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
All rights reserved. The Government of Uganda encourages the reproduction and dissemination of material in this information product. Non-commercial uses will be authorized free of charge, upon request. Reproduction for resale or other commercial purposes, including educational purposes, may incur fees.© Government of Uganda 2011
Design & Layout: CSR Design, +256712669649, [email protected]
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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 achievement 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 the 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 proven to yield cost-effective results, as well as targeting areas and groups with the highest levels of malnutrition.
Investing in the fight against malnutrition will not only save lives but will also yield high economic returns for Uganda: every one thousand shillings we invest in nutrition results in economic benefits worth at least six times more. These gains mainly benefit the poor and most
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disadvantaged, as they spend less money on treating malnutrition-related disease and increase their productivity, reaping sustainable socioeconomic benefits. I extend my sincere appreciation to all those who contributed to the development of this plan. Members of the Nutrition Technical Committee and the Nutrition Forum are commended for a job well done. The donor community is appreciated for its support. I cannot overemphasize 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 the 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 Ministries of Agriculture, Health, Trade, Education, Gender, Labour and Social Development, the general public, the private sector, civil society, and faith-based organisations, 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 MuseveniPresident of the Republic of Uganda
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Statement of Commitment
The process of developing the Uganda Nutrition Action Plan, 2011-15 (UNAP) was led by the National Planning Authority, which coordinated and harmonized all efforts made. The process started in September 2010 following the statement made at the UN General Assembly in New York by the Minister of Foreign Affairs, Hon. Sam Kuteesa, in which Uganda committed itself to tackle the crisis of malnutrition in the country, with a particular focus on the nutritional needs of young children and their mothers during the period from conception to a child’s second birthday.
In order to add technical content to this expression of political will, in early-October 2010 the NPA Chairperson, Dr. Wilberforce Kisamba-Mugerwa, convened a Technical Committee to 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. 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.
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, Health, and Education 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 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 untiring efforts of these individuals and organizations.
Formal responsibility for improving nutrition in Uganda is mandated to the Ministry of Agriculture, Animal Industries and Fisheries and the Ministry of Health. However, as is made clear in this Action Plan, successfully addressing the problem of malnutrition in Uganda, as elsewhere,
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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 Uganda. 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 requires multi-sectoral commitment across all of government.
As such, all of the ministries of government, which we the undersigned lead, have a responsibility to ensure that those public services that ordinary Ugandans require to be well-nourished are availed to them. Consequently, we commit ourselves to act efficiently and to provide the required human and financial resources necessary to achieve the objectives of this Action Plan. 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.
................................. The Right Honorable Prime Minister
................................. Minister of Agriculture, Animal Industry and Fisheries
................................. Minister of Health
................................. Minister of Education
................................. Minister of Trade and Cooperatives
................................. Minister of Gender, Labour and Social Development
................................. Minister of Local Government
................................. Minister of Public Service
................................. Minister of Finance, Planning and Economic Development
................................. Chairperson, National Planning Authority
Signed at Kampala, on Friday, 12th August 2011
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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 •
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every yearIncrease 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
Inadequate food, health, & care
Inadequate food, health, & care
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 .
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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
Percent60
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01 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55 57 59
Age (months)
Stunted
Note: Includes childrfen below -2SD from the WHO Child Growth Standards UDHS 2006
Wasted Underweight
The window of opportunity outside the womb
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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:
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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
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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
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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
50 45 45
39
2219
16
7 5 6
WastingUnderweightStunting
40
30
20
10
0
perc
ent o
f und
er-fi
ves
1995
2001
2006
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inadequate dietary intake and a high disease burden in young children. These 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.
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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:
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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
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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
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Gap Current performance Opportunities for improvement
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.
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Gap Current performance Opportunities for improvement
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•
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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
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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
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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.
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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.
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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.
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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.
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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.
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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.
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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.
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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
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resource allocation;f) Lobby for the establishment of a consolidated nutrition fund by development
partners; andg) 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
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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:
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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.
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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
28 END MALNUTRITON NOW
Uganda Nutrition Action Plan 2011-2016
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
29END MALNUTRITON NOW
Uganda Nutrition Action Plan 2011-2016
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.
30 END MALNUTRITON NOW
Uganda Nutrition Action Plan 2011-2016
Table 4. Key outcome indicators and annual targets
No. Outcome indicator Base-line 2012 2013 2014 2015
UNAP 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
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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
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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
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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
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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
CTIV
ELY
PLA
N, I
MPL
EMEN
T, M
ON
ITO
R, A
ND
EV
ALU
ATE
NU
TRIT
ION
PR
OG
RA
MM
ESSt
rate
gy 4
.1: S
tren
gthe
n th
e po
licy
and
lega
l fra
mew
ork
for
coor
dina
ting
, pla
nnin
g, a
nd m
onit
orin
g nu
triti
on a
ctivi
ties
Fast
-tra
ck th
e en
actm
ent o
f the
Fo
od a
nd N
utri
tion
Bill.
