900,

000,

000

1,14

0,00

0,00

01,

380,

000,

000

1,62

0,00

0,00

01,

860,

000,

000

6,90

0,00

0,00

0

Prom

ote

prop

er fo

od h

andl

ing,

hyg

iene

and

sa

nita

tion

100,

000,

000

120,

000,

000

100,

000,

000

100,

000,

000

100,

000,

000

520,

000,

000

45EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lSt

rate

gy 1

.2: A

ddre

ss g

ende

r and

soc

io-c

ultu

ral

mat

erna

l, in

fant

and

you

ng c

hild

nut

rition

issu

esPr

omot

e m

ale

invo

lvem

ent i

n fa

mily

hea

lth

serv

ices

and

nut

ritio

n pr

ogra

ms

500,

000,

000

500,

000,

000

500,

000,

000

500,

000,

000

100,

000,

000

2,10

0,00

0,00

0

Adv

ocat

e a

nd s

eek

solu

tions

for

redu

cing

wor

kloa

d fo

r al

l wom

en e

spec

ially

the

preg

nant

and

lact

ating

m

othe

rs

200,

000,

000

250,

000,

000

300,

000,

000

350,

000,

000

400,

000,

000

1,50

0,00

0,00

0

Add

ress

neg

ative

food

tabo

os &

nor

ms

that

affe

ct

nutr

ition

of w

omen

, inf

ants

&yo

ung

child

ren

200,

000,

000

250,

000,

000

300,

000,

000

350,

000,

000

400,

000,

000

1,50

0,00

0,00

0

sub

Tota

l 4,

987,

291,

428

5,69

8,73

0,00

07,

892,

330,

000

10,3

98,9

00,0

0011

,605

,590

,000

45,6

82,8

41,4

28

Objective2:E

nhan

cec

onsu

mpti

on o

f div

erse

die

tsSt

rate

gy 2

.1:

Incr

ease

acc

ess

to d

iver

se n

utriti

ous

food

s an

d us

e at

hou

seho

ld le

vel

Prom

ote

prod

uctio

n an

d co

nsum

ption

of

dive

rsifi

ed n

utri

tious

food

s at

hou

seho

ld a

nd

com

mun

ity le

vels

317,

027,

000

657,

363,

000

857,

363,

000

1,05

7,36

3,00

01,

257,

363,

000

4,14

6,47

9,00

0

Adv

ocat

e an

d su

ppor

t int

egra

tion

of n

utri

tion

serv

ices

in A

gric

ultu

ral p

rogr

ams

60,0

00,0

0075

,000

,000

90,0

00,0

0010

5,00

0,00

012

0,00

0,00

045

0,00

0,00

0

Incr

ease

con

sum

ption

of

both

raw

and

pro

cess

ed

nutr

itiou

s fo

ods

100,

000,

000

200,

000,

000

200,

000,

000

200,

000,

000

200,

000,

000

900,

000,

000

Prom

ote

and

supp

ort

the

utiliz

ation

of

safe

labo

ur

savi

ng te

chno

logi

es a

t hou

seho

ld

50,0

00,0

0010

0,00

0,00

014

0,00

0,00

018

0,00

0,00

01,

000,

000,

000

1,47

0,00

0,00

0

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lPr

omot

e an

d su

ppor

t loc

al fo

od p

roce

ssin

g an

d va

lue

addi

tion

at h

ouse

hold

and

com

mun

ity le

vel

100,

000,

000

500,

000,

000

600,

000,

000

700,

000,

000

800,

000,

000

2,70

0,00

0,00

0

Supp

ort o

n fa

rm e

nter

pris

e m

ix to

pro

mot

e st

able

di

vers

ified

food

pro

ducti

on

100,

000,

000

100,

000,

000

150,

000,

000

150,

000,

000

200,

000,

000

700,

000,

000

Prom

ote

prod

uctio

n &

con

sum

ption

of l

ocal

in

dige

nous

food

s to

enh

ance

die

t div

ersi

ficati

on60

,000

,000

70,0

00,0

0080

,000

,000

.00

90,0

00,0

0010

0,00

0,00

040

0,00

0,00

0

Stra

tegy

2.2

: Enh

ance

pos

t-ha

rves

t han

dlin

g, s

tora

ge &

util

izati

on o

f nut

ritiou

s fo

ods

at h

ouse

hold

& fa

rm le

vel

Prom

ote

& s

uppo

rt a

dopti

on o

f pos

t-ha

rves

t ha

ndlin

g &

sto

rage

tech

nolo

gies

at h

ouse

hold

&

com

mun

ity le

vel.

60,0

00,0

0010

0,00

0,00

020

0,00

0,00

0.00

300,

000,

000

400,

000,

000

1,06

0,00

0,00

0

46EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Prov

ide

an e

nabl

ing

envi

ronm

ent t

o th

e pr

ivat

e se

ctor

to m

anuf

actu

re,

& d

istr

ibut

e a

ppro

pria

te

post

-har

vest

han

dlin

g &

sto

rage

tech

nolo

gies

40

0,00

0,00

050

0,00

0,00

020

,000

,000

20,0

00,0

0094

0,00

0,00

0

Stra

tegy

2.3

: Pro

mot

e an

d st

abili

ze c

onsu

mpti

on n

utrie

nt e

nhan

ced

food

s

Prom

ote

prod

uctio

n of

forti

fied

com

mon

sta

ples

by

loca

l man

ufac

ture

rs

100,

000,

000

625,

000,

000

750,

000,

000

875,

000,

000

1,00

0,00

0,00

03,

350,

000,

000

Prom

ote

prod

uctio

n of

bio

-for

tified

var

ietie

s13

0,00

0,00

035

0,00

0,00

050

0,00

0,00

065

0,00

0,00

080

0,00

0,00

02,

430,

000,

000

Prom

ote

utiliz

ation

of n

utri

ent e

nhan

ced

food

s20

,000

,000

100,

000,

000

150,

000,

000.

0010

0,00

0,00

080

,000

,000

450,

000,

000

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lSu

ppor

t lo

cal p

rodu

ction

of r

eady

to u

se

ther

apeu

tic &

com

plem

enta

ry fo

ods

130,

000,

000

500,

000,

000

600,

000,

000

700,

000,

000

800,

000,

000

2,73

0,00

0,00

0

sub

Tota

l 1,

227,

027,

000

3,77

7,36

3,00

04,

817,

363,

000

5,12

7,36

3,00

06,

777,

363,

000

21,7

26,4

79,0

00Objective3:P

rote

ct h

ouse

hold

s fr

om t

he im

pact

of s

hock

s an

d ot

her

vuln

erab

iliti

es th

at a

ffec

t the

ir n

utri

tion

al s

tatu

sSt

rate

gy 3

.1: D

evel

op p

repa

redn

ess

plan

s fo

r sho

cks

Stre

ngth

en a

nd s

cale

up

earl

y w

arni

ng s

yste

ms

on

food

and

nut

ritio

n in

form

ation

from

com

mun

ity to

na

tiona

l lev

els

100,

000,

000

150,

000,

000

250,

000,

000

300,

000,

000

350,

000,

000

1,15

0,00

0,00

0

Dev

elop

, pro

mot

e &

tim

ely

impl

emen

t a

com

preh

ensi

ve p

acka

ge o

f nut

ritio

nal s

ervi

ces

and

food

item

s to

pro

vide

dur

ing

emer

genc

ies

&

reco

very

per

iods

60,0

00,0

0012

0,00

0,00

060

,000

,000

60,0

00,0

0060

,000

,000

360,

000,

000

Inte

grat

e nu

triti

on in

dis

aste

r m

anag

emen

t pr

ogra

ms.

