THE REPUBLIC OF UGANDA UGANDA NUTRITION ACTION … · THE REPUBLIC OF UGANDA UGANDA NUTRITION...

THE REPUBLIC OF UGANDA

UGANDA NUTRITION ACTION PLAN 2 0 1 1 - 2 0 1 6

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

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 1 - 2 0 1 6

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Design & Layout: CSR Design, +256712669649, [email protected]

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Uganda Nutrition Action Plan 2011-2016

Table of Contents

Foreword iiiStatement of Commitment vAcronyms and Abbreviations viiExecutive Summary viii

PART I: OVERVIEW 11. Introduction 12. Policy Context 53. Situation and Problem Analysis 6 3.1 Causes of High Malnutrition in Uganda 7 3.2 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 to Reduce Malnutrition in the Plan Period (2011–2016) 145. Goal, Objectives, Strategic interventions, and Core ProJECTS 16 5.1 Goal 16 5.2 Objectives, Strategies, and Strategic Interventions 17 5.3 Priority Investment Areas 22

PART III: IMPLEMENTATION, FINANCING, AND MONITORING & EVALUATION FRAMEWORKS 236. Implementation Framework 23 6.1 Institutional Arrangements 23 6.2 Coordination Arrangements 24 6.3 Implementation Strategy 25 6.4 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 29

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LIST OF FIGURESFigure 1. Malnutrition’s Impact on Productivity during the Life -cycle and across Generations 2Figure 2. Prevalence of Stunting, Underweight, and Wasting Among Young Children in Uganda, by Age in Months 3Figure 3. National Trends in the Prevalence of Malnutrition among Children under 5 7Figure 4. Young Child Malnutrition: A Conceptual Framework for Uganda 9

LIST OF TAbLESTable 1. Gap Analysis for Scaling Up Nutrition Interventions in Uganda 11Table 2. Key Nutrition Outcome Indicators 16Table 3. Summary of Five-Year UNAP Implementation Cost Matrix 28Table 4. Key outcome indicators and annual targets 30

ANNEXES ANNEX I: Implementation Matrix 31ANNEX II: Implementation Cost Matrix, UShs million 41ANNEX III: Reviewed Documents 46ANNEX IV: List of UNAP Technical Committee Members 47

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Foreword

We have made progress in reducing poverty over the years. However, malnutrition still ravages our country. Malnutrition affects millions of Ugandans in various ways, but it is particularly devastating to women, babies and children. Malnutrition also impairs educational achievements and economic productivity, costing the Government and families enormous amounts of money to treat related illnesses.

Adequate nutrition is a prerequisite for human development and socioeconomic well-being. The Government of Uganda is committed to fulfilling the constitutional obligation of ensuring food and nutrition security for all Ugandans. This five-year Uganda Nutrition Action Plan (UNAP) is thus an important step as it provides the framework for addressing nutrition issues in the country sequentially to develop strong and quality human capital that will propel socioeconomic transformation. The UNAP has been formulated within the context of National Development Plan (NDP), which is the overall vision for Uganda: transforming Uganda into a modern and prosperous country.

The goal of this Plan is to improve the nutrition status of all Ugandans, with special emphasis on women of reproductive age, infants and young children. Different forms of malnutrition affect different groups of people in Uganda. However, it is during the “window of opportunity” - the 1,000 days from conception through the child’s second birthday - that the greatest returns to effective action to prevent malnutrition are realized.

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 toward the achievement of acceptable levels of nutrition security, especially for women of reproductive age, infants, young children and other vulnerable groups. I am pleased that the factors that 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 disease and reduces productivity while compounding poverty and its after-effects. These are interrelated factors, which call for multi-disciplinary approaches in order to address them. Effective intra- and inter-sectoral linkages must be put in place to promote coordination and resource utilization. The UNAP, therefore, calls for scaling up multi-sectoral interventions, placing more emphasis on community-based initiatives that have been proved to yield cost-effective results, as well as targeting areas and group 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: every one thousand shillings we invest in nutrition results in economic benefits at least six times more. These gains mainly benefit the poor and most disadvantaged, as

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they spend less money on treating malnutrition-related disease and increase their productivity, reaping sustainable socioeconomic benefits.

Fortunately, malnutrition does not require space science knowledge. It is just due to ignorance in the case of Uganda. The District Medical Officers and all those concerned need to inform the families, through the radios that most of the time spew out rubbish, that a human being needs the following basic nutrients: proteins for body building, carbohydrates for energy, fats for body insulation as well as energy, minerals (iron, zinc, calcium, potassium, phosphorus, iodine etc) and vitamins (A, B, C, D, E etc). Minerals are important for body building along with the proteins and also for co-ordination of body functions and so are the vitamins.

I extend my sincere appreciation to all those who contributed to the development of this plan. Members of the Nutrition Technical Committee and Nutrition Forum are commended for a job well done. The donor community is appreciated for its support. I cannot over emphasize the role played by the National Planning Authority in coordinating the development of this plan. All these actors truly deserve our recognition and gratitude.

Now, as Ugandans, we must all do whatever is possible in the fight against malnutrition. So, I call upon all those concerned to support the quick enactment of the Food and Nutrition’Bill. This Bill will establish a legal institution to coordinate different nutrition partners, ensure accountability in reaching the objectives of both the NDP and UNAP, and increase commitment of resources and expertise to scale up high-impact programmes and policies to improve nutrition in our country.

Since nutrition is a cross-cutting issue with economic, socio-cultural, political and biomedical dimensions, it is imperative that all sectors of the economy play their roles to achieve the goal and objectives of this plan. I, therefore, call upon the Ministers of Agriculture, Animal Industry and Fisheries; Health; Trade and Cooperatives; Education and Sports; Gender, Labour and Social Development; the General Public; Local Government; the Private Sector, Civil Society and Faith-Based Organizations, as well as Development Partners, to support the implementation of this Action Plan and align their programmes to it for a united response. We must act now: our actions will send a message to the Ugandan people 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 Museveni President of The Republic of Uganda 29th September, 2011

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Statement of Commitment

Following upon the statement made at the UN General Assembly in September 2010 in New York by the Minister of Foreign Affairs, Hon. Sam Kuteesa, in which Uganda committed itself to tackling the crisis of malnutrition in the country, a concerted effort was set in motion to respond to the hitherto persistent malnutrition problem in the country. The effort was led by the National Planning Authority and aimed at developing a concrete Action Plan with measurable and time-bound interventions.

We, as a Government, found the high malnutrition rates reported in various surveys over the years completely unacceptable. We all supported the new resolve to prioritize eradication of malnutrition from Uganda as one of the most viable strategies for achieving the Millennium Development Goals. The rationale for this strategy is that nutrition forms the basis for most other areas of human development. Conversely, malnutrition undermines the entire person’s life. We have therefore adopted the Scaling Up Nutrition (SUN) strategy of focused interventions covering the 1000 days window of opportunity directed at women in the reproductive age bracket, new born and young children under the age of two years.

In order to add technical content to this expression of political will, a Multi-Sectoral Technical Committee was set up to conceptualize and draft this Action Plan. The membership of the committee included experts on nutrition from several sectors of government, academic institutions, Non-governmental Organizations, and several international organizations working in Uganda. Staff members of the National Planning Authority provided active and timely secretariat services for the Committee. A comprehensive draft of the UNAP for use in stakeholder consultations was completed in early-December 2010. Separate structured consultations were held with several stakeholder groups, including senior government officials, representatives of local government, the private sector, civil society organizations, and development partners between December 2010 and June 2011. The draft UNAP also was formally submitted for review to all of the Ministries that will be involved in the implementation of the Action Plan. Comments and suggestions submitted through all of these reviews and consultations were incorporated by the Technical Committee into this final version of the UNAP. Cabinet, under the chairmanship of H. E. the President, Yoweri Kaguta Museveni, adopted the Plan on Wednesday, 28th October, 2011.

Sincere gratitude is due to the individuals and institutions that played a leading role in the drafting of the UNAP. Notably, the Government wishes to recognize officers from the Ministries of Agriculture, Animal Industry and Fisheries; Health; Education and Sports; and the National Planning Authority who participated in the Technical Committee. We also wish to recognize the specific technical or financial contributions to the UNAP formulation process made by experts and partners from Makerere and Kyambogo Universities, the Uganda National Academy of Sciences, the Food and Nutrition Technical Assistance II Project, the World Food Programme, the

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International Food Policy Research Institute, World Vision, the World Health Organization, the United Nations Children’s Fund, the Food and Agriculture Organization,the Intergovernmental Authority for Development (IGAD), and the United States Agency for International Development. The process was rigorous, and the development of the UNAP would not have been possible without the combined and untiring efforts of these individuals and organizations.

Although formal responsibility for improving nutrition in Uganda is mandated to the Ministry of Agriculture, Animal Industries and Fisheries and the Ministry of Health, successfully addressing the problem of malnutrition necessarily requires the engagement of several other sectors in a joint effort. Ensuring that all Ugandans are well-nourished and able to live long, healthy, active, and creative lives requires that every Ugandan has access to a high-quality and sufficient diet, good health services, clean water, adequate sanitation, and, perhaps most importantly, proper knowledge on how to provide for the nutritional needs of themselves and those that they care for. All of these services are needed for the nutritional security of Ugandans. The responsibilities for the provision of public services related to all of these key determinants of improved nutrition span a wide range of ministries within government. Addressing malnutrition in Uganda therefore requires multi-sectoral commitment across all of government.

Consequently, we the undersigned commit ourselves and the ministries we lead to do everything necessary to support the implementation of this Nutrition Action Plan. We undertake to promote the provision of the required human, financial and other resources that may be necessary to achieve the objectives of this Plan. We recognize that by ensuring that the mothers of Uganda and the children that they bear and care for are well-nourished, we are establishing the best foundation for Uganda’s development. We acknowledge our responsibility to the people of Uganda to see that this foundation is solid. A Uganda in which all its citizens are well-nourished is a legacy of which we can all be proud.

Rt Hon Henry Muganwa-Kajura 2nd Deputy Prime Minister & Minister of Public Service ……………………

Hon Tress Bucyanayandi Minister of Agriculture, Animal Industry & Fisheries ……………………

Hon Dr D Christine Ondoa Minister of Health ……………………

Hon Lt Jessica Alupo Epel Minister of Education & Sports ……………………

Hon Amelia Anne Kyambadde Minister of Trade and Cooperatives ……………………

Hon Syda Bbumba Minister of Gender, Labour & Social Development ……………………

Hon Adolf Mwesige Minister of Local Government ……………………

Hon Martia Kasaija Minister of State, Finance, Planning & Economic Development (Planning) Holding the Portfolio of Minister of Finance, Planning & Economic Development …………………….

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Acronyms and Abbreviations

BMI Body-mass indexCAADP Comprehensive Africa Agriculture Development ProgrammeCSO Civil Society OrganisationFNC Food and Nutrition CouncilHIV Human Immunodeficiency Viruskcal kilocalorieLG Local GovernmentMAAIF Ministry of Agriculture, Animal Industry and FisheriesM&E monitoring and evaluationMoES Ministry of Education and SportsMFPED Ministry of Finance, Planning and Economic DevelopmentMGLSD Ministry of Gender, Labour and Social DevelopmentMoH Ministry of HealthMOICT Ministry of Information, Communication, and TechnologyMoLG Ministry of Local GovernmentMTC Ministry of Trade, and CooperativesMWE Ministry of Water and Environment NDP National Development Plan, 2010–2015NGO Non-governmental OrganizationNPA National Planning AuthorityOPM Office of the Prime MinisterUDHS Uganda Demographic and Household SurveyUFNP Uganda Food and Nutrition PolicyUNAP Uganda Nutrition Action PlanUNCF Uganda Nutrition Coordination Forum

Exchange rate (August 2011): UShs 2,600 = US$ 1.00

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Executive Summary

Nutrition plays a crucial role in the socioeconomic development of any country. Malnutrition accounts for about 35 percent of deaths among children under 5 years old around the world. Stunting, severe wasting, and intrauterine growth retardation are the major contributors to child mortality, accounting for about 2 million deaths annually. Malnutrition is the major cause of morbidity for all age groups, accounting for 11 percent of the disease burden globally. In addition, iron deficiency is the leading cause of maternal mortality, accounting for 20 percent of the estimated 536,000 deaths worldwide. About 43 percent of all deaths among children under 5 occur in Africa. According to the Uganda Demographic and Household Survey (UDHS), 19 percent of the Ugandan population was malnourished in 2006, and 38 percent of children under 5 were stunted. This prevalence means that about 2.3 million young children in Uganda today are chronically malnourished. In addition, 16 percent of children under 5 are underweight while 6 percent are wasted, and 12 percent of women are malnourished.

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 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 Uganda Nutrition Action Plan (UNAP) is to reduce levels of malnutrition among women of reproductive age, infants, and young children through 2016 ensuring that all Ugandans are properly nourished will enable them live healthy and productive lives. However, it is particularly at the start of the life cycle where we must work together to ensure that all Ugandans are properly nourished. To attain this, women of reproductive 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 malnutrition 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 why the 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 through 2016will have the following benefits:

Reduce the number of maternal deaths by over 6,000 and child deaths by over 16,000 •every year

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Increase national economic productivity, both physical and intellectual, by about UShs •130 billion per year at present value Provide a strong return on public investment – for every UShs 1,000 invested, about UShs •6,000 worth of increased productivity will result from reduced child stunting, improved maternal health, enhanced micronutrient intake, and improved nutrition care

Investing in nutrition makes economic sense, and the economic benefits far outweigh the investments required for scaling up nutrition programmes.