•Fo
od a
nd N
utri
tion
Bill
enac
ted
NPA
/M
AA
IFM
oH, M
inis
try
of Ju
stice
and
Con
stitu
tiona
l A
ffai
rs, d
evel
opm
ent p
artn
ers
Revi
talis
e th
e fu
nctio
nalit
y of
th
e U
gand
a Fo
od a
nd N
utri
tion
Coun
cil (
FNC)
and
est
ablis
h its
se
cret
aria
t.
•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
40EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
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
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
nIN
TER
VEN
TIO
N20
11-1
220
12-1
320
13-1
420
14-1
520
15-1
6TO
TAL
OB
JECT
IVE
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, 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
Subt
otal
– O
bjec
tive
15,
087
7,19
910
,392
13,3
9913
,706
49,7
83
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
L
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 an
d us
e 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
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
JECT
IVE
3: P
RO
TEC
T H
OU
SEH
OLD
S FR
OM
TH
E IM
PACT
OF
SHO
CKS
AN
D O
THER
VU
LNER
AB
ILIT
IES
THAT
AFF
ECT
THEI
R N
UTR
ITIO
NA
L ST
ATU
SSt
rate
gy 3
.1: D
evel
op p
repa
redn
ess
plan
s fo
r sh
ocks
Stre
ngth
en a
nd s
cale
up
earl
y w
arni
ng s
yste
ms
on fo
od a
nd n
utri
tion
info
rmati
on fr
om c
omm
unity
to n
ation
al le
vels
. 10
015
025
030
035
01,
150
Supp
ort a
nd p
rom
ote
urba
n fa
rmin
g fo
r vu
lner
able
hou
seho
lds
502,
100
3,10
04,
150
4,15
013
,550
Dev
elop
, pro
mot
e &
impl
emen
t in
a tim
ely
fash
ion
a co
mpr
ehen
sive
pac
kage
of
nut
ritio
n se
rvic
es a
nd fo
od it
ems
to p
rovi
de d
urin
g em
erge
ncie
s &
reco
very
pe
riod
s.
6012
060
6060
360
Mak
e in
tegr
ation
of n
utri
tion
in d
isas
ter
man
agem
ent p
rogr
amm
es m
anda
tory
.40
4040
4040
200
Prom
ote
and
supp
ort d
iver
sifie
d pr
oduc
tion
of d
roug
ht-r
esis
tant
cro
ps a
nd
vege
tabl
es a
nd ra
isin
g of
ani
mal
s to
lera
nt o
f hea
t str
ess.
6040
4040
4022
0
Carr
y ou
t sen
sitis
ation
pro
gram
mes
for
com
mun
ities
to p
reve
nt, m
itiga
te, a
nd
resp
ond
to r
isks
of m
alnu
triti
on d
urin
g sh
ocks
.50
8080
5050
310
Stra
tegy
3.2
: Pro
mot
e so
cial
pro
tecti
on in
terv
enti
ons
for
impr
oved
nut
riti
on
Prov
ide
soci
al tr
ansf
ers
(cas
h, fo
od, a
gric
ultu
ral i
nput
s) to
and
sup
port
liv
elih
oods
for
vuln
erab
le h
ouse
hold
s an
d co
mm
uniti
es.
150
2,00
03,
000
4,00
05,
000
14,1
50
Dev
elop
& im
plem
ent p
rogr
amm
es fo
r sp
ecia
l soc
ial a
ssis
tanc
e an
d fo
r liv
elih
ood
prom
otion
and
pro
tecti
on in
are
as w
ith h
igh
leve
ls o
f mal
nutr
ition
.35
035
035
035
035
01,
750
Adv
ocat
e fo
r an
d pr
omot
e sc
hool
mea
ls p
rogr
amm
es.
4040
4040
4020
0
Supp
ort “
hom
egro
wn”
sch
ool m
eals
. 20
2,00
03,
000
4,00
05,
000
14,0
20
Subt
otal
– O
bjec
tive
392
06,
920
9,96
013
,030
15,0
8045
,910
OB
JEC
TIV
E 4:
STR
ENG
THEN
TH
E PO
LICY
, LEG
AL,
AN
D IN
STIT
UTI
ON
AL
FRA
MEW
OR
KS,
AN
D T
HE
CAPA
CITY
TO
EF
FECT
IVEL
Y PL
AN
, IM
PLEM
ENT,
MO
NIT
OR
, AN
D E
VA
LUAT
E N
UTR
ITIO
N P
RO
GR
AM
MES
St
rate
gy 4
.1: S
tren
gthe
n th
e po
licy
and
lega
l fra
mew
ork
for
coor
dina
ting
, pla
nnin
g, a
nd m
onit
orin
g nu
triti
on a
ctivi
ties
Fast
-tra
ck e
nact
men
t of t
he F
ood
and
Nut
ritio
n Bi
ll.30
30…
……
60
Revi
taliz
e th
e fu
nctio
nalit
y of
the
Uga
nda
Food
and
Nut
ritio
n Co
unci
l an
d es
tabl
ish
its s
ecre
tari
at.
2525
2525
2512
5
Revi
ew th
e Fo
od a
nd N
utri
tion
Polic
y to
inte
grat
e em
ergi
ng is
sues
.…
90…
110
…20
0
44EN
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
LRe
vise
the
draft
Uga
nda
Food
and
Nut
ritio
n St
rate
gy.