40,0

00,0

0040

,000

,000

40,0

00,0

0040

,000

,000

40,0

00,0

0020

0,00

0,00

0

Prom

ote

and

supp

ort d

iver

sifie

d pr

oduc

tion

of

drou

ght-

resi

stan

t cro

ps, v

eget

able

s an

d an

imal

s to

lera

nt to

hea

t str

ess

60,0

00,0

0040

,000

,000

40,0

00,0

0040

,000

,000

40,0

00,0

0022

0,00

0,00

0

Sens

itiza

tion

prog

ram

s fo

r co

mm

uniti

es to

pre

vent

, m

itiga

te a

nd re

spon

d to

ris

ks o

f mal

nutr

ition

du

ring

sho

cks

50,0

00,0

0080

,000

,000

80,0

00,0

0050

,000

,000

50,0

00,0

0031

0,00

0,00

0

Stra

tegy

3.2

: Pro

mot

e so

cial

pro

tecti

on in

terv

entio

ns fo

r im

prov

ed n

utriti

on

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lPr

ovid

e so

cial

tran

sfer

s (c

ash,

food

s, a

gric

ultu

ral

inpu

ts) f

or v

ulne

rabl

e ho

useh

olds

and

co

mm

uniti

es15

0,00

0,00

02,

000,

000,

000

3000

0000

004,

000,

000,

000

5,00

0,00

0,00

014

,150

,000

,000

47EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Dev

elop

& Im

plem

ent s

peci

al s

ocia

l ass

ista

nce

prog

ram

s in

are

as w

ith h

igh

leve

ls o

f mal

nutr

ition

350,

000,

000

350,

000,

000

350,

000,

000

350,

000,

000

350,

000,

000

1,75

0,00

0,00

0

Adv

ocat

e an

d pr

omot

e sc

hool

mea

ls p

rogr

ams

40,0

00,0

0040

,000

,000

40,0

00,0

0040

,000

,000

40,0

00,0

0020

0,00

0,00

0Su

ppor

t “H

ome

Gro

wn

Scho

ol M

eals

”20

,000

,000

2,00

0,00

0,00

03,

000,

000,

000

4,00

0,00

0,00

05,

000,

000,

000

14,0

20,0

00,0

00Su

ppor

t and

pro

mot

e ur

ban

farm

ing

for

vuln

erab

le

hous

ehol

ds50

,000

,000

2,10

0,00

0,00

03,

100,

000,

000

4,15

0,00

0,00

04,

150,

000,

000

13,5

50,0

00,0

00

sub

Tota

l92

0,00

0,00

06,

920,

000,

000

9,96

0,00

0,00

013

,030

,000

,000

15,0

80,0

00,0

0045

,910

,000

,000

Obj

ecti

ve 4

: Str

engt

hen

the

polic

y, le

gal,

insti

tuti

onal

fram

ewor

k, a

nd c

apac

ity

to e

ffec

tive

ly p

lan,

impl

emen

t, m

onit

or a

nd e

valu

ate

nutr

ition

pr

ogra

ms

Stra

tegy

4.1

: Str

engt

hen

the

polic

y an

d le

gal f

ram

ewor

k fo

r coo

rdin

ating

, pla

nnin

g an

d m

onito

ring

nutr

ition

acti

vitie

s F

ast t

rack

the

enac

tmen

t of t

he F

ood

and

Nut

ritio

n Bi

ll30

,000

,000

30,0

00,0

00-

-

60,0

00,0

00

Revi

taliz

e th

e fu

nctio

nalit

y of

the

Uga

nda

Food

an

d N

utri

tion

Coun

cil a

nd e

stab

lish

its s

ecre

tari

at25

,000

,000

25,0

00,0

0025

,000

,000

25,0

00,0

0025

,000

,000

125,

000,

000

Revi

ew o

f the

Foo

d &

Nut

ritio

n Po

licy

-90

,000

,000

-11

0,00

0,00

0-

200,

000,

000

Revi

se th

e dr

aft U

gand

a Fo

od a

nd N

utri

tion

Stra

tegy

.-

90,0

00,0

00-

110,

000,

000

-20

0,00

0,00

0

Adv

ocat

e fo

r en

actm

ent o

f by-

law

s an

d or

dina

nces

th

