Upload
others
View
37
Download
0
Embed Size (px)
Citation preview
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 authorised 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]
iEND MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Table of Contents
Foreword iiiStatement of Commitment vAcronyms and Abbreviations viiExecutive Summary ix
PART I: OVERVIEW 11. Introduction 12. Policy Context 53. Situation and Problem Analysis 6 3.1 Causes of High Rates of Malnutrition in Uganda 7 3.2 Consequences of High Rates of 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 21
PART III: IMPLEMENTATION, FINANCING, AND MONITORING AND EVALUATION FRAMEWORKS 236. Implementation Framework 23 6.1 Institutional Arrangements 23 6.2 Co-ordination Arrangements 24 6.3 Implementation Strategy 25 6.4 Prerequisites for Implementation 257. Financing Framework 26 7.1 Government of Uganda 26 7.2 Development Partners 26 7.3 Public-Private Partnerships 278. Monitoring and Evaluation Framework 29
ii END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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. The Causes of Young Child Malnutrition in 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 5-Year UNAP Implementation Cost Matrix 28Table 4. Key Outcome Indicators and Annual Targets 30
ANNEXES ANNEX I: Implementation Matrix 31ANNEX II: Implementation Cost Matrix 43ANNEX III: Reviewed Documents 50ANNEX IV: List of UNAP Technical Committee Members 51
iiiEND MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Foreword
We have made progress in reducing poverty over the years. However, malnutrition still ravages our country. Malnutrition affects millions of Ugandans in various ways, but it is particularly devastating to women, babies, and children. Malnutrition also impairs educational achievements and economic productivity, costing the government and families enormous amounts of money to treat related illnesses.
Adequate nutrition is a prerequisite for human development and socioeconomic well-being. The Government of Uganda is committed to fulfilling the constitutional obligation of ensuring food and nutrition security for all Ugandans. This 5-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 realised.
The plan is intended to reduce the magnitude of malnutrition in Uganda and its impact on the individual, the household, the 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. Effective intra- and inter-sectoral linkages must be put in place to promote co-ordination and resource utilisation. The UNAP, therefore, calls for scaling up multi-sectoral interventions, placing more emphasis on community-based initiatives that have been proved to yield cost-effective results, and 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 1,000 shillings we invest in nutrition results in economic benefits at least six times more. These gains mainly benefit the poor and most disadvantaged, as they spend less money on treating malnutrition-related diseases and increase their productivity, reaping sustainable socioeconomic benefits.
iv END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Fortunately, malnutrition does not require ‘space science’ knowledge, but it does require information. District medical officers and others concerned need to inform families, through all appropriate media, that a human being needs the following basic nutrients: proteins for body building, carbohydrates for energy, and fats for body insulation, as well as energy, minerals (iron, zinc, calcium, potassium, phosphorus, iodine, etc.), and vitamins (A, B, C, D, E, etc.). Along with proteins, minerals are important for body building and for co-ordination of body functions; so are vitamins.
I extend my sincere appreciation to all those who contributed to the development of this plan. Members of the Nutrition Technical Committee and Nutrition Forum are commended for a job well done. The donor community is appreciated for its support. I cannot overemphasise the role played by the National Planning Authority in co-ordinating 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 co-ordinate different nutrition partners, ensure accountability in reaching the objectives of both the NDP and UNAP, and increase commitment of resources and expertise to scale up high-impact programmes and policies to improve nutrition in our country.
Since nutrition is a cross-cutting issue with economic, socio-cultural, political, and biomedical dimensions, it is imperative that all sectors of the economy play their roles to achieve the goal and objectives of this plan. I therefore call upon the Ministers of Agriculture, Animal Industry and Fisheries; Health; Trade and Cooperatives; Education and Sports; Gender, Labour and Social Development; the General Public; Local Government; and the Private Sector, Civil Society and Faith-Based Organizations, as well as development partners, to support the implementation of this action plan and align their programmes to it for a united response. We must act now: Our actions will send a message to the Ugandan people and the world that Uganda will not look on while its people are ravaged by malnutrition. Truly, the price of malnutrition in Uganda today and in the future is too high to ignore.
For God and My Country
Yoweri Kaguta Museveni President of the Republic of Uganda 29 September 2011
vEND MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Statement of Commitment
Following upon the statement made at the United Nations General Assembly in September 2010 in New York by the Minister of Foreign Affairs, Hon. Sam Kuteesa, in which Uganda committed itself to tackling the crisis of malnutrition in the country, a concerted effort was set in motion to respond to the hitherto persistent malnutrition problem in the country. The effort was led by the National Planning Authority and was aimed at developing a concrete action plan with measurable and time-bound interventions.
We, as a government, found the high malnutrition rates reported in various surveys over the years completely unacceptable. We all supported the new resolve to prioritise eradication of malnutrition from Uganda as one of the most viable strategies for achieving the Millennium Development Goals. The rationale for this strategy is that nutrition forms the basis for most other areas of human development. Conversely, malnutrition undermines an entire person’s life. We have therefore adopted the Scaling Up Nutrition (SUN) strategy of focused interventions covering the 1,000-day window of opportunity directed at women in the reproductive age bracket, newborns, and young children under the age of 2 years.
To add technical content to this expression of political will, a Multi-Sectoral Technical Committee was set up to conceptualise and draft this action plan. The membership of the committee included experts on nutrition from several sectors of government, academic institutions, non-governmental organisations (NGOs), and several international organisations working in Uganda. Staff members of the National Planning Authority provided active and timely secretariat services for the committee. A comprehensive draft of the Uganda National Action Plan (UNAP) for use in stakeholder consultations was completed in early December 2010. Separate structured consultations were held with several stakeholder groups, including senior government officials, representatives of local government, the private sector, civil society organisations, and development partners, between December 2010 and June 2011. The draft UNAP was also formally submitted for review to all of the ministries that will be involved in the implementation of the Action Plan. Comments and suggestions submitted through all of these reviews and consultations were incorporated by the technical committee into this final version of the UNAP. Cabinet, under the chairmanship of H. E. the President, Yoweri Kaguta Museveni, adopted the Plan on Wednesday, 28 September 2011.