The sorry state of nutrition in Uganda highlights the need for strategic interventions to enable government at various levels to meet its obligations toward the many malnourished Ugandans. It is in view of comprehensively addressing these problems that the UNAP has been formulated as a guide for action for the Uganda Food and Nutrition Policy (UFNP) that was approved by government in 2003. The UNAP 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 UNAP was guided by several concerns. These include vulnerability and gap analyses; attention to human rights and gender differences; decentralisation, and the cross-sectoral nature of effective measures that can redress malnutrition. Nutrition issues are cross-cutting, and with no strong sectoral advocates for 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. It is critical that these sectors undertake the nutrition-related activities for which they are responsible and are held accountable for doing so. The UNAP seeks to minimise duplication of effort and conflicts of interest that 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 hinder 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 Uganda Nutrition Action Plan (UNAP) is to ensure that all Ugandans are properly nourished so they can live healthy and productive lives. However, it is at the start of life in particular that we must work together to ensure that all Ugandans are properly nourished.

To attain this goal, women of reproductive age (15-49 years), must receive proper nutrition so that when they are pregnant, they can properly nourish their children from the time of conception until those children are weaned. These same women must receive relevant 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 UNAP focuses on young children and mothers, both actual and potential, and seeks to scale up efforts to ensure that all Ugandan children are properly nourished from the day they are conceived.

According to the three most recent Uganda Demographic Health Surveys (UDHS), nutrition indicators for young children and their mothers have not improved much over the past 15 years, with some indicators showing a worsening trend. For example, in 1995, 45 percent of children under 5 years old in Uganda were short for their age (stunted); 10 years later, the prevalence of stunted under-5s 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. As noted, 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.

Many of the nutrition problems that women and children experience in Uganda are hidden. Micronutrient deficiencies are common among both groups:

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

b) Iron-deficiency anaemia affects three-quarters of children age 6 to 59 months and half of women of reproductive age. Anaemia in women leads to chronic fatigue and impairs

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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 slowdown in cognitive development, decreased physical activity, and reduced resistance to disease.

c) The prevalence of zinc deficiency ranges from 20 percent to 70 percent in young children and 20 percent to 30 percent in adults. Zinc deficiency results in poor growth, reduced resistance to infectious diseases, and increased incidence of stillbirths.

Figure 1. Malnutrition’s Impact on Productivity during the Life -cycle and across Generations

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 –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 strain on often overburdened health systems. Malnourished 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 improved general welfare.

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 .



The principal points of intervention to break this cycle of malnutrition are:

a) Address the nutritional needs of the young child from conception through about 24 months

b) Ensure the nutritional well-being of the mother of the child even before she is pregnant.

For young children, the period from conception to their second birthday is characterised as the 1,000 days of opportunity to effectively and sustainably address malnutrition. Interventions to prevent malnutrition have the greatest benefit during these 1,000 days. Interventions after the second birthday can make a difference but often cannot undo the damage done by malnutrition 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 from 6 months 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 2 years. For these reasons, the objective of the UNAP is to stop the rapid rise in levels of chronic malnutrition among children in their first two years of life.

Figure 2. Prevalence of Stunting, Underweight, and Wasting Among Young Children in Uganda, by Age in Months

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 (10-14 years) will also be targeted under the UNAP. Ensuring the

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Stunted

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

Wasted Underweight

The window of opportunity outside the womb



proper nutrition of these future mothers will result in their experiencing easier pregnancies and deliveries and giving birth to healthier babies who have a good birth weight. Hence, the focus of the UNAP includes both the children and mothers of today and of the future.

The Government of Uganda is committed to achieving its development objectives set out in the 2010–2015 National Development Plan (NDP)—Uganda’s master development framework—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 Socioeconomic Transformation for Prosperity cannot be achieved if the population is unhealthy and if children and women continue to face problems related to 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 UNAP’s goal is to focus public resources and national efforts to bring about sharp improvements in nutrition among young children and women of reproductive age by scaling up the implementation of a package of proven and cost-effective interventions. The UNAP focuses on young children and their mothers to operationalise the nutrition component of the NDP, as well as the Uganda Food and Nutrition Policy (UFNP) and the draft Uganda Food and Nutrition Strategy. The UNAP will also foster action to address sectoral priorities, such as those laid out in the Health Sector Strategic and Investment Plan and the Agricultural Sector Development Strategy and Investment Plan.

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;

b) Increase national economic productivity, both physical and intellectual, by an estimated UShs 130 billion per year at present value; and

c) Provide a strong return on public investment: for every UShs 1,000 invested, about UShs 6,000 worth of increased productivity will result from reduced child stunting, improved maternal health, enhanced micronutrient intake, and improved nutrition care. Investing in nutrition makes economic sense, with the economic benefits far outweighing the investments required for scaling up nutrition programmes.

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 recognises that cross-sectoral, inter-agency collaboration is necessary. This action plan prioritises multi-sectoral interventions that will have the quickest impact on improving key nutrition 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 target populations’ consumption of diverse nutritious foods by increasing the production of and access to micronutrient-rich foods at the household and community levels.

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

d) Strengthen the legal and institutional framework and the capacity to effectively plan and implement nutrition programmes 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

This action plan to address the nutritional needs of young children and women of reproductive age in Uganda was developed within the context of a specific set of policy and legal frameworks. The Constitution of the Republic of Uganda requires the state to encourage and promote good nutrition 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 develop relevant policies to ensure provision of quality food and nutrition services in the country.

The NDP 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 its broader development goals. 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. Implementation and monitoring and evaluation of the UNAP will follow a similar approach.

Under the joint leadership of MoH and MAAIF in exercising their constitutional mandate, the 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 implementing the UFNP, in particular the Uganda Food and Nutrition Council (FNC). The UNAP draws much of its content from these documents in seeking to operationalise efforts to effectively implement the UFNP.

At the sectoral level, the Health Sector Strategic and Investment Plan identifies nutrition as part of the National Minimum Health Care Package for Uganda, while the Agricultural Sector Development Strategy and Investment Plan and the draft National Agriculture Policy recognise



food and nutrition security as key factors for the country’s social and economic development. 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.

At the international level, the UNAP also builds upon several agreements to which Uganda is a signatory. These include:

a) International Conference on Nutrition, 1992b) World Food Summit, 1996c) Declaration on the Millennium Development Goals, 2000, and the follow-up

summit in 2010d) Scaling-up Nutrition Initiativee) International Covenant on Economic, Social and Cultural Rightsf) Convention on Elimination of All Forms of Discrimination Against Womeng) International Health Partnerships and related initiatives (IHP+).

At the regional level, Uganda adopted the African Regional Nutrition Strategy of the African Union. The strategy’s main focus is to advocate for renewed commitment to nutrition, intensify member states’ efforts to sustainably address malnutrition 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 African Union heads of state, hosted by Uganda, member states approved the establishment of an Africa Food and Nutrition Day to be commemorated each year on 31 October to remind Africa of the constant need to address its nutrition problems.)

Uganda has also adopted the Comprehensive Africa Agriculture Development Programme (CAADP), an African Union-driven initiative for substantially improving agricultural production. Nutrition and food security are one of the four pillars of the CAADP

3. Situation and Problem Analysis

Uganda has made progress in reducing HIV, malaria, and tuberculosis; produces sufficient food nationally to meet the needs of its population; and has experienced a significant reduction in poverty levels, from 39 percent in 2002 to 23 percent in 2009–2010. 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.

Among children, while there has been some reduction in the prevalence of malnutrition in Uganda over the past 15 years (Figure 3), the change is slow. Moreover, child malnutrition in Uganda remains largely a “hidden problem.” Most children affected are moderately malnourished, which is difficult to identify without regular assessment. Micronutrient deficiencies are similarly difficult to detect.



Figure 3. National Trends in the Prevalence of Malnutrition among Children under 5

Source: UDHS 1995, 2001, and 2006

Among women of reproductive age, over 12 percent were found to be underweight in 2006, with a body mass index (BMI) of less than 18.5 kg/m2. Iron-deficiency anaemia remains the most serious micronutrient deficiency faced by Ugandan women. In addition, Uganda is faced with a double burden of malnutrition—the increasing co-existence of obesity and malnutrition in communities across the country. The 2006 UDHS showed high levels of overweight among women living in urban centres, as well as in many rural areas of Western and Central regions.

3.1 Causes of High Malnutrition in Uganda

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: inadequate dietary intake resulting from suboptimal maternal and infant feeding practices and 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:

A. 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 foods that households frequently consume 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 the household consumes through the year.

B. Inadequate maternal and child care. Care-related constraints lead to both inadequate dietary intake and a high disease burden in young children. These

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WastingUnderweightStunting

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er-fi

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constraints include the heavy workload that women as primary caregivers in the household must shoulder every day. Women do both farm and household chores and might 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 a woman’s ability to properly care for her infant and other young children, while also regaining her own health. In addition, 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 worsen the quality of the nutrition and health care women and young children receive.

C. Poor access to health care and a healthy environment. In far too many cases, young children do not live 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 nutrition services such as micronutrient supplementation and nutrition education.



Figure 4. Young Child Malnutrition: A Conceptual Framework for Uganda

Malnourished young child

Inadequate dietary intake Poor feeding frequency Poor feeding practices Insufficiently diverse diets

Frequent illness Malaria, diarrhoea, infections Too early & improper weaning Late seeking of health care

Household food insecurity Poor access to diversified foods Low nutrient content of foods;

low use of fortified foods Seasonal fluctuation in food

supply and diet quality Low agricultural productivity

Inadequate maternal & child care

High daily workload for women Teenage pregnancy and too

frequent births Lack of knowledge of good caring

ti

Access to health care & healthy environment

Improper sanitation and hygiene; unsafe water sources

Poor food safety Poor access to health care &

nutrition support services

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 Few adapted tools for production

Culture, education, awareness Maternal education often limited Traditional practices may adversely affect maternal & child feeding and health & reproductive care

Insufficient access to household economic resources by primary

Policies Limited policy guidance to facilitate private

sector investment in nutrition Policies and legal instruments lacking for

nutrition planning structures and financing Mechanisms absent for national and district

multi-sectoral coordination & accountability

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 nutrition not considered to be priority expenditure in

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

Inadequate human capacity in nutrition policy & programme design and analysis

Immediate causes:

Underlying causes:

Basic causes:



The nature of the underlying causes of child malnutrition is largely dependent 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. Basic/root causes are a function of how society 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 malnutrition in Uganda is the overall low awareness of nutrition as being critical to the country’s economic development and to efforts to reduce child and maternal mortality. The inadequate political commitment and public funding for nutrition have limited the development of the necessary policies and legislation to create the environment for increased investment in nutrition. In addition, the lack of political support has hindered the establishment of the necessary structures for coordinating action to address young child and maternal malnutrition, developing a monitoring and evaluation (M&E) framework to improve these efforts, and strengthening human capacity for nutrition analysis, programme design, and implementation in Uganda.

3.2 Consequences of High Malnutrition in Uganda

A. Malnutrition kills many Ugandans each year• Low birth weight is rampant in Uganda. Over 16,000 children who were born

weighing less than 2.5 kg died in 2009. 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. Malnutrition significantly reduces agricultural productivity• In the agricultural sector, Uganda’s main employer, over US$ 34 million worth of

productivity was lost in 2009 alone 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 other types of malnutrition or time lost while dealing with family illnesses or deaths associated with malnutrition.

C. Malnutrition contributes to poverty in Uganda• 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 is expensive to treat. For instance, treating severe acute malnutrition

costs more than US$120 per child.



• Malnutrition contributes to a loss of about 4.1% of the gross domestic product (GDP) per year.

D. Malnutrition affects education and intellectual potential of schoolchildren• 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 children to start school late because they look too small for their age. In 2006, one in four 7-year-olds had not started school, even with the Universal Primary Education programme.

• 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 programmes, 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 malnutrition with potential and desired performance.

Table 1. Gap Analysis for Scaling Up Nutrition Interventions in Uganda

Gap Current performance Opportunities for improvement

Weak advocacy for nutrition at all levels

Limited recognition by •government and general population of the centrality of improved nutrition to developmentLow prioritisation of •nutrition by government and implementersWeak leadership for nutrition •across all sectorsLimited advocacy skills among •nutrition stakeholdersLack of commitment to •achieve the national nutrition agenda No communication strategy for •nutritionInadequate number of •nutrition activists

Emerging commitment for improving •nutrition in the country.Food and Nutrition Bill drafted, awaits •enactment by Parliament to empower the Food and Nutrition Council.Nutrition is integrated in various policy •documents, including the Constitution of Uganda and the NDP.Government staff structure allows •for strengthening human capacity; 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 infra-structure to support quality nutrition programming at all levels, including lack of equipment and skilled human resources

Nutrition is inadequately •mainstreamed into existing sectoral programmes. Poor appreciation of centrality •of nutrition to developmentLow recruitment, poor •professional growth opportunities, and poor retention of nutritionists due to low prioritisation of nutritionists as cadres of the civil serviceLack of a comprehensive •nutrition curriculum and training plan for in-service capacity strengthening of personnel who do not specialise in nutritionLack of incentives for nutrition •personnel in all sectors

Nutrition is part of the curricula at all •education 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 utilised to fill gaps in nutrition expertise.Increasing appreciation of the role •of nutrition as a preventive health mechanismTraining and information, education, and •communication 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 programmingLack of a national nutrition •agenda to act as a reference point for implementersExisting Food and Nutrition •Policy and other guidelines not adequately implemented and disseminated.