at p

rom

ote

nutr

ition

and

food

sec

urity

50

,000

,000

50,0

00,0

0050

,000

,000

50,0

00,0

0050

,000

,000

250,

000,

000

Inte

grat

e nu

triti

on is

sues

into

pla

ns a

nd b

udge

ts a

t al

l lev

els

of g

over

nmen

ts10

0,00

0,00

012

0,00

0,00

014

0,00

0,00

014

0,00

0,00

012

0,00

0,00

062

0,00

0,00

0

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lSu

ppor

t the

dev

elop

men

t of n

utri

tion

curr

icul

a fo

r al

l lev

els

of e

duca

tion

& tr

aini

ng10

0,00

0,00

012

5,00

0,00

015

0,00

0,00

017

5,00

0,00

020

0,00

0,00

075

0,00

0,00

0

Adv

ocat

e fo

r es

tabl

ishm

ent o

f low

er &

mid

dle

cadr

e nu

triti

on c

ours

es in

the

educ

ation

str

uctu

re10

0,00

0,00

012

5,00

0,00

015

0,00

0,00

017

5,00

0,00

020

0,00

0,00

075

0,00

0,00

0

Revi

ew &

in

tegr

ate

nutr

ition

issu

es in

the

exis

ting

curr

icul

a of

form

al &

non

-for

mal

edu

catio

n &

pre

&

in-s

ervi

ce tr

aini

ng10

0,00

0,00

012

5,00

0,00

015

0,00

0,00

017

5,00

0,00

020

0,00

0,00

075

0,00

0,00

0

Stra

tegy

4.2

: Str

engt

hen

and

harm

oniz

e in

stitu

tiona

l fra

mew

ork

for n

utriti

on fr

om lo

cal t

o ce

ntra

l gov

ernm

ent

Revi

ew th

e cu

rren

t ins

tituti

onal

fram

ewor

k fo

r nu

triti

on in

the

coun

try

and

impl

emen

t an

appr

opri

ate

fram

ewor

k.60

,000

,000

60,0

00,0

00-

--

120,

000,

000

Esta

blis

h an

inte

rim

mul

ti-se

ctor

al c

oord

inati

on

mec

hani

sm fo

r nu

triti

on p

rogr

amm

ing,

mon

itori

ng

and

eval

uatio

n20

,000

,000

22,0

00,0

0024

,000

,000

26,0

00,0

0028

,000

,000

120,

000,

000

48EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Stre

ngth

en in

stitu

tiona

l cap

acity

for

nutr

ition

pr

ogra

mm

ing

at a

ll le

vels

200,

000,

000

400,

000,

000

400,

000,

000

400,

000,

000

400,

000,

000

1,80

0,00

0,00

0

Stra

tegy

4.3

: Str

engt

hen

hum

an re

sour

ce c

apac

ity to

pla

n, im

plem

ent

and

mon

itor a

nd e

valu

ate

food

and

nut

rition

pro

gram

sD

esig

n a

capa

city

bui

ldin

g pl

an fo

r nu

triti

on

prog

ram

min

g at

nati

onal

, LG

& c

omm

unity

leve

l50

,000

,000

60,0

00,0

0070

,000

,000

80,0

00,0

0090

,000

,000

350,

000,

000

Nut

ritio

n H

uman

reso

urce

cap

acity

bui

ldin

g pr

ojec

t50

,000

,000

400,

000,

000

600,

000,

000

800,

000,

000

400,

000,

000

2,25

0,00

0,00

0

Stra

tegy

4.4

: Mon

itor a

nd e

valu

ate

the

food

and

nut

rition

situ

ation

to in

form

pol

icy

and

prog

ram

min

gInterven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

lEs

tabl

ish

food

and

nut

ritio

n M

&E

syst

em fo

r tim

ely

deci

sion

mak

ing

1,00

0,00

0,00

01,

500,

000,

000

2,00

0,00

0,00

02,

500,

000,

000

2,50

0,00

0,00

09,

500,

000,

000

Cond

uct a

nati

onal

nut

ritio