Sincere gratitude is due to the individuals and institutions that played a leading role in the drafting of the UNAP. Notably, the government wishes to recognise officers from the ministries of Agriculture, Animal Industry and Fisheries; Health; and Education and Sports; and the National Planning Authority who participated in the technical committee. We also wish to recognise 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,
vi END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
the International Food Policy Research Institute, World Vision, the World Health Organisation (WHO), UNICEF, the Food and Agriculture Organization, the Intergovernmental Authority for Development, and the United States Agency for International Development. The process was rigorous, and the development of the UNAP would not have been possible without the combined and untiring efforts of these individuals and organisations.
Although formal responsibility for improving nutrition in Uganda is mandated to the Ministry of Agriculture, Animal Industry and Fisheries and the Ministry of Health, successfully addressing the problem of malnutrition necessarily requires the engagement of several other sectors in a joint effort. Ensuring that all Ugandans are well nourished and able to live long, healthy, active, and creative lives requires that every Ugandan has access to a high-quality and sufficient diet, good health services, clean water, adequate sanitation, and, perhaps most importantly, proper knowledge on how to provide for the nutritional needs of themselves and those that they care of. All of these services are needed for the nutritional security of Ugandans. The responsibilities for the provision of public services related to all of these key determinants of improved nutrition span a wide range of ministries within government. Addressing malnutrition in Uganda therefore requires a multi-sectoral commitment across all of government.
Consequently, we the undersigned commit ourselves and the ministries we lead to do everything necessary to support the implementation of this nutrition action plan. We undertake to promote the provision of the required human, financial, and other resources that may be necessary to achieve the objectives of this plan. We recognise that by ensuring that the mothers of Uganda and the children that they bear and care for are well nourished, we are establishing the best foundation for Uganda’s development. We acknowledge our responsibility to the people of Uganda to see that this foundation is solid. A Uganda in which all its citizens are well nourished is a legacy of which we can all be proud.
Rt Hon Henry Muganwa-Kajura 2nd Deputy Prime Minister & Minister of Public Service ……………………
Hon Tress Bucyanayandi Minister of Agriculture, Animal Industry & Fisheries ……………………
Hon Dr D Christine Ondoa Minister of Health ……………………
Hon Lt Jessica Alupo Epel Minister of Education and Sports ……………………
Hon Amelia Anne Kyambadde Minister of Trade and Cooperatives ……………………
Hon Syda Bbumba Minister of Gender, Labour and Social Development ……………………
Hon Adolf Mwesige Minister of Local Government ……………………
Hon Martia Kasaija Minister of State, Finance, Planning and Economic Development (Planning) Holding the Portfolio of Minister of Finance, Planning and Economic Development …………………….
viiEND MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Acronyms and Abbreviations
BMI Body mass indexCAADP Comprehensive Africa Agriculture Development ProgrammeCSO Civil Society OrganisationFNC Food and Nutrition CouncilHIV Human Immunodeficiency VirusM&E Monitoring and evaluation MAAIF Ministry of Agriculture, Animal Industry and FisheriesMEMD Ministry of Energy and Mineral DevelopmentMFPED Ministry of Finance, Planning and Economic DevelopmentMGLSD Ministry of Gender, Labour and Social DevelopmentMOES Ministry of Education and Sports MOH 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 OrganisationNPA National Planning AuthorityOPM Office of the Prime MinisterSUN Scaling Up NutritionUDHS Uganda Demographic and Health SurveyUFNP Uganda Food and Nutrition PolicyUNAP Uganda Nutrition Action PlanWHO World Health Organisation
Exchange rate (August 2011): UShs 2,600 = US$1
viii END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
ixEND MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 Health 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 realise its 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 to 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 begin complementary feeding. 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 2016 will have the following benefits:
• Reduce the number of maternal deaths by more than 6,000 and child deaths by more than 16,000 every year
x END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
• Increase national economic productivity, both physical and intellectual, by about UShs 130 billion per year at present value
• Provide a strong return on public investment: For every UShs 1,000 invested, about UShs 6,000 worth of increased productivity will result from reduced child stunting, improved maternal health, enhanced micronutrient intake, and improved nutrition care
Investing in nutrition makes economic sense, and the economic benefits far outweigh the investments required for scaling up nutrition programmes.
The poor 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 fulfil 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 unco-ordinated 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.
1END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 that 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 begin complementary feeding. 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 and Health Surveys (UDHS), although some nutrition indicators for young children and their mothers have improved over the past 15 years, the improvement has been minimal. 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). Other indicators have actually worsenend over that 15-year period.1 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 meagre 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.
•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.
1 See the UDHS and FHI 360/FANTA-2, 2010, The Analysis of the Nutrition Situation in Uganda, http://www.fantaproject.org/downloads/pdfs/Uganda_NSA_May2010.pdf.
2 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
• Iron-deficiency anaemia affects three-quarters of children 6–59 months old and half of women of reproductive age. Anaemia in women leads to chronic fatigue and impairs productivity, earnings, and caregiving 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.
•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 Generations2
Malnutrition 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. These costs stem from the need to deal 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 caused by hunger and malnutrition. As shown in Figure 1, malnourished children suffer from irreparable 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, stunted 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 malnutrition at the national level impose a heavy burden on efforts to foster sustained economic growth and improved general welfare.
2 Adapted from the United Nations Administrative Committee on Coordination/Sub-Committee on Nutrition (ACC/SCN) (2000), 4th Report on the World Nutrition Situation, Geneva: ACC/SCN in collaboration with the International Food Policy Research Institute (IFPRI).
Reduced physical labour capacity,
Figure 1: The burden of malnutrition through the life cycle and across generations.
OLDER PEOPLE
Malnourished
BABY Low
birth weight
CHILD Stunted
ADOLESCENT Stunted
WOMAN Malnourished
PREGNANCY Low weight gain
Inadequate food, health,
and 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, and care
Reduced mental capacity
Inadequate food, health, and care
Inadequate food, health, and care
Higher maternal mortality
Inadequate foetal nutrition
Inadequate infant nutrition
lower educational attainment,
restricted economic potential,
shortened life
Reduced physical labour capacity,
lower educational attainment
3END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
The principal points of intervention to break this cycle of malnutrition are: •Address the nutritional needs of the young child from conception through about 24 months • Ensure the nutritional well-being of the mother of the child even before she becomes
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 2 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 proper nutrition of these future mothers will result in their experiencing pregnancies and
Perc
ent
60
50
40
30
20
10
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 children below -2 standard deviations from the WHO Child Growth Standards UDHS 2006
Wasted Underweight
The window of opportunity outside the womb
4 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
deliveries that are less prone to problems and giving birth to healthier babies who have a good birth weight. Hence, the focus of the UNAP includes both the children and the 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 5 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, diarrhoea, 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 5 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 5 years will have the following outcomes.