Presence of National Planning Authority •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 and 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 on changing innovations in nutrition

Lack of a national nutrition •database and information system Lack of standardised data •collection and analytical toolsLow demand for nutrition •informationWeak coordination, •information sharing, and adaptation of promising practicesLack of a national nutrition •research agenda

Existing and forthcoming survey datasets •with nutrition contentDevelopment partners are 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 preventive.Nutrition activities often do •not promote community involvement. Few good models for community engagementInadequate public knowledge •on importance of good nutritionFew community organisations •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 partnersInadequate knowledge about •food supplementationLimited data on nutrition •needs

Local production of enriched foods is •increasing.Commitment by government and •development partnersIncreasing interest in the private sector•



PART II: THE STRATEGIC DIRECTION

4. Action Plan Target Groups and Broad Strategies

4.1 Target Groups

As discussed earlier, different forms of malnutrition affect different groups of Ugandans. However, investments in preventing malnutrition yield the greatest returns during the “window of opportunity,” the 1,000 days from conception through the nine months of pregnancy to the child’s second birthday. 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, young children, and mothers, both women of reproductive age and adolescent girls who will become mothers in later years.

Uganda has about 2.7 million children under two years of age, 7.1 million women of reproductive age, and 2 million adolescent girls. These 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 equally important, 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. In consequence, the UNAP will directly and indirectly address the nutritional needs of all Ugandans, particularly the most vulnerable, and will lead to a sustained decline in the numbers of malnourished Ugandans.

4.2 Broad Strategies to Reduce Malnutrition in the Plan Period (2011–2016)

To effectively meet the nutrition needs of the target groups, the UNAP will seek to:

a) Address 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 private arenas. Intra- and inter-sectoral linkages, public-private partnerships, coordination, and collaboration will be strengthened to facilitate adequate nutrition advocacy, programming, and M&E.

b) Implement proven high-impact interventions in reducing young child and maternal malnutrition both nationally and internationally. Most interventions will be in the areas of production of nutritious food, nutrition care within the



household, public health, and livelihood support.c) Identify and implement cost-effective nutrition programme 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 programmes, among others.

d) Equip local institutions to provide leadership and capacity in nutrition policy and programming. This will include the legal establishment of the FNC and its secretariat. The ability of key public sectors to finance nutrition programmes 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) Plan nutrition programmes appropriately. Whenever possible, the programmes will be planned, managed, and implemented at community and local government levels in a cross-sectoral manner. Geographic areas that are very vulnerable to young child and maternal malnutrition will be specifically targeted under the UNAP.

The UNAP will therefore focus on the following four broad action areas:

a) Promoting 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 programmes.

b) Supporting households and communities to increase access to and consumption of diversified foods throughout the year through their own food production or purchased food. Complementary programmes will focus on reducing post-harvest losses and spoilage and on addressing issues related to women’s workload within the household.

c) Providing care and support to individuals with severe acute malnutrition.d) Mobilising the community to promote 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:

a) Facilitate behavior change, using nutrition information, education, and communication materials

b) Provide nutrition care and supportc) Collect information on the nutritional condition of the target groups and all

Ugandans over time for analysis and use in 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.

5. Goal, Objectives, Strategic interventions, and Core ProJECTS

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 from 2011 through 2016 and beyond. Table 2 lists the key indicators on which the UNAP will focus.

Table 2. Key Nutrition Outcome Indicators

Outcome indicator baseline UNAP target 2016

1 Stunting among under-5s, % 38 32

2 Underweight among under-5s, % 16 10

3 Underweight among non-pregnant women age 15-49 (BMI less than 18.5 kg/m2), %

12 8

4 Iron deficiency anemia among under-5s, % 73 50

5 Iron deficiency anemia among women age 15-49, % 49 30

6 Vitamin A deficiency among under-5s, % 19 13

7 Vitamin A deficiency among women age 15-49, % 20 12

8 Low birth weight (newborns weighing less than 2.5 kg, % 13 9

9 Exclusive breastfeeding to age 6 months (percentage of infants) , %

60 75

10 Dietary diversification index (percentage calories consumed from foods other than cereals and starchy roots) , %

57 75

11 Calorie consumption (average daily energy intake per capita), kcal

2,220 2,500 l

Baseline data obtained from the 2006 UDHS and from FAO 2008.

These indicators have been chosen to cover the two principal target groups of the UNAP, young children and women of reproductive 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 nutrition in pregnancy (as indicated by the infant’s birth weight), breastfeeding, and dietary diversity.



5.2 Objectives, Strategies, and Strategic Interventions

To achieve the above goal and to improve the nutrition status indictors, the following five strategic objectives will be pursued through 2016.

Objective 1: Improve access to and utilisation of services related to maternal, infant, and young child nutrition

Strategy 1.1: Promote access and utilisation of nutrition and health services to all women of reproductive age, infants, and young children.

Interventions

1) Promote and support health and nutrition education to increase the level of awareness of good nutrition.

2) Promote integration of nutrition services in all routine and outreach health services and programmes targeting children and mothers.

3) Manage nutrition for sick children, pregnant and lactating mothers, and other women of reproductive age.

4) Integrate the management of severe and moderate acute malnutrition into routine health services.

5) Promote utilisation of antenatal and postnatal care services among all pregnant and lactating mothers to monitor child growth, and the health and nutrition status of both the mother and the child.

6) Promote and support breastfeeding policies, programmes, 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.

Strategy 1.2: Address gender and socio-cultural issues that affect maternal, infant, and young child nutrition.

Intervention

1) Promote male involvement in family health services and in food security and nutrition programmes.

2) Advocate and seek solutions for reducing workload for all women, especially pregnant women and lactating mothers.

3) Address detrimental food taboos and norms that impair nutrition of women, infants, and young children.



Objective 2: Enhance consumption of diverse diets

Strategy 2.1: Increase access and use of diverse nutritious foods at household level

Intervention

1) Promote production and consumption of diversified nutritious foods at household and community levels.

2) Advocate for and support integration of nutrition in agricultural programmes 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 levels. 5) Promote and support the utilisation of safe labour-saving technologies at household

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

diversification. 8) Promote positive indigenous dietary practices.

Strategy 2.2: Enhance post-harvest handling, storage, and utilisation of nutritious foods at household and farm levels.

Interventions

1) Promote and support adoption of post-harvest handling and storage technologies at household and community levels.

2) Provide an enabling environment to the private sector to manufacture, market, and distribute appropriate post-harvest handling and storage technologies.

Strategy 2.3: Promote the consumption of nutrient-enhanced foods.

Interventions

1) Promote production of fortified common staples by local manufacturers. 2) Promote production of bio-fortified varieties. 3) Promote consumption of nutrient-enhanced foods through increased awareness of

their benefits.4) Support local production of ready-to-use therapeutic and complementary food.



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

Strategy 3.1: Develop preparedness plans for shocks.

Interventions

1) Strengthen and scale up early warning systems on food and nutrition information from community to national levels.

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

3) Develop, promote, and implement in a timely fashion a comprehensive package of nutrition services and food items to provide during emergencies and recovery periods.

4) Make integration of nutrition in all disaster management programmes mandatory.5) Promote and support diversified production of drought-resistant crops including

vegetables and raising of animals tolerant to heat stress at household and community levels.

6) Carry out sensitisation programmes for communities to raise their awareness of prevention, mitigation, and response to risks of malnutrition during shocks.

Strategy 3.2: Promote social protection interventions for improved nutrition.

Interventions

1) Provide social transfers to and support livelihoods for the most vulnerable households and communities.

2) Develop and implement programmes for special social assistance and for livelihood promotion and protection in areas with high levels of malnutrition.

3) Advocate for and promote school feeding programmes. 4) Manage cases of SAM by integrating care into routine health services and providing

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

Objective 4: Strengthen the policy, legal, and institutional frameworks and the capacity to effectively plan, implement, monitor, and evaluate nutrition programmes.

Strategy 4.1: Strengthen the policy and legal framework for coordinating, planning, and monitoring nutrition activities.

Interventions

1) Fast-track enactment of the Food and Nutrition Bill, which will provide the statutory mechanism for establishing the FNC and its secretariat.



2) Revitalise and legalise the functionality of the FNC 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 bylaws 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 in pre- and in- service training.

Strategy 4.2: Strengthen and harmonise the institutional framework for nutrition from local to central government levels.

Interventions

1) Review the country’s current institutional framework for nutrition and implement a suitable one.

2) Establish an interim multi-sectoral coordination mechanism for nutrition programming and M&E.

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 food and nutrition programmes in the country.

Interventions

1) Design and implement a capacity-strengthening plan for nutrition programming at national, local government, and community levels.

2) Establish a food and nutrition M&E 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 vulnerable areas and among vulnerable populations.



5) Undertake mid-term and end-of-term impact evaluation of the UNAP.6) Strengthen district-level food and nutrition surveillance systems.

Strategy 4.4: Enhance operational research for nutrition.

Interventions

1) Conduct formative research studies on best practices for nutrition.2) Research, document, and disseminate findings on positive indigenous dietary

practices.3) Compile food composition data for all foods consumed in Uganda.4) Identify and conduct 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.

Objective 5: Create awareness of and maintain national interest in and commitment to improving and supporting nutrition programmes in the country.

Strategy 5.1: Increase awareness of and commitment to addressing nutrition issues in the country.

Interventions

1) Develop and implement a nutrition communication strategy.2) Produce annual policy statements and periodic policy briefs on the national food

security and nutrition situation.3) Commemorate nutrition-related events and take advantage of other opportunities

to raise the profile of nutrition.

Strategy 5.2: Advocate for increased commitment to improving nutrition outcomes.

Interventions

1) Develop and implement a nutrition communication strategy.2) Develop and implement a comprehensive and sustainable nutrition advocacy

plan.3) Produce and publish an annual report on the state of the food security and

nutrition situation in the country.



5.3 Priority Investment Areas

1) Scale-up cost-effective community-based initiatives that emphasise prevention and control of malnutrition: Key areas of focus will include growth monitoring and promotion, Community-Based Management of Acute Malnutrition, initiatives to promote baby-friendly hospitals and communities, food fortification, and increased production of bio-fortified staple food crops.

2) Establish an enabling legal environment and strong institutional capacity and mechanisms to implement the UNAP at all levels: Critical areas of focus under this investment area will include fast-tracking the Food and Nutrition Bill, strengthening human resource capacity for nutritional assessment and programming, and establishing institutional structures for nutrition program implementation and coordination at national and decentralised levels.

3) Strengthening of food security and nutrition safety nets at national and decentralised levels. This includes the establishment of a National Food and Nutrition Information System.

4) Operational research in nutrition to inform implementation and monitoring of the UNAP progress. The activities under this investment area include research on improved community and household-level food processing for value addition, improved post-harvest handling and storage of food crops, community-based school feeding pilot programs, and investigation and demonstration of labour-saving technologies for women with young children.



PART III: IMPLEMENTATION, FINANCING, AND MONITORING & EVALUATION FRAMEWORKS

6. Implementation Framework

This section provides an overview of how the UNAP will be implemented and coordinated at the national and local government levels to achieve its goal and objectives. Nutrition is a multi-sectoral issue that is best addressed through a well-coordinated multi-sectoral approach.Thus, this implementation framework is aimed at supporting nutrition stakeholders at all levels and sectors in the country to successfully operationalise the UNAP.

The lack of an institutionalised coordinating mechanism for nutrition has been one of the main contributors to the ineffectiveness of past interventions. Inadequate coordination of the planning and implementation of nutrition programmes and projects often resulted in duplication of services and programmes 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 new institutional arrangements and strengthen existing ones to adequately provide policy direction, coordinate and harmonise nutrition programming, and conduct M&E in the country.

6.1 Institutional Arrangements

The UNAP specifically recognises the urgent need to establish and strengthen the institutional structure for national-level coordination by legally establishing the FNC and its secretariat in the Office of the Prime Minister (OPM) as proposed in the draft Food and Nutrition Bill. Assisted by its secretariat, the council will be responsible for providing policy direction, guidance, and oversight as well as national coordination of the implementation, monitoring, and evaluation of the UNAP and other nutrition programmes in the country. Specifically the council, assisted by its secretariat, will:

a) Coordinate joint planning and review with other ministries and departments as well as development partners, civil society, the private sector, and academia;

b) Monitor and evaluate national nutrition response in the country;c) Mobilise resources and support for nutrition response;d) Provide national standards and norms for nutrition;e) Advocate for both the development of nutrition structures and adequate

resource allocation;



f) Lobby for the establishment of a consolidated nutrition fund by development partners; and

g) Facilitate cross-sector collaboration and work with higher-level committees (in the Cabinet and Parliament) and the Multi-Sectoral Technical Committee on Nutrition.

6.2 Coordination Arrangements

The UNAP further recognizes the need to establish, strengthen, and support nutrition coordination structures at both national and local government levels and to strengthen sector-specific capacity at all levels to effectively implement nutrition programmes.

National- Level Coordination

A. Policy-Level Coordination

Policy coordination will be done through three entities: a Cabinet sub-committee, the FNC, and the Parliamentary Sub-Committee on Nutrition. The Cabinet sub-committee will meet biannually to review progress on key nutrition indicators in the country and provide policy direction. The FNC, which will include key Line Ministers and Permanent Secretaries, will meet quarterly to review progress on performance of key nutrition indicators, analyze budget performance of nutrition programmes, analyze the constraints to implementation, and provide strategic direction. Recommendations from the Cabinet sub-committee and the FNC will then be fed into the Parliamentary Sub-Committee on Nutrition, which will pass the key policy and financial decisions, and then to the technical committee for implementation of decisions.