n ba

selin

e su

rvey

500,

000,

000

750,

000,

000

950,

000,

000

700,

000,

000

680,

000,

000

3,58

0,00

0,00

0Co

nduc

t sel

ecte

d di

stri

ct le

vel s

urve

ys b

ased

on

high

pre

vale

nce

of m

alnu

triti

on50

0,00

0,00

075

0,00

0,00

095

0,00

0,00

070

0,00

0,00

068

0,00

0,00

03,

580,

000,

000

End

of U

NA

P im

pact

ass

essm

ent s

urve

y

100,

000,

000

100,

000,

000

Stre

ngth

en d

istr

ict-

leve

l foo

d an

d nu

triti

on

surv

eilla

nce

syst

ems

50,0

00,0

0050

,000

,000

50,0

00,0

0050

,000

,000

50,0

00,0

0025

0,00

0,00

0

Stra

tegy

4.5

: Enh

ance

ope

ratio

nal r

esea

rch

for n

utriti

on

Form

ative

rese

arch

on

the

best

pra

ctice

s30

0,00

0,00

040

0,00

0,00

040

0,00

0,00

050

0,00

0,00

050

0,00

0,00

02,

100,

000,

000

Rese

arch

on

posi

tive

indi

geno

us d

ieta

ry p

racti

ces

50,0

00,0

0050

,000

,000

50,0

00,0

0050

,000

,000

50,0

00,0

0025

0,00

0,00

0Co

mpi

le fo

od c

ompo

sitio

n da

ta fo

r al

l foo

ds

cons

umed

in U

gand

a50

0,00

0,00

01,

000,

000,

000

1,50

0,00

0,00

02,

000,

000,

000

2,00

0,00

0,00

5,00

0,00

0,00

0

Iden

tify

and

unde

rtak

e re

sear

ch

rele

vant

to

scal

ing-

up n

utri

tion

50,0

00,0

0050

,000

,000

50,0

00,0

0050

,000

,000

50,0

00,0

0025

0,00

0,00

0

Colla

te a

nd s

hare

rese

arch

find

ings

and

bes

t pr

actic

es fo

r sc

alin

g-up

nut

ritio

n in

Uga

nda

20,0

00,0

0020

,000

,000

20,0

00,0

0020

,000

,000

20,0

00,0

0010

0,00

0,00

0

sub

Tota

l3,

855,

000,

000

6,29

2,00

0,00

07,

729,

000,

000

8,83

6,00

0,00

06,

343,

000,

000

33,0

55,0

00,0

00

49EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Interven

tion

2010

-11

2011

-12

2012

-13

2013

-14

2014

-15

ToTa

l

Obj

ecti

ve 5

: Cre

ate

a aw

aren

ess

and

mai

ntai

n na

tion

al in

tere

st a

nd c

omm

itm

ent t

o im

prov

e an

d su

ppor

t n

utri

tion

pro

gram

s in

the

coun

try

Stra

tegy

5.1

: Inc

reas

e le

vels

of a

war

enes

s an

d co

mm

itmen

t to

addr

essi

ng n

utriti

on is

sues

in th

e co

untr

y

Dev

elop

& im

plem

ent a

Nut

ritio

n co

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unic

ation

str

ateg

y19

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0,00

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Prod

uce

annu

al p

olic

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atem

ents

and

pe

riod

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olic

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iefs

on

stat

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ritio

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na

tiona

l lev

els

50,0

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Com

mem

orat

e ev

ents

that

rais

e th

e pr

ofile

of

nut

ritio

n an

d nu

triti

on b

est p

racti

ces.