• Every year the number of maternal deaths will be reduced by more than 6,000 and the number of child deaths will be reduced by more than 16,000.
• National economic productivity, in terms of both physical and intellectual output, will be increased by an estimated UShs 130 billion per year at present value.
• There will be 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:
1. Improve maternal, infant, and young child nutrition and health to increase the likelihood of healthy pregnancy and infancy and proper physical and mental growth
5END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
2. 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
3. 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
4. Strengthen the legal and institutional frameworks and the capacity to effectively plan and implement nutrition programmes in the country
5. 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 Industry 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 (M&E) of the UNAP will follow a similar approach.
Under the joint leadership of MOH and MAAIF in exercising their constitutional mandate, the UFNP was developed in 2003. Thereafter, a National Food and Nutrition Strategy was drafted, as was a Food and Nutrition Bill (2008) to put in place statutory regulations and institutions for implementing the UFNP, in particular the Uganda Food and Nutrition Council (FNC). The UNAP draws much of its content from these documents in seeking to operationalise efforts to effectively implement the UFNP.
At the sectoral level, the Health Sector Strategic and Investment Plan identifies nutrition as part of the National Minimum Health Care Package for Uganda, while the Agricultural Sector Development Strategy and Investment Plan and the draft National Agriculture Policy recognise food and nutrition security as key factors for the country’s social and economic development. Also, nutrition and food security are central components in the draft School Health Policy, the draft School Feeding Policy Guidelines, and the National Orphans and Other Vulnerable Children Policy.
6 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
At the international level, the UNAP also builds on several agreements to which Uganda is a signatory. These include:
• International Conference on Nutrition, 1992• World Food Summit, 1996• Declaration on the Millennium Development Goals, 2000, and the follow-up summit in
2010• Scaling Up Nutrition Initiative• International Covenant on Economic, Social and Cultural Rights• Convention on Elimination of All Forms of Discrimination Against Women• International Health Partnerships and related initiatives
At the regional level, Uganda adopted the African Regional Nutrition Strategy of the African Union. The strategy’s main focus is to advocate for renewed commitment to nutrition, intensify member states’ efforts to sustainably address malnutrition in the wake of the worsening nutrition status of vulnerable groups across Africa, and stimulate actions at national and regional levels that result in improved nutrition outcomes. (In light of the above, at the 2010 summit of African Union heads of state, hosted by Uganda, member states approved the establishment of an Africa Food and Nutrition Day to be commemorated each year on 31 October to remind Africa of the constant need to address its nutrition problems.)
Uganda has also adopted the Comprehensive Africa Agriculture Development Programme (CAADP), an African Union-driven initiative for substantially improving agricultural production. Nutrition and food security are one of the four pillars of the CAADP.
3. Situation and Problem Analysis
Uganda has made progress in reducing HIV, malaria, and tuberculosis; produces sufficient food nationally to meet the needs of its population; and has experienced a significant reduction in poverty levels, from 39 percent in 2002 to 23 percent in 2009–2010. However, the levels of malnutrition among women and young children have improved only minimally and some indicators, like micronutrient deficiency, have even worsened over the past two decades.
Among children, while there has been some reduction in the prevalence of malnutrition in Uganda over the past 15 years (Figure 3), the change is slow. Moreover, child malnutrition in Uganda remains largely a ‘hidden problem’. Most children affected are moderately malnourished, which is difficult to identify without regular assessment. Micronutrient deficiencies are similarly difficult to detect.
7END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Figure 3. National Trends in the Prevalence of Malnutrition among Children under 5
Sources: UDHS 1995, 2001, and 2006
Among women of reproductive age, more than 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 Rates of Malnutrition in Uganda
There are several interconnected 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 diseases, acute respiratory infections, and worm infestations. There are three broad underlying causes of inadequate dietary intake and high disease burden:
1. 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.
2. Inadequate maternal and child care. Care-related constraints lead to both inadequate dietary intake and a high disease burden in young children. These constraints include the 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
50 45 45
39
2219
16
7 5 6
WastedUnderweightStunted
40
30
20
10
0
Perc
ent o
f und
er-5
s1995
2001
2006
8 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 simultaneously 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.
3. 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.
9END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Figure 4. The Causes of Young Child Malnutrition in 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 practices
Poor access to health care and 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 caregiver
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
Policy & leadership commitment to improved nutrition
• Low awareness of the role of nutrition in the national development agenda
• Poor appreciation of evidence of what needs to be done to reduce malnutrition
• Inadequate human capacity in nutrition policy & programme design and analysis
Immediate causes:
Underlying causes:
Basic causes:
10 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 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.
One of the important causes of the continuing high levels of young child malnutrition in Uganda is the fact that there is generally little awareness that nutrition is 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 policies and legislation to create the environment for increased investment in nutrition. In addition, the lack of political support has hindered the country’s ability to establish the necessary structures for co-ordinating action to address young child and maternal malnutrition; to develop an M&E framework to improve these efforts; and to strengthen human capacity for nutrition analysis, programme design, and implementation in Uganda.
3.2 Consequences of High Rates of Malnutrition in Uganda
A. Malnutrition kills many Ugandans each year.• Low birth weight is rampant in Uganda. More than 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 2009.3
• 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 Uganda doubled its coverage of iron supplementation among pregnant women.
B. Malnutrition significantly reduces agricultural productivity.• Uganda’s main employer, the agriculture sector, lost more than US$34 million worth of
productivity 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.
3 Data are from PROFILES, a process developed by FHI 360 with USAID funding for nutrition policy analysis and
advocacy that uses spreadsheet models to estimate the functional consequences of malnutrition. For more information, see the Uganda Nutrition Advocacy Profiles at http://www.fantaproject.org/publications/uganda_advocacy2010.shtml.
11END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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, and malnutrition contributes to a loss of about 4.1 percent of the gross domestic product per year.
• Malnutrition is expensive to treat. For instance, treating severe acute malnutrition costs more than US$120 per child.