B. Technical-Level Coordination

Technical coordination of nutrition will be done through the Nutrition Multi-Sectoral Technical Committee, which will comprise key technical experts from government, development partners, the private sector, academia, and civil society. The Committee, whose establishment and terms of reference will be defined during the plan period, will be led by the FNC chairperson and coordinated by the head of the secretariat.

Until the FNC and its secretariat are established, the National Planning Authority, in line with its mandate to coordinate and harmonise national development planning, monitoring and evaluation, will undertake this role. The NPA also will work with other stakeholders to ensure that the proposed institutional structures are established as soon as possible.

C. Nutrition Development Partners Committee

This committee will be responsible for promoting and identifying funding resources for the nutrition agenda in Uganda; promoting joint resource mobilisation, allocation, and support; responding to the proposed development partners’ consolidated nutrition fund; and providing



policy guidance on alignment of nutrition programmes to the Millennium Development Goals and the nutrition commitments of the UN Development Agency Fund and other international organisations. This committee will be composed of representatives of nutrition development partners and will feed into the policy and technical level committees.

D. The Uganda Nutrition Coordination Forum

The Uganda Nutrition Coordination Forum, which will be inaugurated in the plan period, will meet biannually to review implementation of the UNAP and to provide advice and advocacy for nutrition. Chaired by the NPA, the Coordination Forum will comprise all key national and local nutrition stakeholders, including heads of the principal government departments and agencies and representatives of the private sector, NGOs, and CSOs involved in implementing programmes under the UNAP.

Decentralised-Level Coordination

A. Sectoral-Level Coordination Committees

At the sector level, the various ministries, departments, and agencies will form committees that will coordinate nutrition programmes and support implementation by central government departments, local governments, the private sector, academia, and civil society. These committees will also ensure joint planning and budgeting for nutrition activities within each sector, prepare quarterly monitoring reports to submit to the secretariat (or NPA in the interim), and provide technical guidance to stakeholders and service providers in each sector. Nutrition focal persons in each sector will coordinate nutrition activities within their area of responsibility.

B. District-Level Coordination Committee

The District Nutrition Coordination Committee, which will be composed of representatives from key sector departments, CSOs, the private sector, and academia, will provide technical advice to the District technical planning committees and subsequently to the District Council. The committee also will monitor and evaluate nutrition activities, carrying out reviews and providing technical advice to the lower local government levels. Nutrition focal persons/officers in local governments and at the community level will coordinate nutrition activities within their area of responsibility.

6.3 Implementation Strategy

The UNAP will be implemented along five main dimensions that are interrelated and mutually reinforcing:

a) Preventing and controlling malnutrition by targeting and investing in interventions that have an impact within the “window of opportunity” (the 1,000 days from conception through pregnancy until the child’s second birthday);



b) Scaling up community-based initiatives that have proven to have a high impact and are cost-effective;

c) Comprehensively managing cases of acute and moderate malnutrition;d) Supporting food-based approaches to improve nutrition that have proven

sustainable; ande) Creating an enabling legal environment and building strong institutional structures

and mechanisms and capacity at all levels

6.4 Prerequisites for Implementation

Implementation of the UNAP will be a shared responsibility of the public sector, the private sector, development partners, NGOs, CSOs, and research institutions and academia. Successful implementation of the UNAP will require the following:

a) Ownership of the action plan by the key government ministries—MoH, MAAIF, MoES, Ministry of Water and Environment (MWE), Ministry of Local Government (MoLG), MGLSD, and MTC—and support from the Ministry of Finance, Planning and Economic Development (MFPED), OPM, and NPA.

b) Political will and financial commitment at both national and local government levels.

c) Behavior change at national, local, and household levels to promote good nutrition.

d) Routine and effective M&E of the implementation of the UNAP to ensure that the plan is on track.

e) Effective coordination and networking of implementing agencies and development partners.

7. Financing Framework

The budget is the sum of all budget estimates from the programmes and activities under each objective, representing a snapshot of the current nutrition priorities for Uganda. The total cost of the five-year UNAP is UShs 161,614 million (Table 3 and Annex II). Financing the UNAP will require concerted effort from the Government of Uganda, development partners, CSOs, and the private sector. However, the major investor in these nutrition priorities will be the Government of Uganda.

7.1 Government of Uganda

Uganda’s central and local governments, in alliance with other agencies and development partners, will finance the UNAP through focused resource reallocation within existing budgets and through mainstreaming nutrition in various sector programmes to increase resource availability. This calls for making food security and nutrition a high priority in national programmes, specifically in sectors such as health, agriculture, social development, finance, education, trade and tourism,



and local development. For successful resource mobilisation, a strong advocacy strategy will be used to demonstrate to sectors and development partners the cost-effectiveness of improved investment in nutrition and the consequences of failing to do so.

7.2 Development Partners

The Government recognizes that the current domestic budgets will not be able to independently finance the UNAP at the level required to sustainably improve the nutrition indicators. While in the long term, the Government will seek to fund the UNAP through domestic revenues, it will continue to depend on external resources in the short to medium term, while progressively reducing its reliance on such resources. Opportunities for initial resource mobilisation will be through forums such as monthly local development partner group meetings. The government will further take advantage of existing and new global and regional initiatives including Scaling-up Nutrition, CAADP, USAID’s Feed the Future, and others to identify potential sources for financing the nutrition programmes.

The current support for nutrition programmes is fragmented and has minimal impact on the nutrition indicators. Thus, at national level, advocacy for basket funding for nutrition programmes from the national nutrition development partners to maximise nutrition investments will be adopted. This will facilitate a more holistic approach to nutrition programming and implementation, since the tendency is to implement only activities that would have received funding, even when their scope and potential impact are limited (e.g., micronutrient programmes have received a lot of funding and yet macronutrient problems remain largely not addressed).

In addition, some development partners provide support directly to CSOs, NGOs, and some districts outside the Government budget. While this arrangement is not discouraged, it will be appropriate to share information on the level of support provided and the activities of the UNAP being funded to have an accurate assessment of the impact on the nutrition indicators.

7.3 Public-Private Partnerships

Experience shows that cooperation between the public and private sectors in form of public-private partnerships can be a powerful incentive for improving the quality and efficiency of public services and a source of financing for public infrastructure. There will be strategic exploration of public-private partnerships with the highest cost-effectiveness in sustainably addressing malnutrition in Uganda, especially through the value addition, energy, and labour-saving technologies.

Existing and available resources for nutrition within the national budget and from private sector and development partners must be coordinated effectively to maximise impact. In addition, the government envisions encouraging affected communities to take ownership of their nutrition problems. If communities recognize how these problems affect their development and see that they can help identify strategies to address the problems, then community contribution to nutrition interventions would increase and help sustain activities.



Table 3. Summary of Five-Year UNAP Implementation Cost Matrix

UShs millions US$ thou-sands

Percent of total budgetOBJECTIVE 2011-12 2012-13 2013-14 2014-15 2015-16 TOTAL

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

5,087 7,199 10,392 13,399 13,706 49,783 19,147 30.8

2. Enhance consumption of diverse diets

1,227 3,777 4,817 5,127 6,777 21,726 8,356 13.4

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 17,658 28.4

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

3,855 6,292 7,729 8,836 8,343 35,055 13,483 21.7

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

1,595 1,733 1,835 1,938 2,040 9,140 3,515 5.7

TOTAL 12,684 25,921 34,734 42,330 45,946 161,614 62,159 100.0



8. Monitoring and Evaluation framework

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

An annual multi-sectoral monitoring and reporting system will be established with a lead coordinating agency, which will be NPA in the interim and the FNC once it is 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 the reports to produce an annual report. An annual review meeting for the implementing agencies and other nutrition stakeholders will be held.

All implementing agencies will submit quarterly reports in their thematic areas to the coordinating agency, which will compile them and produce a quarterly report. Quarterly meetings will be held to discuss the reports and come up with appropriate measures if implementation is slow or off track.

To evaluate the effectiveness and impact of the various programmes, interventions, and the UNAP overall, evaluations and reviews will be conducted annually, at mid-term (two and a half years), and final (five years).

Table 4 below shows the key outcome indicators and targets that will be monitored during the five-year plan period.



Table 4. Key outcome indicators and annual targets

No. Outcome indicator Base-line 2012 2013 2014 2015UNAP Target (2016)

1. Stunting – prevalence in under-5s, % 38 1 37 35 34 33 32

2. Underweight – prevalence in under-5s, % 16 1 15 14 12 11 10

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

12 1 11 10 10 9 8

4. Iron deficiency anemia – prevalence in under-5s, %

73 1 68 64 59 54 50

5. Iron deficiency anemia – prevalence among women age 15-49 years, %

49 1 45 41 38 34 30

6. Vitamin A deficiency – prevalence in under-5s, %

19 1 18 17 15 14 13

7. Vitamin A deficiency – prevalence among women age 15-49 years, %

20 1 18 17 15 14 12

8. Low birth weight - newborns less than 2.5 kg, %

13 1 12 11 11 10 10

9. Exclusive breastfeeding to 6 months, percentage of infants

60 1 63 66 69 72 75

10. Dietary diversification index (percentage of calories consumed from foods other than cereals & starchy roots)

57 1 61 64 69 71 75

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

2,220 2 2,276 2,332 2,388 2,444 2,500

1 2006 UDHS 2 FAO, 2008

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

31EN

D M

ALN

UTR

ITO

N N

OW

AN

NEX

I: Im

ple

men

tati

on

Mat

rix

Goa

l: To

redu

ce m

alnu

triti

on le

vels

am

ong

wom

en o

f rep

rodu

ctive

age

, inf

ants

and

you

ng

child

ren

over

the

next

five

yea

rs 2

010–

2015

Inte

rven

tion

sEx

pect

edO

utpu

tLe

ad

Age

ncy

Oth

er

OB

JEC

TIV

E 1:

IM

PRO

VE

ACC

ESS

TO A

ND

UTI

LISA

TIO

N O

F SE

RV

ICES

REL

ATED

TO

MAT

ERN

AL,

INFA

NT,

AN

D Y

OU

NG

CH

ILD

NU

TRIT

ION

Stra

tegy

1.1

Pro

mot

e ac

cess

to a

nd u

tilis

ation

of n

utri

tion

and

hea

lth

serv

ices

to a

ll w

omen

of r

epro

ducti

ve a

ge, i

nfan

ts &

yo

ung

child

ren

PPro

mot

e an

d su

ppor

t hea

lth a

nd

nutr

ition

edu

catio

n (in

form

ation

, ed

ucati

on, a

nd c

omm

unic

ation

m

ater

ials

, med

ia).

•In

crea

sed

leve

l of a

war

enes

s of

goo

d nu

triti

on•

Incr

ease

d ac

cess

to a

nd u

tilis

ation

of

info

rmati

on, e

duca

tion,

and

com

mun

icati

on

mat

eria

ls &

mes

sage

s to

targ

et b

enefi

ciar

ies

MoH

LGs

,MG

LSD

, MA

AIF

, MoE

S, d

evel

opm

ent

part

ners

, CSO

s, M

FPED

Prom

ote

inte

grati

on o

f nut

ritio

n se

rvic

es in

all

routi

ne &

out

reac

h he

alth

ser

vice

s an

d pr

ogra

mm

es

targ

eting

chi

ldre

n an

d m

othe

rs.

•G

row

th m

onito

ring

and

pro

moti

on a

nd o

ther

nu

triti

on s

ervi

ces

inte

grat

ed in

all

routi

ne &

ou

trea

ch h

ealth

ser

vice

s•

Incr

ease

d ac

cess

to a

nd u

tilis

ation

of n

utri

tion

serv

ices

MoH

LGs,

MG

LSD

, MA

AIF

, MoE

S, d

evel

opm

ent

part

ners

, CSO

s, M

FPED

Man

age

nutr

ition

for

sick

chi

ldre

n,

preg

nant

wom

en, l

acta

ting

mot

hers

& o

ther

wom

en o

f re

prod

uctiv

e ag

e.

•In

crea

sed

acce

ss to

& in

take

of n

utri

tious

food

s by

sic

k ch

ildre

n, p

regn

ant w

omen

, lac

tatin

g m

othe

rs &

oth

er w

omen

of r

epro

ducti

ve a

ge

MoH

LGs,

MG

LSD

, MA

AIF

, MoE

S, M

FPED

, de

velo

pmen

t par

tner

s, C

SOs

Inte

grat

e m

anag

emen

t of s

ever

e an

d m

oder

ate

acut

e m

alnu

triti

on

into

rou

tine

heal

th s

ervi

ces.

•Ca

paci

ty fo

r m

anag

emen

t of s

ever

e an

d m

oder

ate

acut

e m

alnu

triti

on e

nhan

ced

•Ce

ntre

s fo

r m

anag

emen

t of s

ever

e an

d m

oder

ate

acut

e m

alnu

triti

on in

crea

sed

with

in

exis

ting

heal

th fa

ciliti

es c

ount

ryw

ide

•Ca

ses

of s

ever

e an

d m

oder

ate

acut

e m

alnu

triti

on m

onito

red

& fo

llow

ed u

p

MoH

MG

LSD

, LG

s, M

oES,

MA

AIF

, MFP

ED, p

riva

te

sect

or, d

evel

opm

ent p

artn

ers,

CSO

s

32EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

Prom

ote

utilis

ation

of a

nten

atal

ca

re a

nd p

ostn

atal

car

e se

rvic

es

by a

ll pr

egna

nt w

omen

and

la

ctati

ng m

othe

rs.