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WD

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take

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anta

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f ot

her

advo

cacy

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nts

300,

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450,

000,

000

525,

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Stra

tegy

5.2

: Adv

ocat

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r in

crea

sed

com

mit

men

t to

impr

ovin

g nu

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omes

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emen

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ition

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te o

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d an

d nu

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n th

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untr

y50

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000,

000

140,

000,

000

160,

000,

000

570,

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000

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8

50EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

AN

NEX

III:

Outpu

tLevelM

onitoringan

dEvalua

tion

Matrix

Objective

so

utpu

t ind

icat

orba

selin

eTa

rget

sfr

eque

ncy

Dat

a so

urce

lead

a

genc

y20

05/

2006

2010

/20

1120

11/

2012

2012

/20

1320

13/

2014

2014

/20

15Objective

1:

Impr

ove

acce

ss to

and

uti

li-za

tion

of m

ater

nal,

infa

nt

and

youn

g ch

ild n

utri

tion

re

late

d se

rvic

es

No.

of d

istr

icts

pro

vidi

ng

com

plet

e gr

owth

mon

itori

ng

and

prom

otion

dat

a

MO

H

No.

of D

istr

icts

w

ith a

N

utri

tioni

st

27 (FA

NTA

-2

, 201

0)

4461

7895

112

Ann

ually

UN

ISM

OH

No.

of c

ertifi

ed b

aby

frie

ndly

he

alth

faci

lities

(pub

lic &

pr

ivat

e)

38 fa

cili-

ties

(UN

ICEF

, 20

09)

Ann

ual

UN

ISM

OH

Objective

2:E

nhan

cec

on-

sum

ption

of d

iver

se d

iets

Gui

delin

es fo

r in

tegr

ation

of

nutr

ition

in a

gric

ultu

ral p

ro-

gram

s in

pla

ce

non

1M

AA

IF

Polic

y on

ince

ntive

s to

sm

all

& m

ediu

m s

cale

pri

vate

sec

-to

r pl

ayer

s in

pla

ce

Non

eYe

sM

TTI

A P

olic

y pr

omoti

ng m

anda

to-

ry fo

od fo

rtific

ation

in p

lace

Yes

MTT

I/M

OH

Polic

y pr

omoti

ng b

io- f

ortifi

-ca

tion

in p

lace

Non

eYe

sM

AA

IF/M

OH

Polic

y pr

omoti

ng th

erap

eutic

&

com

plem

enta

ry fo

ods

in

plac

e

Non

eYe

sM

OH

No.