D. Malnutrition affects the 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.
• Malnutrition 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 co-ordination 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 development
• Low prioritisation of nutrition by government and implementers
• Weak leadership for nutrition across all sectors
• Limited advocacy skills among nutrition stakeholders
• Lack of commitment to achieve the national nutrition agenda
• No communication strategy for nutrition
• Inadequate number of nutrition activists
• Emerging commitment for improving nutrition in the country
• Food and Nutrition Bill drafted, awaits enactment by parliament to empower the FNC
• Nutrition is integrated in various policy documents, including the Constitution of Uganda and the NDP
• Government staff structure that allows for strengthening human capacity; for example, nutritionists recruited in health system and agricultural extension and community development officers at sub-county levels
• Increasing commitment to nutrition from development partners
12 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 inadequately mainstreamed into existing sectoral programmes
• Poor appreciation of centrality of nutrition to development
• Low recruitment, poor professional growth opportunities, and poor retention of nutritionists due to low prioritisation of nutritionists as cadres of the civil service
• Lack of a comprehensive nutrition curriculum and training plan for in-service capacity strengthening of personnel who do not specialise in nutrition
• Lack of incentives for nutrition personnel in all sectors
• Nutrition incorporated in the curricula at all education levels
• In-service training curriculum 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 mechanism
• Training and information, education, and communication materials on nutrition in Uganda available for local adaptation
• Development partners supportive of capacity strengthening in nutrition
Weak co-ordination and inadequate implementation of policy guidelines
• Lack of co-ordination structure to link sectors on nutrition programming
• Lack of a national nutrition agenda to act as a reference point for implementers
• Existing food and nutrition policy and other guidelines not adequately implemented and disseminated
• Presence of National Planning Authority to co-ordinate multi-sectoral efforts on nutrition programming and M&E
• National co-ordination forum for nutrition stakeholders to meet 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 tools
• Low demand for nutrition information
• Weak co-ordination, information sharing, and adaptation of promising practices
• Lack of a national nutrition research agenda
• Existing and forthcoming survey datasets with nutrition content
• Supportive development partners• National nutrition indicators established.• Some surveillance systems for nutrition
and food security established
13END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Gap Current performance Opportunities for improvement
Low involvement of communities in nutrition
• Curative health services seen as more important than preventive
• Nutrition activities that often do not promote community involvement; few good models for community engagement
• Inadequate public knowledge on importance of good nutrition
• Few 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 the private sector
• High dependence on development partners
• Inadequate knowledge about food supplementation
• Limited data on nutrition needs
• Local production of enriched foods increasing
• Commitment by government and development partners
• Increasing interest in the private sector
14 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 9 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 2 years old, 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 that malnourished children face and will reduce the burdens they impose on the household, the community, and the nation. The nutritional condition of the women who bear these children is equally important, as the health and nutritional well-being of the newborn 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 the household or community level. As a result, the UNAP will directly and indirectly address the nutritional needs of all Ugandans, particularly the most vulnerable, leading 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: 1. 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, co-ordination, and collaboration will be strengthened to facilitate adequate nutrition advocacy, programming, and M&E.
2. Implement proven high-impact interventions in reducing young child and maternal malnutrition. Most interventions will be in the areas of production of nutritious food, nutrition care within the household, public health, and livelihood support.
3. Identify and implement cost-effective nutrition programme models that are scalable at both district and national levels. Such models will involve behaviour change and social marketing, fortification of common staple foods, use of bio-fortified produce, and
15END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
micronutrient supplementation programmes, among others.4. 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.
5. 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. The UNAP will target geographic areas where young child and mothers are most vulnerable to malnutrition.
The UNAP will therefore focus on the following four broad action areas:1. Promoting key maternal, infant, and young child feeding and nutrition practices to improve
awareness and increase targeted healthy feeding behaviours. These include breastfeeding, appropriate complementary feeding, dietary diversification, and increased coverage of micronutrient supplementation programmes.
2. 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.
3. Providing care and support to individuals with severe acute malnutrition.4. Mobilising the community to promote the adoption of healthy nutrition behaviours,
community-based growth monitoring and promotion, 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 nutrition to community and national development.
Appropriate materials and tools will be employed to:1. Facilitate behaviour change, using nutrition information, education, and communication
materials2. Provide nutrition care and support3. Collect information on the nutritional condition of the target groups and all Ugandans over
time for analysis and use in programming
To support priority nutrition areas and their complementary activities, key structural functions will be invested in institutions that will be established or strengthened at national, district, sub-county, and community levels in both government and private arenas, as provided for in the Food and Nutrition Policy and the draft Food and Nutrition Bill. Strengthened links between different levels of nutrition actors to enable informed and appropriate decisions for co-ordinated nutrition programming across Uganda will also be an element of the implementation of the UNAP.
16 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
5. Goal, Objectives, Strategic Interventions, and Core Projects
5.1 Goal
The goal of the UNAP 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 that the UNAP will focus on.
Table 2. Key Nutrition Outcome Indicators
Outcome indicator baseline UNAP target 2016
1 Stunting: prevalence in children under 5, % 38 32
2 Underweight: prevalence in children under 5, % 16 10
3 Underweight non-pregnant women 15–49 years old with BMI less than 18.5 kg/m2, %
12 8
4 Iron-deficiency anemia: prevalence in under-5s, % 73 50
5 Iron-deficiency anemia: prevalence in women 15–49 years old, %
49 30
6 Vitamin A deficiency: prevalence in under-5s, % 19 13
7 Vitamin A deficiency: prevalence in women 15–49 years old, %
20 12
8 Low birth weight: newborns weighing less than 2.5 kg, % 13 9
9 Infants aged under 6 months who were exclusively breastfed: %
60 75
10 Dietary diversification index: percentage of 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
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.
17END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
5.2 Objectives, Strategies, and Strategic Interventions
To achieve the above goal and to improve the nutrition status indicators, 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 to 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 women, lactating mothers, and other women of reproductive age.
4. Integrate management of severe and moderate acute malnutrition into routine health services.
5. Promote utilisation of antenatal and post-natal care services among all pregnant women and lactating mothers.
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 the household level.
Strategy 1.2: Address gender and socio-cultural issues that affect maternal, infant, and young child nutrition.
Interventions
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 the nutrition of women, infants, and young children.
18 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Objective 2: Enhance consumption of diverse diets.
Strategy 2.1: Increase access to and use of diverse nutritious foods at the household level.