•In

crea

sed

num

ber

of m

othe

rs a

tten

ding

an

tena

tal c

are

and

post

nata

l car

e se

rvic

esM

oHLG

s, M

GLS

D, M

AA

IF, M

oES,

MFP

ED,

deve

lopm

ent p

artn

ers,

CSO

s, P

opul

ation

Se

cret

aria

t

Prom

ote

and

supp

ort

brea

stfee

ding

pol

icie

s,

prog

ram

mes

, and

initi

ative

s.

•In

crea

sed

num

ber

of e

xclu

sive

ly b

reas

tfed

ba

bies

•In

crea

sed

num

ber

of B

aby

Frie

ndly

wor

kpla

ces,

co

mm

uniti

es &

hea

lth fa

ciliti

es, b

oth

publ

ic &

pr

ivat

e •

Incr

ease

d nu

mbe

r of

em

ploy

ers,

insti

tutio

ns/

agen

cies

impl

emen

ting

the

mat

erni

ty &

pa

tern

ity la

w

MoH

LGs,

MG

LSD

, MA

AIF

, MoE

S, d

evel

opm

ent

part

ners

, CSO

s

Prom

ote

& s

uppo

rt a

ppro

pria

te

com

plem

enta

ry fe

edin

g pr

actic

es.•

Incr

ease

d us

e of

div

ersi

fied

loca

l foo

ds fo

r w

eani

ng•

Incr

ease

d fr

eque

ncy

of c

ompl

emen

tary

mea

ls a

t ho

useh

old

leve

l•

Incr

ease

d kn

owle

dge

amon

g m

othe

rs o

f ap

prop

riat

e co

mpl

emen

tary

feed

ing

prac

tices

•

Incr

ease

in n

umbe

r of

app

ropr

iate

co

mpl

emen

tary

feed

ing

prac

tices

/ini

tiativ

es

supp

orte

d

MoH

LGs,

MoG

LSD

, MA

AIF

, MoE

S, M

FPED

, de

velo

pmen

t par

tner

s, C

SOs,

MIC

T

Supp

ort a

nd s

cale

up

com

mun

ity-

base

d nu

triti

on in

itiati

ves.

•In

crea

se in

num

ber

of c

omm

unity

- bas

ed

nutr

ition

initi

ative

s su

ppor

ted

•In

crea

sed

cove

rage

of c

omm

unity

-bas

ed

nutr

ition

initi

ative

s•

Incr

ease

d le

vel o

f com

mun

ity p

artic

ipati

on

&in

volv

emen

t in

com

mun

ity-b

ased

nut

ritio

n pr

ogra

mm

es

MoH

/M

GLS

D/M

AA

IF/

MoE

S

LGs,

MA

AIF

, MoE

S, M

FPED

, dev

elop

men

t pa

rtne

rs, C

SOs,

MIC

T

Prom

ote

prop

er fo

od h

andl

ing

hygi

ene

and

sani

tatio

n.

•In

crea

sed

know

ledg

e of

pro

per

food

han

dlin

g hy

gien

e an

d sa

nita

tion

•In

crea

se h

ouse

hold

use

of s

afe

wat

er•

Incr

ease

in h

and

was

hing

pra

ctice

s by

ho

useh

olds

MoH

LGs,

MW

E, M

oES,

dev

elop

men

t par

tner

s, C

SOs,

M

FPED

, MIC

T

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

33EN

D M

ALN

UTR

ITO

N N

OW

Stra

tegy

1.2

: Add

ress

gen

der

and

soci

o-cu

ltur

al is

sues

that

aff

ect m

ater

nal,

infa

nt, a

nd y

oung

chi

ld n

utri

tion

Prom

ote

mal

e in

volv

emen

t in

fam

ily h

ealth

ser

vice

s an

d in

food

sec

urity

and

nut

ritio

n pr

ogra

mm

es.

•In

crea

sed

know

ledg

e am

ong

men

of f

amily

he

alth

& n

utri

tion

issu

es•

Incr

ease

d m

ale

invo

lvem

ent i

n fa

mily

hea

lth,

food

sec

urity

, and

nut

ritio

n se

rvic

es a

nd

prog

ram

mes

MG

LSD

/MoH

/M

AA

IFM

oH, M

AA

IF, L

Gs,

MFP

EDD

evel

opm

ent P

artn

ers,

CSO

s

Adv

ocat

e an

d se

ek s

oluti

ons

for

redu

cing

wor

kloa

d fo

r al

l wom

en,

espe

cial

ly p

regn

ant w

omen

and

la

ctati

ng m

othe

rs.

•In

crea

sed

awar

enes

s am

ong

husb

ands

and

ot

her

fam

ily m

embe

rs o

f ben

efits

of r

educ

ing

wom

en’s

wor

kloa

ds•

Incr

ease

in s

hari

ng o

f far

m a

nd h

ouse

hold

wor

k am

ong

hous

ehol

d m

embe

rs•

Incr

ease

d us

e of

labo

ur-s

avin

g te

chno

logi

es a

t fa

rm &

hou

seho

ld le

vels

MG

LSD

/MA

AIF

MoH

, LG

s, M

FPED

D

evel

opm

ent p

artn

ers,

CSO

s

Add

ress

det

rim

enta

l foo

d ta

boos

&

nor

ms

that

impa

ir n

utri

tion

of

wom

en, i

nfan

ts &

you

ng c

hild

ren.

•In

crea

sed

know

ledg

e on

the

impa

ct o

f de

trim

enta

l foo

d ta

boos

& n

orm

s th

at im

pair

nu

triti

on•

Chan

ge in

neg

ative

atti

tude

s, b

elie

fs, a

nd

prac

tices

•In

crea

sed

inta

ke o

f cul

tura

lly p

rohi

bite

d fo

ods

MA

AIF

/ M

GLS

DM

oH, L

Gs,

dev

elop

men

t par

tner

s, C

SOs

OB

JECT

IVE

2: E

NH

AN

CE C

ON

SUM

PTIO

N O

F D

IVER

SE D

IETS

Stra

tegy

2.1

: Inc

reas

e ac

cess

to a

nd u

se o

f div

erse

nut

riti

ous

food

s at

hou

seho

ld le

vel

Prom

ote

prod

uctio

n an

d co

nsum

ption

of d

iver

sifie

d nu

triti

ous

food

s at

hou

seho

ld a

nd

com

mun

ity le

vels

.

•In

crea

sed

prod

uctio

n of

div

ersi

fied

nutr

itiou

s fo

ods

•In

crea

sed

cons

umpti

on o

f div

ersi

fied

nutr

itiou

s fo

ods

•In

crea

sed

prov

isio

n of

app

ropr

iate

agr

icul

tura

l in

puts

& s

ervi

ces

at h

ouse

hold

and

com

mun

ity

leve

l

MA

AIF

MoH

, LG

s, M

GLS

D, M

FPED

, pri

vate

sec

tor,

de

velo

pmen

t par

tner

s, C

SOs

Adv

ocat

e &

sup

port

inte

grati

on

of n

utri

tion

in A

gric

ultu

ral

prog

ram

mes

•In

crea

sed

inte

grati

on o

f nut

ritio

n is

sues

in

agri

cultu

ral p

rogr

amm

es

MA

AIF

/ N

PAPr

ivat

e se

ctor

, dev

elop

men

t par

tner

s, C

SOs,

M

FPED

Incr

ease

con

sum

ption

of b

oth

raw

an

d pr

oces

sed

nutr

itiou

s fo

ods.

•In

crea

sed

cons

umpti

on o

f raw

veg

etab

les

and

frui

ts•

Incr

ease

d co

nsum

ption

of e

nric

hed

proc

esse

d fo

ods

•In

crea

sed

cons

umpti

on o

f for

tified

food

s

MA

AIF

/ M

oHM

TC, M

FPED

, pri

vate

sec

tor,

dev

elop

men

t pa

rtne

rs

34EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

Prom

ote

and

supp

ort l

ocal

food

pr

oces

sing

and

val

ue a

dditi

on a

t ho

useh

old

and

com

mun

ity le

vel.

•In

crea

sed

proc

essi

ng o

f nut

ritio

us fo

ods

at

hous

ehol

d &

com

mun

ity le

vels

•D

iver

sifie

d pr

oces

sed

food

pro

duct

s at

ho

useh

old

& c

omm

unity

leve

l

MA

AIF

/M

TCPr

ivat

e se

ctor

, dev

elop

men

t par

tner

s, M

oH,

MG

LSD

, MFP

ED

Prom

ote

and

supp

ort t

he

utilis

ation

of s

afe

labo

ur-s

avin

g te

chno

logi

es a

t hou

seho

ld a

nd

com

mun

ity le

vel.

•In

crea

sed

type

s of

labo

ur-s

avin

g te

chno

logi

es a

t ho

useh

old

& c

omm

unity

leve

l•

Incr

ease

d uti

lisati

on o

f lab

our-

savi

ng

tech

nolo

gies

at h

ouse

hold

& c

omm

unity

leve

l

MA

AIF

/M

TCM

GLS

D, M

WE,

MEM

D, L

Gs,

pri

vate

sec

tor,

de

velo

pmen

t par

tner

s, C

SOs

Supp

ort o

n fa

rm e

nter

pris

e m

ix to

pr

omot

e st

able

div

ersi

fied

food

pr

oduc

tion.

•In

crea

sed

num

ber

of h

ouse

hold

s &

co

mm

uniti

es w

ith s

tabl

e di

vers

ified

food

su

pplie

s &

inco

mes

MA

AIF

LLG

s, M

GLS

D, M

TC, M

FPED

, pri

vate

sec

tor,

de

velo

pmen

t par

tner

s, C

SOs

Pro

mot

e pr

oduc

tion

&

cons

umpti

on o

f loc

al in

dige

nous

fo

ods

to e

nhan

ce d

iet

dive

rsifi

catio

n.

•In

crea

sed

prod

uctio

n &

con

sum

ption

of

indi

geno

us fo

ods

•In

crea

sed

awar

enes

s of

the

nutr

ition

val

ue o

f in

dige

nous

food

s•

Incr

ease

d ex

ploi

tatio

n an

d uti

lisati

on o

f foo

ds

from

non

-con

venti

onal

sou

rces

•D

ieta

ry p

racti

ces

rela

ted

to in

dige

nous

food

s em

phas

ized

in th

e sc

hool

cur

ricu

la &

nati

onal

ex

amin

ation

•In

crea

sed

appl

icati

on o

f die

tary

pra

ctice

s re

late

d to

indi

geno

us fo

ods

at h

ouse

hold

&

com

mun

ity le

vels

MA

AIF

MoH

, MoE

S, M

WE,

MG

LSD

, Dev

elop

men

t Pa

rtne

rs, C

SOs

Stra

tegy

2.2

: Enh

ance

pos

t-ha

rves

t han

dlin

g, s

tora

ge &

uti

lisati

on o

f nut

riti

ous

food

s at

hou

seho

ld &

farm

leve

lPr

omot

e &

sup

port

ado

ption

of

post

-har

vest

han

dlin

g &

sto

rage

te

chno

logi

es a

t hou

seho

ld &

co

mm

unity

leve

l.

•In

crea

sed

awar

enes

s &

ado

ption

of a

ppro

pria

te

post

-har

vest

han

dlin

g &

sto

rage

tech

nolo

gies

MA

AIF

/M

oES

MoH

, MTC

, MG

LSD

, dev

elop

men

t par

tner

s, C

SOs

Prov

ide

an e

nabl

ing

envi

ronm

ent

to th

e pr

ivat

e se

ctor

to

man

ufac

ture

, mar

ket &

dis

trib

ute

appr

opri

ate

post

-har

vest

han

dlin

g &

sto

rage

tech

nolo

gies

•Cl

ear

polic

y de

velo

ped

to g

uide

& p

rovi

de

ince

ntive

s to

sm

all &

med

ium

-sca

le p

riva

te

sect

or p

laye

rs

•Pr

ivat

e pl

ayer

s su

ppor

ted

to a

cqui

re e

quip

men

t,

finan

cial

sup

port

& in

fras

truc

ture

•In

crea

se in

pub

lic-p

riva

te p

artn

ersh

ips

for

food

pr

oces

sing

& s

tora

ge•

Affi

rmati

ve a

ction

pro

vide

d fo

r ge

ogra

phic

ally

m

argi

nalis

ed a

reas

MTC

/ M

TCM

AA

IF, M

oES,

dev

elop

men

t par

tner

s, p

riva

te

sect

or

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

35EN

D M

ALN

UTR

ITO

N N

OW

Stra

tegy

2.3

: Pro

mot

e th

e co

nsum

ption

of n

utri

ent-

enha

nced

food

sPr

omot

e pr

oduc

tion

of fo

rtifie

d co

mm

on s

tapl

es b

y lo

cal

man

ufac

ture

rs.

•A

pol

icy

prom

oting

forti

ficati

on in

pla

ce•

Food

forti

ficati

on p

ublic

-pri

vate

par

tner

ship

s in

crea

sed

& s

tren

gthe

ned

•In

crea

sed

vari

ety

of fo

rtifie

d fo

ods

•In

dust

ries

that

forti

fy fo

ods

scal

ed u

p co

untr

ywid

e

MoH

/M

TCU

gand

a N

ation

al B

urea

u of

Sta

ndar

ds, N

DA

, LG

s,

priv

ate

sect

or, d

evel

opm

ent p

artn

ers,

CSO

s

Prom

ote

prod

uctio

n of

bio

-fo

rtifie

d va

rieti

es.