of P

PPs

for

com

plem

en-

tary

food

s pr

oduc

tion

Ann

ually

Repo

rtM

OH

/MTT

I

51EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objective

so

utpu

t ind

icat

orba

selin

eTa

rget

sfr

eque

ncy

Dat

a so

urce

lead

a

genc

y20

05/

2006

2010

/20

1120

11/

2012

2012

/20

1320

13/

2014

2014

/20

15O

bjec

tive

3: P

rote

ct h

ouse

-ho

lds

from

the

impa

ct o

f sh

ocks

& o

ther

vul

nera

bili-

ties

tha

t aff

ect

thei

r nu

tri-

tion

al s

tatu

s

Effici

ent &

eff

ectiv

e EW

S on

fo

od a

nd n

utri

tion

in M

AA

IFBi

-an

nual

lyM

AA

IF

Com

preh

ensi

ve n

utri

tion

in-

form

ation

sys

tem

in M

OH

Bi

-an

nual

lyU

NIS

MO

H

Nati

onal

Nut

ritio

n Su

rvei

llanc

e Sy

stem

in p

lace

Non

e Ye

sBi

-an

nual

lyO

PM/F

NS

Com

preh

ensi

ve p

acka

ge o

f nu

triti

on s

ervi

ces

& r

equi

re-

men

ts fo

r U

gand

a in

em

er-

genc

ies

Yes

OPM

/ FN

S

Objective

4:S

tren

gthe

n th

e po

licy,

lega

l, in

stitu

tion

al

fram

ewor

k, a

nd c

apac

ity

to

effec

tive

ly p

lan,

impl

emen

t,

mon

itor

and

eva

luat

e nu

tri-

tion

pro

gram

s

Food

and

nut

ritio

n Bi

ll as

-se

nted

todraft

Fina

l dr

aftBi

ll en

-ac

ted

NPA

/MA

AIF

Lega

l FN

C e

stab

lishe

dYe

sO

PM/N

PAF&

NC

secr

etar

iat w

ith a

n ap

-pr

oved

ope

ratio

nal

budg

et

in p

lace

Yes

(es-

tabl

ishe

d &

ope

ra-

tionn

a-lis

ed)

Yes

Yes

Yes

Ann

ually

Repo

rtO

PM/N

PA

Vote

func

tions

for

nutr

ition

in

pla

ceYe

sYe

sYe

sYe

sA

nnua

llyRe

port

MFP

ED

Num

ber

of s

ecto

rs a

nd lo

cal

gove

rnm

ent p

lans

inte

grati

ng

nutr

ition

issu

es.

Yes

Yes

Yes

Yes

Ann

ually

Plan

s/BF

Ps/

Polic

y st

ate-

men

ts

NPA

/ M

oLG

52EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objective

so

utpu

t ind

icat

orba

selin

eTa

rget

sfr

eque

ncy

Dat

a so

urce

lead

a

genc

y20

05/

2006

2010

/20

1120

11/

2012

2012

/20

1320

13/

2014

2014

/20

15N

utri

tion

curr

icul

a re

vise

d at

al

l lev

els

of e

duca

tion

Yes

Yes

A

nnua

llyRe

port

M

oES

stra

tegy

4.2

: Str

engt

hen

and

harm

oniz

e th

e in

stitu

tiona

l fr

amew

ork

for

nut

ritio

n fr

om lo

cal

to c

entr

al g

over

n-m

ent l

evel

s

Revi

ew r

epor

t pub

lishe

dYe

sYe

sN

PA

No.

of M

DA

s &

LG

s w

ith

Nut

ritio

n fo

cal p

erso

nsA

nnua

llyM

DA

& L

G

Staff

list

sM

oPS/

MoL

G

Nati

onal

mul

ti-se

ctor

al n

utri

-tio

n co

ordi

natio

n co

mm

ittee

es

tabl

ishe

d &

ope

ratio

na-

lised

11

11

1A

nnua

llyRe

port

NPA

/FN

S

4.3

Stre

ngth

en h

uman

re-

sour

ce c

apac

ity

to p

lan,

im

plem

ent

and

mon

itor

an

d ev

alua

te f

ood

and

nu-

triti

on p

rogr

ams

Nut

ritio

n ca

paci

ty b

uild

ing

plan

in p

lace

1N

PA/F

NS/

MoL

G

4.4

Mon

itor

and

eva

luat

e th

e food

and

nutrition

situa

-tion

toin

form

policyan

dpr

ogra

mm

ing

Mul

ti-se

ctor

al N

ation

al fo

od

and

nutr

ition

info

rmati

on

syst

em in

pla

ce

Yes

Yes

NPA

/FN

S

No.

of c

onso

lidat

ed p

erio

dic

prog

ress

rep

orts

on

impl

e-m

enta

tion

& p

erfo

rman

ce o

f U

NA

P

1 4

44

4Q

uart

erly

M

OH

/MA

AIF

/M

OES

/M

GLS

G/M

TTI

Base

line

nutr

ition

sur

vey

re-

port

in p

lace

Yes

Yes

NPA

/UBO

S

Mid

-ter

m r

evie

w r

epor

t Ye

sN

PA/F

NS

End

of te

rm i

mpa

ct a

sses

s-m

ent r

epor

t Ye

sN

PA/F

NS

Dat

abas

e on

Foo

d Co

mpo

sitio

n Ye

sM

AA

IF/

Aca

dem

ia

53EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

10-2

015

Objective

so

utpu

t ind

icat

orba

selin

eTa

rget

sfr

eque

ncy

Dat

a so

urce

lead

a

genc

y20

05/

2006

2010

/20

1120

11/

2012

2012

/20

1320

13/

2014

2014

/20

15O

bjec

tive

5:

Crea

te a

aw

aren

ess

and

mai

ntai

n na

tion

al in

ter-

est

and

com

mit

men

t to

impr

ove

and

supp

ort

nutr

ition

pro

gram

s in

the

coun

try

Nut

ritio

n co

mm

unic

ation

st

rate

gy in

pla

ceYe

sYe

sM

OH

/MA

AIF

No.

of

polic

y st

atem

ents

in

plac

e1

11

1N

PA/F

NS

A c

ompr

ehen

sive

Nut

ritio

n ad

voca

cy p

lan

in p

lace

Yes

Dev

elop

men

t Pa

rtne

rsCo

mpr

ehen

sive

Nut

ritio

n ad

-vo

cacy

pla

n im

plem

ente

dYe

sYe

sYe

sYe

sD

evel

opm

ent

Part

ners

Ann

ual s

tate

of f

ood

and

nu-

triti

on r

epor

t in

plac

e1

11

1A

nnua

llyN

PA/M

AA

IF/

MO

H/F

NS



ANNEX IV: Reviewed Documents

1) AU, 2005. Africa Regional Nutrition Strategy, 2005-20152) FANTA -2, 2010. Analysis of the Nutrition Situation in Uganda. Food and Nutrition Technical

Assistance II project (FANTA-2), Washington DC: AED.3) FAO, 2008. The State of Food Insecurity in the World 2008. FAO, Rome.4) GoU, 2003. The Uganda Food and Nutrition Policy5) GoU, 2004. The Uganda Food and Nutrition Strategy and Investment Plan, draft.6) Horton. S, Shekar. M, MacDonald. C, Mahal. A, and Brooks, J.K., 2010. Scaling –up Nutrition

Roadmap. What will it cost? The World Bank, Washington DC.7) MOH, 1999. The Health Policy of Uganda.8) MOH, 2010. Health Sector Strategic Plan (HSSP III, draft)9) MOH, 2010. The five year Maternal, Infants and Young Children Nutrition. Action Plan

2010-2015. 10) NPA, 201O. National Development Plan2010/11-2014/15.11) Republic of Malawi, 2007. National Nutrition Policy and Strategic Plan 2007-2012- Malawi12) UBOS and Macro International, 2006. The Uganda Demographic Health Survey, (UDHS)

2006. Ministry of Health.13) Uganda Nutrition Profiles



ANNEX V: List of uNAp technical committee members

name Title Organisation

Prof.JohnKakitahiChairperson Technical committee, former Deputy Head, School of Public Health

Makerere University, School of Public Health

Dr.JohnSebulibaSekamatteManager Health Population and Social Development

National planning Authority

Ms. nahalamba sarahSecretary technical committee, Senior Gender and Social Development Officer.

National planning Authority

Ms.MutabaziJudith Sectoral Policy and Planning officer National planning Authority

Dr. Robert Mwadime Regional Senior Nutrition Advisor Academy for Education and

Development|FANTA-2

Ms. namugumya brenda shenute Public Nutrition Specialist Regional Centre for Quality Health

CareDr.ElizabethMadraa Stakeholder Ministry Of Health

Mr. Todd bensonPolicy Analyst International Food Policy and

Research InstituteMs.AgnesChandiaBaku Acting Head, Nutrition Unit Ministry Of Health

Mr. bambona alex Head of Home Economics and Nutrition section

Ministry of Agriculture Animal Industry and Fisheries.

Mr. Mugisa Tom Plan for Modernisation of Agriculture

Ms. Daisy eresuMinistry of Agriculture Animal Industry and Fisheries.

Ms.SusanOketcho Ministry Of Education and Sports

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