Interventions
1. Promote production and consumption of diversified nutritious foods at the household and community levels.
2. Advocate for and support integration of nutrition in agricultural programmes at the 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 the household and
community levels. 5. Promote and support the utilisation of safe labour-saving technologies at the household
and community levels. 6. Support the on-farm enterprise mix to promote stable diversified food production. 7. Promote production and consumption of indigenous foods to enhance dietary
diversification. 8. Promote positive indigenous dietary practices.
Strategy 2.2: Enhance post-harvest handling, storage, and utilisation of nutritious foods at the household and farm levels.
Interventions
1. Promote and support adoption of post-harvest handling and storage technologies at the 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 foods.
19END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 the community to the national level.
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 the 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 severe acute malnutrition by integrating care into routine health
services and providing follow-up support and monitoring at the 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 frameworks for co-ordinating, 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.
20 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
2. Revitalise and legalise the functionality of the FNC and establish its secretariat/co-ordinating unit.
3. Review the UFNP to integrate emerging issues.4. Revise the draft Uganda Food and Nutrition Strategy to align it with the prevailing
national, regional, and global nutrition agenda and disseminate the strategy widely.5. Advocate for the enactment of by-laws and ordinances that promote nutrition and food
security at district and sub-county levels.6. Integrate nutrition issues into plans and budgets at all levels of government 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 the 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 the local to the central government level.
Interventions
1. Review Uganda’s current institutional framework for nutrition and implement a suitable one.
2. Establish an interim multi-sectoral co-ordination mechanism for nutrition programming and M&E.
3. Strengthen institutional 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 the 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 survey to establish up-to-date nutrition baseline monitoring indicators.
4. Conduct periodic district-level food and nutrition surveys in vulnerable areas and among vulnerable populations.
5. Undertake mid-term and end-of-term impact evaluations of the UNAP.6. Strengthen district-level food and nutrition surveillance systems.
21END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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
interventions 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 Uganda’s food security and
nutrition situation.
5.3 Priority Investment Areas
A. 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.
b. 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
22 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
human resource capacity for nutritional assessment and programming, and establishing institutional structures for nutrition programme implementation and co-ordination at both national and decentralised levels.
C. Strengthen food security and nutrition safety nets at national and decentralised levels. This includes the establishment of a national food and nutrition information system.
D. Conduct operational research in nutrition to inform implementation and monitoring of 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 programmes, and investigation and demonstration of labour-saving technologies for women with young children.
23END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
PART III: IMPLEMENTATION, FINANCING, AND MONITORING AND EVALUATION FRAMEWORKS
6. Implementation Framework
This section of the UNAP provides an overview of how the plan will be implemented and co-ordinated 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-co-ordinated, multi-sectoral approach. Thus, this implementation framework aims to support nutrition stakeholders at all levels and sectors in the country to successfully operationalise the UNAP.
The lack of an institutionalised co-ordinating mechanism for nutrition has been one of the main contributors to the ineffectiveness of past interventions. Inadequate co-ordination 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 emphasises the need to establish new institutional arrangements and to strengthen existing ones to adequately provide policy direction, co-ordinate 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 co-ordination 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 co-ordination of the implementation, monitoring, and evaluation of the UNAP and other nutrition programmes in the country. Specifically the FNC, assisted by its secretariat, will:
• Co-ordinate joint planning and review with other ministries and departments as well as development partners, civil society, the private sector, and academia
• Monitor and evaluate the national nutrition response in the country• Mobilise resources and support for nutrition response• Provide national standards and norms for nutrition• Advocate for the development of nutrition structures and adequate resource allocation• Lobby for the establishment of a consolidated nutrition fund by development partners• Facilitate cross-sector collaboration and work with higher-level committees (in the cabinet
and parliament) and the Multi-Sectoral Technical Committee on Nutrition.
24 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
6.2 Co-ordination Arrangements
The UNAP further recognises the need to establish, strengthen, and support nutrition co-ordination structures at both national and local government levels and to strengthen sector-specific capacity at all levels to effectively implement nutrition programmes.
A. National Co-ordination
Policy Co-ordination. Policy co-ordination 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 bi-annually to review progress on key nutrition indicators in the country and to 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, to analyse budget performance of nutrition programmes, to analyse the constraints to implementation, and to provide strategic direction. Recommendations from the cabinet sub-committee and the FNC will be fed into the Parliamentary Sub-Committee on Nutrition, which will approve the key policy and financial decisions, and then to the Nutrition Multi-Sectoral Technical Committee (see below) for implementation of decisions.
Technical Co-ordination. Technical co-ordination of nutrition will be done through the Nutrition Multi-Sectoral Technical Committee, which will comprise key technical experts from the 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 co-ordinated by the head of the secretariat. Until the FNC and its secretariat are established, the National Planning Authority (NPA) , in line with its mandate to co-ordinate and harmonise national development planning, monitoring, and evaluation, will carry out this role. The NPA will also work with other stakeholders to ensure that the proposed institutional structures are established as soon as possible.
Nutrition Development Partners Committee. The Nutrition Development Partners Committee will be responsible for promoting and identifying funding resources for the nutrition agenda in Uganda; promoting joint resource mobilisation, allocation, and support; responding to the proposed development partners’ consolidated nutrition fund; and providing policy guidance on the alignment of nutrition programmes to the Millennium Development Goals and the nutrition commitments of the United Nations 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 co-ordination committees.
The Uganda Nutrition Co-ordination Forum. The Uganda Nutrition Co-ordination Forum, which will be inaugurated in the plan period, will meet bi-annually to review implementation of the UNAP and to provide advice and advocacy for nutrition. Chaired by the NPA, the Co-ordination 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,
25END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
non-governmental organisations (NGOs), and civil society organisations (CSOs) involved in implementing programmes under the UNAP.
B. Decentralised Co-ordination
Sector-Level Co-ordination Committees. At the sector level, the various ministries, departments, and agencies will form committees that will co-ordinate 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 co-ordinate nutrition activities within their area of responsibility.