•Po

licy

prom

oting

bio

-for

tifica

tion

in p

lace

•In

crea

sed

vari

ety

of b

io-f

ortifi

ed fo

ods

•Bi

o-fo

rtific

ation

of f

oods

sca

led

up c

ount

ryw

ide

•Fo

od b

io-f

ortifi

catio

n pu

blic

-pri

vate

pa

rtne

rshi

ps in

crea

sed

& s

tren

gthe

ned

MA

AIF

/M

TCM

oH, L

Gs,

pri

vate

sec

tor,

dev

elop

men

t par

tner

s,

CSO

s

Prom

ote

cons

umpti

on o

f nut

rien

t-en

hanc

ed fo

ods

•In

crea

sed

awar

enes

s of

the

bene

fits

of n

utri

ent-

enha

nced

food

s•

Incr

ease

d co

nsum

ption

of f

ortifi

ed fo

ods

•In

crea

sed

adop

tion

& c

onsu

mpti

on o

f bio

-fo

rtifie

d fo

ods

MA

AIF

/M

oH/

MTC

Priv

ate

sect

or, d

evel

opm

ent p

artn

ers,

LG

s

Supp

ort l

ocal

pro

ducti

on o

f re

ady-

to-u

se th

erap

eutic

and

co

mpl

emen

tary

food

s

•Po

licy

prom

oting

ther

apeu

tic &

com

plem

enta

ry

food

s in

pla

ce•

Ther

apeu

tic fo

ods

incl

uded

on

the

esse

ntial

dr

ugs

list

•Lo

cal i

ndus

trie

s pr

oduc

ing

ther

apeu

tic &

co

mpl

emen

tary

food

s sc

aled

up

coun

tryw

ide

•Pu

blic

-pri

vate

par

tner

ship

s fo

r th

erap

eutic

&

com

plem

enta

ry fo

ods

stre

ngth

ened

MoH

/M

TCM

AA

IF, L

Gs,

Min

istr

y of

Justi

ce a

nd

Cons

tituti

onal

Aff

airs

, pri

vate

sec

tor,

de

velo

pmen

t par

tner

s, C

SOs,

Uga

nda

Nati

onal

Bu

reau

of S

tand

ards

OB

JEC

TIV

E 3:

PR

OTE

CT H

OU

SEH

OLD

S FR

OM

TH

E IM

PACT

OF

SHO

CKS

& O

THER

VU

LNER

AB

ILIT

IES

THAT

AFF

ECT

THEI

R

NU

TRIT

ION

AL

STAT

US

Stra

tegy

3.1

: Dev

elop

pre

pare

dnes

s pl

ans

for

shoc

ksSt

reng

then

and

sca

le u

p ea

rly

war

ning

sys

tem

s on

food

and

nu

triti

on in

form

ation

from

co

mm

unity

to n

ation

al le

vels

.

•Ea

rly

war

ning

sys

tem

in M

AA

IF s

tren

gthe

ned

(cap

acity

& e

quip

men

t)•

Nut

ritio

n in

form

ation

sys

tem

in M

oH

stre

ngth

ened

•

Nati

onal

Nut

ritio

n Su

rvei

llanc

e Sy

stem

es

tabl

ishe

d

MoH

/M

AA

IF/

FNC

OPM

, LG

s, p

riva

te s

ecto

r, d

evel

opm

ent p

artn

ers,

CS

Os,

aca

dem

ia

36EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

Supp

ort a

nd p

rom

ote

urba

n fa

rmin

g fo

r vu

lner

able

ho

useh

olds

.

•U

rban

farm

ing

polic

y de

velo

ped

and

oper

ation

alis

ed•

Supe

rmar

ket-

linke

d va

lue

chai

ns d

evel

oped

for

high

-val

ue e

nter

pris

e in

urb

an a

nd p

eri-u

rban

ar

eas

MA

AIF

/M

TCM

oH, L

Gs,

dev

elop

men

t par

tner

s, C

SOs,

pri

vate

se

ctor

Dev

elop

, pro

mot

e &

impl

emen

t in

a tim

ely

fash

ion

a co

mpr

ehen

sive

pa

ckag

e of

nut

ritio

n se

rvic

es

and

food

item

s to

pro

vide

dur

ing

emer

genc

ies

& r

ecov

ery

peri

ods.

•Co

mpr

ehen

sive

pac

kage

of n

utri

tion

serv

ices

&

requ

irem

ents

for

emer

genc

ies

deve

lope

d •

Tim

ely

impl

emen

tatio

n of

com

preh

ensi

ve

nutr

ition

ser

vice

s in

em

erge

ncie

s

MoH

/O

PMO

PM, M

AA

IF, p

riva

te s

ecto

r, d

evel

opm

ent

part

ners

, CSO

s

Mak

e in

tegr

ation

of n

utri

tion

in d

isas

ter

man

agem

ent

prog

ram

mes

man

dato

ry.

•Ca

paci

ty o

f loc

al g

over

nmen

ts to

pro

vide

nu

triti

on s

ervi

ces

in e

mer

genc

ies

stre

ngth

ened

•

Nut

ritio

n pa

ckag

e in

tegr

ated

in a

ll di

sast

er

man

agem

ent p

rogr

amm

es

MoH

/O

PM/

MA

AIF

/M

oLG

LGs,

MG

LSD

, MA

AIF

, pri

vate

sec

tor,

de

velo

pmen

t par

tner

s, C

SOs

Prom

ote

and

supp

ort d

iver

sifie

d pr

oduc

tion

of d

roug

ht-r

esis

tant

cr

ops

and

vege

tabl

es, a

nd r

aisi

ng

of a

nim

als

tole

rant

of h

eat s

tres

s.

•In

crea

sed

prod

uctio

n of

dro

ught

-res

ista

nt c

rops

an

d ve

geta

bles

& r

aisi

ng o

f ani

mal

s to

lera

nt o

f he

at s

tres

s

MA

AIF

MW

E, L

Gs,

MG

LSD

, pri

vate

sec

tor,

deve

lopm

ent

part

ners

, CSO

s

Carr

y ou

t sen

sitis

ation

pr

ogra

mm

es fo

r co

mm

uniti

es to

pr

even

t, m

itiga

te, a

nd r

espo

nd

to r

isks

of m

alnu

triti

on d

urin

g sh

ocks

.

•In

crea

sed

awar

enes

s of

pro

per

nutr

ition

dur

ing

shoc

ks

OPM

/M

oH/

MA

AIF

MoH

, MW

E, M

AA

IF, M

GLS

D, L

Gs,

pri

vate

sec

tor,

de

velo

pmen

t par

tner

s, C

SOs

Stra

tegy

3.2

: Pro

mot

e so

cial

pro

tecti

on in

terv

enti

ons

for

impr

oved

nut

riti

onPr

ovid

e so

cial

tran

sfer

s (c

ash,

fo

od, a

gric

ultu

ral i

nput

s) to

and

su

ppor

t liv

elih

oods

for

vuln

erab

le

hous

ehol

ds a

nd c

omm

uniti

es.

•In

crea

se in

vul

nera

ble

hous

ehol

ds r

ecei

ving

so

cial

tran

sfer

s (c

ash,

food

, agr

icul

tura

l inp

uts)

M

GLS

D/

MA

AIF

/O

PM

MFP

ED, L

Gs,

OPM

, pri

vate

sec

tor,

dev

elop

men

t pa

rtne

rs, C

SOs

Dev

elop

& im

plem

ent

prog

ram

mes

for

spec

ial s

ocia

l as

sist

ance

and

for

livel

ihoo

d pr

omoti

on a

nd p

rote

ction

in a

reas

w

ith h

igh

leve

ls o

f mal

nutr

ition

.

•Sp

ecia

l foo

d-ba

sed

prog

ram

mes

for

vuln

erab

le

grou

ps in

are

as w

ith h

igh

mal

nutr

ition

leve

ls

desi

gned

& im

plem

ente

d.•

Incr

ease

d co

vera

ge o

f liv

elih

ood

prog

ram

mes

MG

LSD

/ M

AA

IFLG

s, O

PM, M

oH, p

riva

te s

ecto

r, de

velo

pmen

t pa

rtne

rs, C

SOs

Adv

ocat

e fo

r an

d pr

omot

e sc

hool

m

eals

pro

gram

mes

.•

Incr

ease

d aw

aren

ess

of th

e be

nefit

s of

nu

triti

ous

scho

ol m

eals

on

lear

ning

out

com

es•

“Hom

egro

wn”

sch

ool m

eals

pro

vide

d•

Scho

ols

supp

orte

d to

pro

vide

sch

ool m

eals

MoE

S/M

AA

IF/

MG

LSD

MA

AIF

, MoH

, LG

s, d

evel

opm

ent p

artn

ers,

CSO

s,

priv

ate

sect

or, M

FPED

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

37EN

D M

ALN

UTR

ITO

N N

OW

Prom

ote

soci

al p

rote

ction

in

terv

entio

ns fo

r im

prov

ed

nutr

ition

.

•In

crea

sed

soci

al p

rote

ction

inte

rven

tions

for

impr

oved

nut

ritio

n.M

GLS

DM

oH, M

AA

IF, d

evel

opm

ent p

artn

ers

OB

JECT

IVE

4: S

TREN

GTH

EN T

HE

POLI

CY, L

EGA

L, A

ND

INST

ITU

TIO

NA

L FR

AM

EWO

RK

S A

ND

TH

E CA

PACI

TY T

O

EFFE

CTI

VEL

Y PL

AN

, IM

PLEM

ENT,

MO

NIT

OR

, AN

D E

VA

LUAT

E N

UTR

ITIO

N P

RO

GR

AM

MES

Stra

tegy

4.1

: Str

engt

hen

the

polic

y an

d le

gal f

ram

ewor

k fo

r co

ordi

nati

ng, p

lann

ing,

and

mon

itor

ing

nutr

ition

acti

viti

esFa

st-t

rack

the

enac

tmen

t of t

he

Food

and

Nut

ritio

n Bi

ll.•

Food

and

Nut

ritio

n Bi

ll en

acte

d N

PA/

MA

AIF

MoH

, Min

istr

y of

Justi

ce a

nd C

onsti

tutio

nal

Aff

airs

, dev

elop

men

t par

tner

sRe

vita

lise

the

func

tiona

lity

of

the

Uga

nda

Food

and

Nut

ritio

n Co

unci

l (FN

C) a

nd e

stab

lish

its

secr

etar

iat.

•FN

C fu

nctio

nal

•FN

C se

cret

aria

t est

ablis

hed

OPM

NPA

Revi

ew th

e Fo

od a

nd N

utri

tion

Polic

y to

inte

grat

e em

ergi

ng

issu

es.

•Fo

od a

nd N

utri

tion

Polic

y re

vise

dFN

CM

oH, M

AA

IF, N

PA, M

GLS

D, M

TC, p

riva

te s

ecto

r,

deve

lopm

ent p

artn

ers,

CSO

s

Revi

se th

e dr

aft U

gand

a Fo

od a

nd

Nut

ritio

n St

rate

gy.

•Fo

od a

nd N

utri

tion

stra

tegy

revi

sed

FNC

secr

etar

iat

NPA

, MTC

, LG

s, p

riva

te s

ecto

r, d

evel

opm

ent

part

ners

, CSO

sA

dvoc

ate

for

enac

tmen

t of b

ylaw

s an

d or

dina

nces

that

pro

mot

e nu

triti

on a

nd fo

od s

ecur

ity.

•By

law

s an

d or

dina

nces

that

pro

mot

e nu

triti

on

& fo

od s

ecur

ity d

evel

oped

& e

nact

edFN

C/M

oLG

LGs,

MoH

, MA

AIF

, MTC

, MoE

S, C

SOs,

de

velo

pmen

t par

tner

s, M

FPED

Inte

grat

e nu

triti

on is

sues

into

pl

ans

and

budg

ets

at a

ll le

vels

of

gove

rnm

ents

.

•Vo

te fu

nctio

ns fo

r nu

triti

on e

stab

lishe

d•

Nut

ritio

n m

ains

trea

med

into

sec

tors

and

dis

tric

t de

velo

pmen

t pla

ns

NPA

/ M

FPED

MoH

, MA

AIF

, MTC

, MoE

S, M

GLS

D, M

WE,

MoL

G,

Popu

latio

n Se

cret

aria

t, d

evel

opm

ent p

artn

ers

Supp

ort t

he d

evel

opm

ent o

f nu

triti

on c

urri

cula

for

all l

evel

s of

ed

ucati

on &

trai

ning

•N

utri

tion

curr

icul

a in

pla

ce a

t all

leve

ls o

f ed

ucati

onM

oES

Aca

dem

ia, M

oH, M

AA

IF

Adv

ocat

e fo

r es

tabl

ishm

ent o

f lo

wer

- & m

iddl

e-ca

dre

nutr

ition

co

urse

s in

the

educ

ation

str

uctu

re.

•Lo

wer

- & m

iddl

e-ca

dre

nutr

ition

cou

rses

es

tabl

ishe

dM

oES

MoH

, MA

AIF

, aca

dem

ia

Revi

ew &

inte

grat

e nu

triti

on

issu

es in

the

exis

ting

curr

icul

a of

fo

rmal

& n

on-f

orm

al e

duca

tion

&

pre-

& in

-ser

vice

trai

ning

•N

utri

tion

issu

es in

tegr

ated

in c

urri

cula

MoE

SM

oH, M

AA

IF, a

cade

mia

38EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

Stra

tegy

4.2

: Str

engt

hen

and

harm

onis

e th

e in

stitu

tion

al fr

amew

ork

for

nutr

ition

from

loca

l to

cent

ral g

over

nmen

t lev

els

Revi

ew th

e co

untr

y’s

curr

ent

insti

tutio

nal f

ram

ewor

k fo

r nu

triti

on in

the

coun

try

and

impl

emen

t a s

uita

ble

one.