…90
…11
0…
200
Adv
ocat
e fo
r en
actm
ent
of b
ylaw
s an
d or
dina
nces
tha
t pr
omot
e nu
triti
on a
nd
food
sec
urity
.50
5050
5050
250
Inte
grat
e nu
triti
on is
sues
into
pla
ns a
nd b
udge
ts a
t all
leve
ls o
f gov
ernm
ent.
100
120
140
140
120
620
Supp
ort
the
deve
lopm
ent
of n
utri
tion
curr
icul
a fo
r al
l le
vels
of
educ
ation
&
trai
ning
.10
012
515
017
520
075
0
Adv
ocat
e fo
r es
tabl
ishm
ent
of lo
wer
- &
mid
dle-
cad
re n
utri
tion
cour
ses
in t
he
educ
ation
str
uctu
re.
100
125
150
175
200
750
Revi
ew &
int
egra
te n
utri
tion
issu
es i
n th
e ex
istin
g cu
rric
ula
of f
orm
al &
non
-fo
rmal
edu
catio
n &
pre
- & in
-ser
vice
trai
ning
.10
012
515
017
520
075
0
Stra
tegy
4.2
: Str
engt
hen
and
harm
onis
e in
stitu
tion
al fr
amew
ork
for
nutr
ition
from
loca
l to
cent
ral g
over
nmen
t Re
view
the
coun
try’
s cur
rent
insti
tutio
nal f
ram
ewor
k fo
r nut
ritio
n an
d im
plem
ent
a su
itabl
e on
e.
6060
……
…12
0
Esta
blis
h an
in
teri
m
mul
ti-se
ctor
al
coor
dina
tion
mec
hani
sm
for
nutr
ition
pr
ogra
mm
ing
and
M&
E.
2022
2426
2812
0
Stre
ngth
en in
stitu
tiona
l cap
acity
for
nutr
ition
pro
gram
min
g at
all
leve
ls.
200
400
400
400
400
1,80
0
Stra
tegy
4.3
: Str
engt
hen
hum
an re
sour
ce c
apac
ity
to p
lan,
impl
emen
t and
mon
itor
and
eva
luat
e fo
od a
nd n
utri
tion
pr
ogra
mm
esD
esig
n a
capa
city
-str
engt
heni
ng p
lan
for
nutr
ition
pro
gram
min
g at
nati
onal
, LG
&
com
mun
ity le
vel.
5060
7080
9035
0
Nut
ritio
n hu
man
reso
urce
cap
acity
str
engt
heni
ng p
roje
ct50
400
600
800
400
2,25
0
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
timel
y de
cisi
on m
akin
g.1,
000
1,50
02,
000
2,50
02,
500
9,50
0
Cond
uct a
nati
onal
nut
ritio
n ba
selin
e su
rvey
.50
075
095
070
068
03,
580
Cond
uct
peri
odic
dis
tric
t-le
vel
surv
eys
in a
reas
with
a h
igh
prev
alen
ce o
f m
alnu
triti
on.
500
750
950
700
680
3,58
0
Cond
uct m
id-t
erm
and
end
-of-
term
impa
ct e
valu
ation
of U
NA
P.…
……
…10
010
0
Stre
ngth
en d
istr
ict-
leve
l foo
d an
d nu
triti
on s
urve
illan
ce s
yste
ms.
5050
5050
5025
0
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
45EN
D M
ALN
UTR
ITO
N N
OW
INTE
RV
ENTI
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
Co
nduc
t for
mati
ve re
sear
ch o
n be
st p
racti
ces.
300
400
400
500
500
2,10
0
Rese
arch
pos
itive
indi
geno
us d
ieta
ry p
racti
ces.
5050
5050
5025
0
Com
pile
food
com
posi
tion
data
for
all f
oods
con
sum
ed in
Uga
nda.
500
1,00
01,
500
2,00
02,
000
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
a.20
2020
2020
100
Subt
otal
– O
bjec
tive
43,
855
6,29
27,
729
8,83
68,
343
35,0
55
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
Y
Stra
tegy
5.1
: Inc
reas
e aw
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
olic
y st
atem
ents
and
per
iodi
c po
licy
brie
fs o
n th
e na
tiona
l foo
d se
curi
ty a
nd n
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
ing
Wee
k, H
and
Was
hing
D
ay) a
nd ta
ke a
dvan
tage
of o
ther
adv
ocac
y ev
ents
.
300
375
450
525
600
2,25
0
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 s
usta
inab
le n
utri
tion
advo
cacy
pla
n.1,
000
1,00
01,
000
1,00
01,
000
5,00
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
016
057
0
Subt
otal
– O
bjec
tive
51,
595
1,73
31,
835
1,93
82,
040
9,14
0
GRA
ND
TO
TAL
12,6
8425
,921
34,7
3442
,330
45,9
4616
1,61
4
46 END MALNUTRITON NOW
Uganda Nutrition Action Plan 2011-2016
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.
47END MALNUTRITON NOW
Uganda Nutrition Action Plan 2011-2016
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