District-Level Co-ordination Committee. The District Nutrition Co-ordination 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 will also 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 co-ordinate 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:
1. 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)
2. Scaling up community-based initiatives that have proven to have a high impact and that are cost-effective
3. Comprehensively managing cases of acute and moderate malnutrition4. Supporting food-based approaches to improve nutrition that have proven to be sustainable5. 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 government, the public sector, the private sector, development partners, NGOs, CSOs, and research institutions and academia. Successful implementation of the UNAP will require:
• Ownership of the action plan by the key government ministries—the MOH; the MAAIF; the Ministry of Education and Sports, the Ministry of Water and Environment, the Ministry of Local Government, the Ministry of Gender, Labour and Social Development, and the
26 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Ministry of Trade and Cooperatives—and support from the Ministry of Finance, Planning and Economic Development, the OPM, and the NPA
• Political will and financial commitment at both the national and local government levels• Behaviour change at the national, local, and household levels to promote good nutrition• Routine and effective M&E of the implementation of the UNAP to ensure that the plan is
on track• Effective co-ordination 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 5-year UNAP is UShs 161,614 million (see Table 3 and Annex II). Financing the UNAP will require a concerted effort from the Government of Uganda, development partners, CSOs, and the private sector. However, the major investor in these nutrition priorities will be the Government of Uganda.
7.1 Government of Uganda
Uganda’s central and local governments, in alliance with other agencies and development partners, will finance the UNAP through focused resource reallocation within existing budgets and through mainstreaming nutrition in various sector programmes to increase resource availability. This calls for making food security and nutrition a high priority in national programmes, specifically in such sectors 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 recognises 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 such forums as monthly local development partner group meetings. The government will take further advantage of existing and new global and regional initiatives, including SUN, CAADP, and the United States Agency for International Develoment’s Feed the Future, 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 the national level, advocacy for basket funding for nutrition programmes from the national nutrition development partners to maximise nutrition investments
27END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
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 unaddressed).
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 the 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 co-ordinated effectively to maximise impact. In addition, the government envisions encouraging affected communities to take ownership of their nutrition problems. If communities recognise how these problems affect their development and see that they can help identify strategies to address the problems, the community contribution to nutrition interventions would increase and help sustain activities.
28 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Table 3. Summary of 5-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, and institutional frameworks and the 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 of and maintain national interest in and commitment to improving and supporting 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 MALNUTRITION 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 UNAP 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 co-ordinating agency, which will be the 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 co-ordinating 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 co-ordinating agency, which will compile them and produce a quarterly report. Quarterly meetings will be held to discuss the reports. During these meetings, appropriate measures to address slow or off-track implementation will be developed.
To evaluate the effectiveness and impact of the various programmes and interventions and the UNAP overall, evaluations and reviews will be conducted annually, at the midpoint (2.5 years), and at the end of the implementation period (5 years).
Table 4 below shows the key outcome indicators and targets that will be monitored during the 5-year plan period.
30 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
Table 4. Key Outcome Indicators and Annual Targets
No. Outcome indicator baseline 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 non-pregnant women 15–49 years old 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 in women 15–49 years old, %
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 in women 15–49 years old, %
20 1 18 17 15 14 12
8. Low birth weight: newborns weighing less than 2.5 kg, %
13 1 12 11 11 10 9
9. Exclusive breastfeeding to 6 months: % of infants
60 1 63 66 69 72 75
10. Dietary diversification index: percentage of calories consumed from foods other than cereals and starchy roots
57 1 61 64 69 71 75
11. Calorie consumption: average daily energy intake per capita, kcal
2,220 2 2,276 2,332 2,388 2,444 2,500
1 UDHS 20062 FAO 2008
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
31EN
D M
ALN
UTR
ITO
N N
OW
AN
NEX
I: Im
ple
men
tati
on
Mat
rix
Goa
l: Re
duce
mal
nutr
ition
lev
els
amon
g w
omen
of
repr
oduc
tive
age
, in
fant
s, a
nd y
oung
ch
ildre
n fr
om 2
011
thro
ugh
2016
and
bey
ond
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Obj
ecti
ve 1
: Im
prov
e ac
cess
to a
nd u
tilis
ation
of s
ervi
ces
rela
ted
to m
ater
nal,
infa
nt, a
nd y
oung
chi
ld n
utri
tion
.
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 y
oung
chi
ldre
n.
Prom
ote
and
supp
ort h
ealth
an
d nu
triti
on e
duca
tion
to
incr
ease
the
leve
l of a
war
enes
s of
goo
d nu
triti
on.
•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 i
nfor
mati
on,
educ
ation
, and
com
mun
icati
on m
ater
ials
and
m
essa
ges
to ta
rget
ben
efici
arie
s
MO
HLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, M
OES
, de
velo
pmen
t par
tner
s, C
SOs,
MFP
ED
Prom
ote
inte
grati
on o
f nu
triti
on s
ervi
ces
in a
ll ro
utine
an
d ou
trea
ch h
ealth
ser
vice
s an
d pr
ogra
mm
es ta
rgeti
ng
child
ren
and
mot
hers
.
•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 a
nd
outr
each
hea
lth s
ervi
ces
•In
crea
sed
acce
ss to
and
util
isati
on o
f nut
ritio
n se
rvic
es
MO
HLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, M
OES
, de
velo
pmen
t par
tner
s, C
SOs,
MFP
ED
Man
age
nutr
ition
for
sick
ch
ildre
n, p
regn
ant w
omen
, la
ctati
ng m
othe
rs, a
nd o
ther
w
omen
of r
epro
ducti
ve a
ge.
•In
crea
sed
acce
ss to
and
inta
ke o
f nut
ritio
us fo
ods
by
sick
chi
ldre
n, p
regn
ant w
omen
, lac
tatin
g m
othe
rs,
and
othe
r w
omen
of r
epro
ducti
ve a
ge
MO
HLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, M
OES
, M
FPED
, dev
elop
men
t par
tner
s, C
SOs
Inte
grat
e m
anag
emen
t of
seve
re a
nd m
oder
ate
acut
e m
alnu
triti
on in
to r
outin
e he
alth
se
rvic
es.
•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 e
xisti
ng h
ealth
fa
ciliti
es n
ation
wid
e•
Case
s of
sev
ere
and
mod
erat
e ac
ute
mal
nutr
ition
m
onito
red
and
follo
wed
up
on
MO
HM
GLS
D, l
ocal
gov
ernm
ents
, MO
ES, M
AA
IF,
MFP
ED, p
riva
te s
ecto
r, d
evel
opm
ent p
artn
ers,
CS
Os
32EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Prom
ote
utilis
ation
of a
nten
atal
an
d po
st-n
atal
car
e se
rvic
es
amon
g al
l pre
gnan
t wom
en a
nd
lact
ating
mot
hers
.