•Cu

rren

t ins

tituti

onal

fram

ewor

k re

view

ed•

Key

reco

mm

enda

tions

from

the

revi

ew

impl

emen

ted

NPA

OPM

MoH

, MA

AIF

, MTC

, MoE

S, M

GLS

D, M

WE,

MoL

G,

Popu

latio

n Se

cret

aria

t, d

evel

opm

ent p

artn

ers

Esta

blis

h an

inte

rim

mul

ti-se

ctor

al c

oord

inati

on m

echa

nism

fo

r nu

triti

on p

rogr

amm

ing,

m

onito

ring

and

eva

luati

on

•M

ulti-

sect

oral

coo

rdin

ation

mec

hani

sm in

pla

ceN

PAM

oH, M

AA

IF, M

TC, M

oES,

MG

LSD

, MW

E, M

oLG

, Po

pula

tion

Secr

etar

iat,

dev

elop

men

t par

tner

s,

CSO

s

Stre

ngth

en in

stitu

tiona

l cap

acity

fo

r nu

triti

on p

rogr

amm

ing

at a

ll le

vels

in a

ll se

ctor

s

•N

utri

tion

foca

l per

sons

app

oint

ed o

r as

sign

ed

in k

ey m

inis

trie

s, d

epar

tmen

ts, a

nd a

genc

ies

&

LGs

•N

utri

tion

coor

dina

tion

stru

ctur

es &

com

mitt

ees

at n

ation

al &

loca

l gov

ernm

ent l

evel

est

ablis

hed

FNC

secr

etar

iat,

OPM

MoH

, MW

E, M

AA

IF, M

oES,

MG

LSD

Stra

tegy

4.3

: Str

engt

hen

hum

an re

sour

ce c

apac

ity

to p

lan,

impl

emen

t, m

onit

or, a

nd e

valu

ate

food

and

nut

riti

on p

rogr

amm

esD

esig

n &

impl

emen

t a c

apac

ity

stre

ngth

enin

g pl

an fo

r nu

triti

on

prog

ram

min

g at

nati

onal

, LG

&

com

mun

ity le

vel.

•N

utri

tion

capa

city

str

engt

heni

ng p

lan

deve

lope

d•

Capa

city

in n

utri

tion

polic

y an

alys

is, p

lann

ing,

im

plem

enta

tion,

sur

veill

ance

, M&

E st

reng

then

ed

•N

utri

tion

capa

city

of c

omm

unity

-bas

ed

reso

urce

per

sons

str

engt

hene

d

FNC

secr

etar

iat

MoH

, MA

AIF

, MTC

, MoE

S, M

GLS

D, M

WE,

MoL

G,

Popu

latio

n Se

cret

aria

t, d

evel

opm

ent p

artn

ers

Stra

tegy

4.4

: Mon

itor

and

eva

luat

e th

e fo

od a

nd n

utri

tion

sit

uati

on to

info

rm p

olic

y an

d pr

ogra

mm

ing

Esta

blis

h fo

od a

nd n

utri

tion

M&

E sy

stem

for

trac

king

per

form

ance

an

d fo

r tim

ely

deci

sion

mak

ing.

•N

ation

al fo

od a

nd n

utri

tion

info

rmati

on s

yste

m

esta

blis

hed

•In

tegr

ated

nut

ritio

n M

&E

syst

em e

stab

lishe

d•

Pro

gres

s of

impl

emen

tatio

n &

per

form

ance

of

UN

AP

peri

odic

ally

rep

orte

d

FNC

secr

etar

iat

MoH

, MA

AIF

, MFP

ED, M

TC, L

Gs,

dev

elop

men

t pa

rtne

rs, M

ICT,

aca

dem

ia

Cond

uct p

erio

dic

dist

rict

-leve

l su

rvey

s ba

sed

on h

igh

prev

alen

ce

of m

alnu

triti

on.

•Ba

selin

e fo

od a

nd n

utri

tion

surv

ey c

ondu

cted

FNC

secr

etar

iat

MoH

, MA

AIF

, MFP

ED, M

TC, L

Gs,

dev

elop

men

t pa

rtne

rs, M

ICT,

aca

dem

ia

Cond

uct p

erio

dic

dist

rict

-leve

l su

rvey

s ba

sed

on h

igh

prev

alen

ce

of m

alnu

triti

on.

•D

istr

ict s

peci

fic s

urve

ys c

ondu

cted

FNC

secr

etar

iat/

LGs

MoH

, MA

AIF

, MFP

ED, M

TC, L

Gs,

dev

elop

men

t pa

rtne

rs, M

ICT,

aca

dem

ia

Cond

uct m

id-t

erm

and

end

-of-

term

impa

ct e

valu

ation

s of

UN

AP.

•

UN

AP

impa

ct e

valu

ation

s co

nduc

ted

FNC

secr

etar

iat

MoH

, MA

AIF

, MFP

ED, M

TC, L

Gs,

dev

elop

men

t pa

rtne

rs, M

ICT,

aca

dem

ia

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

39EN

D M

ALN

UTR

ITO

N N

OW

Stre

ngth

en d

istr

ict-

leve

l foo

d an

d nu

triti

on s

urve

illan

ce s

yste

ms.

•D

istr

ict f

ood

& n

utri

tion

surv

eilla

nce

syst

ems

esta

blis

hed

and

capa

city

str

engt

hene

dFN

C se

cret

aria

t/

MoH

/ M

AA

IFLG

s, M

oES,

MTC

, dev

elop

men

t par

tner

s, C

SOs

Stra

tegy

4.5

: Enh

ance

ope

rati

onal

rese

arch

for

nutr

ition

Cond

uct f

orm

ative

rese

arch

on

best

pra

ctice

s.•

For

mati

ve r

esea

rch

stud

ies

cond

ucte

d M

AA

IF/

MoH

NPA

, aca

dem

ia, L

Gs,

dev

elop

men

t par

tner

s,

CSO

s, M

FPED

Re

sear

ch p

ositi

ve in

dige

nous

di

etar

y pr

actic

es.

•Po

sitiv

e in

dige

nous

die

tary

pra

ctice

s do

cum

ente

d &

dis

sem

inat

edM

AA

IFD

evel

opm

ent p

artn

ers,

aca

dem

ia

Com

pile

food

com

posi

tion

data

for

all f

oods

con

sum

ed in

Uga

nda.

•Fo

od c

onsu

mpti

on d

atab

ase

deve

lope

dM

AA

IFD

evel

opm

ent p

artn

ers,

aca

dem

ia

Iden

tify

and

cond

uct r

esea

rch

rele

vant

to s

calin

g up

food

and

nu

triti

on in

terv

entio

ns.

•Re

sear

ch o

n sc

alin

g up

food

and

nut

ritio

n in

terv

entio

ns c

ondu

cted

•

Aca

dem

ia s

uppo

rted

to c

ondu

ct a

pplie

d fo

od

and

nutr

ition

res

earc

h

MoH

/M

AA

IFN

PA, a

cade

mia

, LG

s, d

evel

opm

ent p

artn

ers

Colla

te a

nd s

hare

rese

arch

fin

ding

s an

d be

st p

racti

ces

for

scal

ing

up fo

od a

nd n

utri

tion

inte

rven

tions

in U

gand

a.

•Be

st p

racti

ces

docu

men

ted,

dis

sem

inat

ed, a

nd

scal

ed u

pN

PAM

oH, M

AA

IF, L

Gs,

MoL

G, M

GLS

D, M

oES,

MTC

, de

velo

pmen

t par

tner

s, C

SOs,

aca

dem

ia

OB

JEC

TIV

E 5:

CR

EATE

AW

AR

ENES

S O

F A

ND

MA

INTA

IN N

ATIO

NA

L IN

TER

EST

IN A

ND

CO

MM

ITM

ENT

TO IM

PRO

VE

AN

D

SUPP

OR

T N

UTR

ITIO

N P

RO

GR

AM

MES

IN T

HE

COU

NTR

YSt

rate

gy 5

.1: I

ncre

ase

awar

enes

s of

and

com

mit

men

t to

addr

essi

ng n

utri

tion

issu

es in

the

coun

try

Dev

elop

& im

plem

ent a

nut

ritio

n co

mm

unic

ation

str

ateg

y •

Nut

ritio

n co

mm

unic

ation

str

ateg

y de

velo

ped

Dev

elop

men

t pa

rtne

rs

MoH

, MA

AIF

, CSO

s

Prod

uce

annu

al p

olic

y st

atem

ents

an

d pe

riod

ic p

olic

y br

iefs

on

natio

nal f

ood

secu

rity

and

nu

triti

on s

ituati

on.

•A

nnua

l pol

icy

stat

emen

ts p

rodu

ced

•Q

uart

erly

pol

icy

brie

fs p

rodu

ced

MA

AIF

/M

oHN

PA, L

Gs,

MoL

G, M

GLS

D, M

oES,

MTC

, de

velo

pmen

t par

tner

s, C

SOs

Com

mem

orat

e ev

ents

that

rais

e th

e pr

ofile

of n

utri

tion

and

nutr

ition

bes

t pra

ctice

s (N

ation

al

Food

and

Nut

ritio

n D

ays,

Bre

ast-

feed

ing

Wee

k, H

and

Was

hing

D

ay) a

nd ta

ke a

dvan

tage

of o

ther

ad

voca

cy e

vent

s.

•N

ation

al, r

egio

nal,

and

inte

rnati

onal

food

and

nu

triti

on e

vent

s co

mm

emor

ated

MoH

/M

AA

IFLG

s, M

oLG

, MG

LSD

, MoE

S, M

TC, d

evel

opm

ent

part

ners

, CSO

s, M

ICT

40EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

Stra

tegy

5.2

: Adv

ocat

e fo

r in

crea

sed

com

mit

men

t to

impr

ovin

g nu

triti

on o

utco

mes

Dev

elop

and

impl

emen

t a

sust

aina

ble

nutr

ition

adv

ocac

y pl

an.

•Co

mpr

ehen

sive

nut

ritio

n ad

voca

cy p

lan

deve

lope

d an

d im

plem

ente

dFN

CM

oH, M

AA

IF

Prod

uce

an a

nnua

l rep

ort o

n th

e st

ate

of fo

od s

ecur

ity a

nd

nutr

ition

in th

e co

untr

y.

• A

nnua

l rep

ort o

n th

e st

ate

of fo

od s

ecur

ity a

nd

nutr

ition

pro

duce

d N

PAM

oH, M

AA

IF, L

Gs,

MoL

G, M

GLS

D, M

oES,

MTC

, de

velo

pmen

t par

tner

s, C

SOs

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

41EN

D M

ALN

UTR

ITO

N N

OW

AN

NEX

II: I

mp

lem

enta

tio

n C

ost

Mat

rix,

USh

s m

illio

n

INTE

RV

ENTI

ON

2011

-12

2012

-13

2013

-14

2014

-15

2015

-16

TOTA

L

OB

JEC

TIV

E 1:

IMPR

OV

E A

CCES

S TO

AN

D U

TILI

SATI

ON

OF

SER

VIC

ES R

ELAT

ED T

O M

ATER

NA

L, IN

FAN

T, A

ND

YO

UN

G

CHIL

D N

UTR

ITIO

N

Stra

tegy

1.1

: Pro

mot

e ac

cess

to a

nd u

tilis

ation

of n

utri

tion

and

hea

lth

serv

ices

to a

ll w

omen

of r

epro

ducti

ve a

ge, i

nfan

ts, a

nd

youn

g ch

ildre

nPr

omot

e an

d su

ppor

t hea

lth a

nd n

utri

tion

educ

ation

.14

016

018

020

025

093

0

Prom

ote

inte

grati

on o

f nut

ritio

n se

rvic

es in

all

routi

ne a

nd o

utre

ach

heal

th

serv

ices

and

pro

gram

mes

targ

eting

chi

ldre

n (g

row

th m

onito

ring

and

pr

omoti

on) a

nd w

omen

of r

epro

ducti

ve a

ge.

200

1,50

03,

000

4,50

06,

000

15,2

00

Man

age

nutr

ition

for

sick

chi

ldre

n, p

regn

ant w

omen

, lac

tatin

g m

othe

rs, a

nd

othe

r w

omen

of r

epro

ducti

ve a

ge.

1,20

01,

000

1,00

01,

000

1,00

05,

200

Inte

grat

e m

anag

emen

t of s

ever

e an

d m

oder

ate

acut

e m

alnu

triti

on in

to ro

utine

he

alth

ser

vice

s.96

71,

047

1,33

21,

879

1,59

66,

821

Prom

ote

utilis

ation

of a

nten

atal

and

pos

tnat

al c

are

serv

ices

by

all p

regn

ant

wom

en a

nd la

ctati

ng m

othe

rs.

400

500

600

700

800

3,00

0

Prom

ote

and

supp

ort b

reas

tfee

ding

pol

icie

s, p

rogr

amm

es, a

nd in

itiati

ves.

100

112

100

100

100

512

Prom

ote

excl

usiv

e br

eastf

eedi

ng.

100

500

1,50

02,

000

1,00

05,

100

Prom

ote

& s

uppo

rt a

ppro

pria

te c

ompl

emen

tary

feed

ing

prac

tices

.80

120

100

100

100

500

Supp

ort a

nd s

cale

up

com

mun

ity-b

ased

nut

ritio

n pr

ogra

mm

es.

900

1,14

01,

380

1,62

01,

860

6,90

0

Prom

ote

prop

er fo

od h

andl

ing,

hyg

iene

and

san

itatio

n.10

012

010

010

010

052

0

Stra

tegy

1.2

: Add

ress

gen

der

and

soci

o-cu

ltur

al is

sues

that

aff

ect m

ater

nal,

infa

nt, a

nd y

oung

chi

ld n

utri

tion

Prom

ote

mal

e in

volv

emen

t in

fam

ily h

ealth

ser

vice

s an

d in

food

sec

urity

and

nu

triti

on p

rogr

amm

es.

500

500

500

500

100

2,10

0

Adv

ocat

e an

d se

ek s

oluti

ons

for

redu

cing

wor

kloa

d fo

r al

l wom

en, e

spec

ially

pr

egna

nt w

omen

and

lact

ating

mot

hers

. 20

025

030

035

040

01,

500

Add

ress

det

rim

enta

l foo

d ta

boos

& n

orm

s th

at im

pair

nut

ritio

n of

wom

en,

infa

nts

& y

oung

chi

ldre

n.20

025

030

035

040

01,

500

42EN

D M

ALN

UTR

ITO

N N

OW

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

INTE

RV

ENTI

ON

2011

-12

2012

-13

2013

-14

2014

-15

2015

-16

TOTA

LSu

btot

al –

Obj

ecti

ve 1

5,08

77,

199

10,3

9213

,399

13,7

0649

,783

OB

JEC

TIV

E 2:

EN

HA

NCE

CO

NSU

MPT

ION

OF

DIV

ERSE

DIE

TSSt

rate

gy 2

.1: I

ncre

ase

acce

ss to

and

use

of d

iver

se n

utri

tiou

s fo

ods

and

use

at h

ouse

hold

leve

l

Prom

ote

prod

uctio

n an

d co

nsum

ption

of d

iver

sifie

d nu

triti

ous

food

s at

ho

useh

old

and

com

mun

ity le

vels

.31

765

785

71,

057

1,25

74,

146

Adv

ocat

e fo

r an

d su

ppor

t int

egra

tion

of n

utri

tion

serv

ices

in a

gric

ultu

ral

prog

ram

mes

.60

7590

105

120

450

Incr

ease

con

sum

ption

of b

oth

raw

and

pro

cess

ed n

utri

tious

food

s.10

020

020

020

020

090

0

Prom

ote

and

supp

ort t

he u

tilis

ation

of s

afe

labo

ur-s

avin

g te

chno

logi

es a

t ho

useh

old

and

com

mun

ity le

vels

.50

100

140

180

1,00

01,

470

Prom

ote

and

supp

ort l

ocal

food

pro

cess

ing

and

valu

e ad

ditio

n at

hou

seho

ld

and

com

mun

ity le

vel.

100

500

600

700

800

2,70

0

Supp

ort o

n fa

rm e

nter

pris

e m

ix to

pro

mot

e st

able

div

ersi

fied

food

pro

ducti

on.

100

100

150

150

200

700

Prom

ote

prod

uctio

n &

con

sum

ption

of

indi

geno

us f

oods

to

enha

nce

diet

di

vers

ifica

tion.

6070

8090

100

400

Stra

tegy

2.2

: Enh

ance

pos

t-ha

rves

t han

dlin

g, s

tora

ge &

uti

lisati

on o

f nut

riti

ous

food

s at

hou

seho

ld &

farm

leve

lPr

omot

e &

sup

port

ado

ption

of p

ost-

harv

est h

andl

ing

& s

tora

ge te

chno

logi

es

at h

ouse

hold

& c

omm

unity

leve

l.60

100

200

300

400

1,06

0

Prov

ide

an e

nabl

ing

envi

ronm

ent t

o th

e pr

ivat

e se

ctor

to m

anuf

actu

re, m

arke

t,

and

dist

ribu

te a

ppro

pria

te p

ost-

harv

est h

andl

ing

& s

tora

ge te

chno

logi

es.

…40

050

020

2094

0

Stra

tegy

2.3

: Pro

mot

e an

d st

abili

se c

onsu

mpti

on n

utri

ent e

nhan

ced

food

s Pr

omot

e pr

oduc

tion

of fo

rtifie

d co

mm

on s

tapl

es b

y lo

cal m

anuf

actu

rers

. 10

062

575

087

51,

000

3,35

0

Prom

ote

prod

uctio

n of

bio

-for

tified

var

ietie

s.13

035

050

065

080

02,

430

Prom

ote

cons

umpti

on o

f nut

rien

t-en

hanc

ed fo

ods.

2010

015

010

080

450

Supp

ort l

ocal

pro

ducti

on o

f rea

dy-t

o-us

e th

erap

eutic

& c

ompl

emen

tary

food

s13

050

060

070

080

02,

730

Subt

otal

– O

bjec

tive

21,

227

3,77

74,

817

5,12

76,

777

21,7

26

Uga

nda

Nut

riti

on A

ction

Pla

n 20

11-2

016

43EN

D M

ALN

UTR

ITO

N N

OW

INTE

RV

ENTI

ON

2011

-12

2012

-13

2013

-14

2014

-15

2015

-16

TOTA

L

OB

JEC

TIV

E 3:

PR

OTE

CT H

OU

SEH

OLD

S FR

OM

TH

E IM

PACT

OF

SHO

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AN

D O

THER

VU

LNER

AB

ILIT

IES

THAT

AFF

ECT

THEI

R N

UTR

ITIO

NA

L ST

ATU

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rate

gy 3

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redn

ess

plan

s fo

r sh

ocks

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ngth

en a

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cale

up

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y w

arni

ng s

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ms

on fo

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info

rmati

on fr

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unity

to n

ation

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vels

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015

025

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able

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4,15

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, pro

mot

e &

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ely

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g em

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6012

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Mak

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Stra

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3.2

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Prov

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soci

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port

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es.

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Dev

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plem

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rogr

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ecia

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d fo

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pro

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igh

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2011

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2012

-13

2013

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2014

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2015

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TOTA

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the

draft

Uga

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Food

and

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100

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tion

al fr

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loca

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view

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rent

insti

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plem

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ogra

mm

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and

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E.

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acity

for

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gram

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g at

all

leve

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200

400

400

400

400

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: Str

engt

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an re

sour

ce c

apac

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to p

lan,

impl

emen

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mon

itor

and

eva

luat

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od a

nd n

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tion

pr

ogra

mm

esD

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n a

capa

city

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engt

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lan

for

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gram

min

g at

nati

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&

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mun

ity le

vel.

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man

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str

engt

heni

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roje

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600

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and

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od a

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sit

uati

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rm p

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blis

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stem

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timel

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reas

with

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f m

alnu

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on.

500

750

950

700

680

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0

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uct m

id-t

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and

end

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term

impa

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valu

ation

of U

NA

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leve

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d an

d nu

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ms.

5050

5050

5025

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Uga

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ction

Pla

n 20

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D M

ALN

UTR

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OW

INTE

RV

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ON

2011

-12

2012

-13

2013

-14

2014

-15

2015

-16

TOTA

L

Stra

tegy

4.5

: Enh

ance

ope

rati

onal

rese

arch

for

nutr

ition

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nduc

t for

mati

ve re

sear

ch o

n be

st p

racti

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300

400

400

500

500

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0

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arch

pos

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geno

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racti

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5050

5050

5025

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pile

food

com

posi

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data

for

all f

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con

sum

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nda.

500

1,00

01,

500

2,00

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7,00

0

Iden

tify

and

cond

uct r

esea

rch

rele

vant

to s

calin

g up

nut

ritio

n in

terv

entio

ns.

5050

5050

5025

0

Colla

te a

nd s

hare

res

earc

h fin

ding

s an

d be

st p

racti

ces

for

scal

ing

up n

utri

tion

inte

rven

tions

in U

gand

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2020

2020

100

Subt

otal

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bjec

tive

43,

855

6,29

27,

729

8,83

68,

343

35,0

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OB

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EATE

AW

AR

ENES

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F A

ND

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INTA

IN N

ATIO

NA

L IN

TER

EST

IN A

ND

CO

MM

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ENT

TO IM

PRO

VE

AN

D

SUPP

OR

T N

UTR

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N P

RO

GR

AM

MES

IN T

HE

COU

NTR

Y

Stra

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5.1

: Inc

reas

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aren

ess

of a

nd c

omm

itm

ent t

o ad

dres

sing

nut

riti

on is

sues

in th

e co

untr

yD

evel

op &

impl

emen

t a n

utri

tion

com

mun

icati

on s

trat

egy.

195

200

200

200

200

995

Prod

uce

annu

al p

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atem

ents

and

per

iodi

c po

licy

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fs o

n th

e na

tiona

l foo

d se

curi

ty a

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utri

tion

situ

ation

. 50

5865

7380

325

Com

mem

orat

e ev

ents

tha

t ra

ise

the

profi

le o

f nu

triti

on a

nd n

utri

tion

best

pr

actic

es (N

ation

al F

ood

and

Nut

ritio

n D

ays,

Bre

ast-

feed

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Wee

k, H

and

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hing

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ay) a

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ke a

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tage

of o

ther

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ocac

y ev

ents

.

300

375

450

525

600

2,25

0

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tegy

5.2

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ocat

e fo

r in

crea

sed

com

mit

men

t to

impr

ovin

g nu

triti

on o

utco

mes

Dev

elop

and

impl

emen

t a s

usta

inab

le n

utri

tion

advo

cacy

pla

n.1,

000

1,00

01,

000

1,00

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000

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0

Prod

uce

an a

nnua

l re

port

on

the

stat

e of

foo

d se

curi

ty a

nd n

utri

tion

in t

he

coun

try.

5010

012

014

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0

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otal

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bjec

tive

51,

595

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31,

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82,

040

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0

GRA

ND

TO

TAL

12,6

8425

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34,7

3442

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45,9

4616

1,61

4



ANNEX III: Reviewed Documents

African Union. 2005. Africa Regional Nutrition Strategy, 2005–2015.

Food and Nutrition Technical Assistance II Project. 2010. Analysis of the Nutrition Situation in Uganda. Washington, DC: AED.

Food and Agriculture Organisation (FAO). 2008. The State of Food Insecurity in the World 2008. Rome: FAO.

Government of Uganda. 2003. The Uganda Food and Nutrition Policy.

Government of Uganda. 2004. The Uganda Food and Nutrition Strategy and Investment Plan (draft).

Horton, S., M. Shekar, C. MacDonald, A. Mahal, and J.K. Brooks. 2010. Scaling Up Nutrition Roadmap: What Will It Cost? Washington, DC: World Bank.

Ministry of Health (MoH). 1999. The Health Policy of Uganda.

MoH. 2010. Health Sector Strategic Plan (HSSP III, draft).

MoH. 2010. The Five-Year Maternal, Infant and Young Children Nutrition Action Plan 2010–2015.

National Planning Authority. 2010. National Development Plan 2010/11–2014/15.

Republic of Malawi. 2007. National Nutrition Policy and Strategic Plan 2007–2012.

Uganda Bureau of Statistics and Macro International. 2006. The Uganda Demographic and Health Survey, 2006. Kampala: UBOS & Calverton, Maryland, USA: Macro International Inc.

Uganda Action for Nutrition (UGAN). 2010. Malnutrition – Uganda is paying too high a price. Advocacy briefs.



ANNEX IV: List of UNAP Technical Committee Members

Name Title Organisation

Hon. Wilberforce Kisamba-Mugerwa Chairperson National Planning AuthorityProf. John Kakitahi Chairperson, Technical Committee;

Former Deputy Head, Makerere University School of Public Health

Makerere University School of Public Health

Dr. John Ssekamatte-Ssebuliba Manager, Population, Health and Social Development Planning

National Planning Authority

Ms. Nahalamba Sarah Secretary, Technical Committee;Senior Gender and Social Development Officer

National Planning Authority

Ms. Mutabazi Judith Sectoral Policy and Planning Officer National Planning AuthorityMs. Julia Tagwireyi Senior Nutrition Advisor to Country

DirectorWorld Food Programme

Mr. Geoffrey Ebong Programme & Policy Advisor World Food ProgrammeDr. Robert Mwadime Regional Senior Nutrition Advisor Food and Nutrition Technical

Assistance II ProjectMs. Namugumya Brenda Shenute Public Nutrition Specialist Regional Centre for Quality

Health CareDr. Elizabeth Madraa Stakeholder Ministry of HealthMr. Todd Benson Senior Research Fellow International Food Policy

Research InstituteMs. Agnes Chandia Baku Acting Head, Nutrition Unit Ministry of HealthMr. Bambona Alex Head, Home Economics and Nutrition

SectionMinistry of Agriculture, Animal Industry, and Fisheries

Ms. Zaam Ssali Programme Officer Uganda National Academy of Sciences

Mr. Mugisa Tom Technical Officer Plan for Modernisation of Agriculture

Ms. Daisy Eresu Programme Officer Ministry of Agriculture, Animal Industry, and Fisheries

Ms. Susan Oketcho Nutrition Focal Person Ministry of Education and Sports

Ms. Lilia Turcan Nutrition Officer United Nations Children’s FundMs. Beatrice Okello Technical Officer Food and Agricultural

OrganisationDr. Geoffrey Bisoborwa Technical Officer World Health Organisation

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