•In
crea
sed
num
ber
of m
othe
rs a
tten
ding
ant
enat
al a
nd
post
-nat
al c
are
serv
ices
MO
HLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, M
OES
, M
FPED
, dev
elop
men
t par
tner
s, C
SOs,
Po
pula
tion
Secr
etar
iat
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
bab
ies
•In
crea
sed
num
ber
of ‘b
aby-
frie
ndly
’ wor
kpla
ces,
co
mm
uniti
es, a
nd h
ealth
faci
lities
, bot
h pu
blic
and
pr
ivat
e •
Incr
ease
d nu
mbe
r of
em
ploy
ers
and
insti
tutio
ns/
agen
cies
impl
emen
ting
the
mat
erni
ty a
nd p
ater
nity
la
w
MO
HLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, M
OES
, de
velo
pmen
t par
tner
s, C
SOs
Prom
ote
and
supp
ort
appr
opri
ate
com
plem
enta
ry
feed
ing
prac
tices
.
•In
crea
sed
use
of d
iver
sifie
d lo
cal f
oods
for
com
plem
enta
ry fe
edin
g•
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 app
ropr
iate
co
mpl
emen
tary
feed
ing
prac
tices
•
Incr
ease
in n
umbe
r of
app
ropr
iate
com
plem
enta
ry
feed
ing
prac
tices
/ini
tiativ
es s
uppo
rted
MO
HLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, M
OES
, M
FPED
, dev
elop
men
t par
tner
s, C
SOs,
MO
ICT
Supp
ort a
nd s
cale
up
com
mun
ity-b
ased
nut
ritio
n in
itiati
ves.
•In
crea
se in
num
ber
of c
omm
unity
-bas
ed n
utri
tion
initi
ative
s su
ppor
ted
•In
crea
sed
cove
rage
of c
omm
unity
-bas
ed n
utri
tion
initi
ative
s•
Incr
ease
d le
vel o
f com
mun
ity p
artic
ipati
on a
nd
invo
lvem
ent i
n co
mm
unity
-bas
ed n
utri
tion
prog
ram
mes
MO
H/M
GLS
D/
MA
AIF
/MO
ESLo
cal g
over
nmen
ts, M
AA
IF, M
OES
, MFP
ED,
deve
lopm
ent p
artn
ers,
CSO
s, M
OIC
T
Prom
ote
prop
er fo
od h
andl
ing
hygi
ene,
and
san
itatio
n th
roug
h in
crea
sed
know
ledg
e, u
se o
f sa
fe w
ater
, and
han
d-w
ashi
ng
prac
tices
at t
he h
ouse
hold
leve
l.
•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
hou
seho
lds
MO
HLo
cal g
over
nmen
ts, M
WE,
MO
ES,
deve
lopm
ent p
artn
ers,
CSO
s, M
FPED
, MO
ICT
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
33EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
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
hea
lth a
nd
nutr
ition
issu
es•
Incr
ease
d m
ale
invo
lvem
ent i
n fa
mily
hea
lth, f
ood
secu
rity
, and
nut
ritio
n se
rvic
es a
nd p
rogr
amm
es
MG
LSD
/MO
H/
MA
AIF
MO
H, M
AA
IF, l
ocal
gov
ernm
ents
, MFP
ED,
deve
lopm
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 w
omen
, esp
ecia
lly p
regn
ant
wom
en a
nd la
ctati
ng m
othe
rs.
•In
crea
sed
awar
enes
s am
ong
husb
ands
and
oth
er
fam
ily m
embe
rs o
f ben
efits
of r
educ
ing
wom
en’s
w
orkl
oads
•In
crea
se in
sha
ring
of f
arm
and
hou
seho
ld w
ork
amon
g ho
useh
old
mem
bers
•In
crea
sed
use
of la
bour
-sav
ing
tech
nolo
gies
at t
he
farm
and
hou
seho
ld le
vels
MG
LSD
/M
AA
IFM
OH
, loc
al g
over
nmen
ts, M
FPED
, de
velo
pmen
t par
tner
s, C
SOs
Add
ress
det
rim
enta
l foo
d ta
boos
and
nor
ms
that
impa
ir
the
nutr
ition
of w
omen
, inf
ants
, an
d yo
ung
child
ren.
•In
crea
sed
know
ledg
e on
the
impa
ct o
f det
rim
enta
l fo
od ta
boos
and
nor
ms
that
impa
ir n
utri
tion
•Ch
ange
in n
egati
ve a
ttitu
des,
bel
iefs
, and
pra
ctice
s re
late
d to
nut
ritio
n•
Incr
ease
d in
take
of c
ultu
rally
pro
hibi
ted
food
s
MA
AIF
/M
GLS
DM
OH
, loc
al g
over
nmen
ts, d
evel
opm
ent
part
ners
, CSO
s
Obj
ecti
ve 2
: Enh
ance
con
sum
ption
of 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
the
hous
ehol
d le
vel.
Prom
ote
prod
uctio
n an
d co
nsum
ption
of d
iver
sifie
d nu
triti
ous
food
s at
the
hous
ehol
d an
d co
mm
unity
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 inp
uts
and
serv
ices
at t
he h
ouse
hold
and
com
mun
ity le
vels
MA
AIF
MO
H, l
ocal
gov
ernm
ents
, MG
LSD
, MFP
ED,
priv
ate
sect
or, d
evel
opm
ent p
artn
ers,
CSO
s
Adv
ocat
e fo
r an
d su
ppor
t in
tegr
ation
of n
utri
tion
in
agri
cultu
ral p
rogr
amm
es a
t the
na
tiona
l and
loca
l gov
ernm
ent
leve
ls.
•In
crea
sed
inte
grati
on o
f nut
ritio
n is
sues
in a
gric
ultu
ral
prog
ram
mes
M
AA
IF/N
PAPr
ivat
e se
ctor
, dev
elop
men
t par
tner
s, C
SOs,
M
FPED
34EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Incr
ease
con
sum
ption
of b
oth
raw
and
pro
cess
ed n
utri
tious
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
/MO
HM
TC, M
FPED
, pri
vate
sec
tor,
dev
elop
men
t pa
rtne
rs
Prom
ote
and
supp
ort l
ocal
fo
od p
roce
ssin
g an
d va
lue
addi
tion
at th
e ho
useh
old
and
com
mun
ity le
vels
.
•In
crea
sed
proc
essi
ng o
f nut
ritio
us fo
ods
at th
e ho
useh
old
and
com
mun
ity le
vels
•D
iver
sifie
d pr
oces
sed
food
pro
duct
s at
the
hous
ehol
d an
d co
mm
unity
leve
ls
MA
AIF
/MTC
Priv
ate
sect
or, d
evel
opm
ent p
artn
ers,
MO
H,
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 the
hou
seho
ld
and
com
mun
ity le
vels
.
•In
crea
sed
type
s of
labo
ur-s
avin
g te
chno
logi
es a
t the
ho
useh
old
and
com
mun
ity le
vels
•In
crea
sed
utilis
ation
of l
abou
r-sa
ving
tech
nolo
gies
at
the
hous
ehol
d an
d co
mm
unity
leve
ls
MA
AIF
/MTC
MG
LSD
, MW
E, M
EMD
, loc
al g
over
nmen
ts,
priv
ate
sect
or, d
evel
opm
ent p
artn
ers,
CSO
s
Supp
ort o
n-fa
rm e
nter
pris
e m
ix
to p
rom
ote
stab
le d
iver
sifie
d fo
od p
rodu
ction
.
•In
crea
sed
num
ber
of h
ouse
hold
s an
d co
mm
uniti
es
with
sta
ble
dive
rsifi
ed fo
od s
uppl
ies
and
inco
mes
MA
AIF
Loca
l gov
ernm
ents
, MG
LSD
, MTC
, MFP
ED,
priv
ate
sect
or, d
evel
opm
ent p
artn
ers,
CSO
s
Prom
ote
prod
uctio
n an
d co
nsum
ption
of l
ocal
in
dige
nous
food
s to
enh
ance
di
etar
y di
vers
ifica
tion.
•In
crea
sed
prod
uctio
n an
d co
nsum
ption
of i
ndig
enou
s 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 fr
om
non-
conv
entio
nal s
ourc
es
MA
AIF
MO
H, M
OES
, MW
E,M
GLS
D, d
evel
opm
ent
part
ners
, CSO
s
Prom
ote
posi
tive
indi
geno
us
diet
ary
prac
tices
.•
Die
tary
pra
ctice
s re
late
d to
indi
geno
us fo
ods
emph
asis
ed in
the
scho
ol c
urri
cula
and
nati
onal
ex
amin
ation
•In
crea
sed
appl
icati
on o
f die
tary
pra
ctice
s re
late
d to
in
dige
nous
food
s at
the
hous
ehol
d an
d co
mm
unity
le
vels
MA
AIF
MO
H, M
OES
, MW
E,M
GLS
D, d
evel
opm
ent
part
ners
, CSO
s
Stra
tegy
2.2
: Enh
ance
pos
t-ha
rves
t ha
ndlin
g, s
tora
ge, a
nd u
tilis
ation
of n
utri
tiou
s fo
ods
at th
e ho
useh
old
and
farm
leve
ls.
Prom
ote
and
supp
ort a
dopti
on
of p
ost-
harv
est h
andl
ing
and
stor
age
tech
nolo
gies
at t
he
hous
ehol
d an
d co
mm
unity
le
vels
.
•In
crea
sed
awar
enes
s an
d ad
optio
n of
app
ropr
iate
po
st-h
arve
st h
andl
ing
and
stor
age
tech
nolo
gies
MA
AIF
/MO
ESM
OH
, MTC
, MG
LSD
, dev
elop
men
t par
tner
s,
CSO
s
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
35EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
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
and
stor
age
tech
nolo
gies
.
•Cl
ear
polic
y de
velo
ped
to g
uide
and
pro
vide
in
centi
ves
to s
mal
l- an
d m
ediu
m-s
cale
pri
vate
sec
tor
play
ers
•Pr
ivat
e pl
ayer
s su
ppor
ted
to a
cqui
re e
quip
men
t,
finan
cial
sup
port
, and
infr
astr
uctu
re•
Incr
ease
in p
ublic
-pri
vate
par
tner
ship
s fo
r fo
od
proc
essi
ng a
nd s
tora
ge•
Affi
rmati
ve a
ction
pro
vide
d fo
r ge
ogra
phic
ally
m
argi
nalis
ed a
reas
MTC
/MTC
MA
AIF
, MO
ES, d
evel
opm
ent p
artn
ers,
pri
vate
se
ctor
Stra
tegy
2.3
: Pro
mot
e th
e co
nsum
ption
of n
utri
ent-
enha
nced
food
s.
Prom
ote
prod
uctio
n of
forti
fied
com
mon
sta
ples
by
loca
l m
anuf
actu
rers
.
•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
and
stre
ngth
ened
•In
crea
sed
vari
ety
of fo
rtifie
d fo
ods
•In
dust
ries
that
forti
fy fo
ods
scal
ed u
p na
tionw
ide
MO
H/M
TCU
gand
a N
ation
al B
urea
u of
Sta
ndar
ds,
ND
A, l
ocal
gov
ernm
ents
, pri
vate
sec
tor,
de
velo
pmen
t par
tner
s, C
SOs
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 n
ation
wid
e•
Food
bio
-for
tifica
tion
publ
ic-p
riva
te p
artn
ersh
ips
incr
ease
d an
d st
reng
then
ed
MA
AIF
/MTC
MO
H, l
ocal
gov
ernm
ents
, pri
vate
sec
tor,
de
velo
pmen
t par
tner
s, C
SOs
Prom
ote
cons
umpti
on o
f nu
trie
nt-e
nhan
ced
food
s th
roug
h in
crea
sed
awar
enes
s of
th
eir
bene
fits.
•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
and
cons
umpti
on o
f bio
-for
tified
fo
ods
MA
AIF
/MO
H/
MTC
Priv
ate
sect
or, d
evel
opm
ent p
artn
ers,
loca
l go
vern
men
ts
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 a
nd c
ompl
emen
tary
fo
ods
in p
lace
•Th
erap
eutic
food
s in
clud
ed o
n th
e es
senti
al d
rugs
list
•Lo
cal i
ndus
trie
s pr
oduc
ing
ther
apeu
tic a
nd
com
plem
enta
ry fo
ods
scal
ed u
p na
tionw
ide
•Pu
blic
-pri
vate
par
tner
ship
s fo
r th
erap
eutic
and
co
mpl
emen
tary
food
s st
reng
then
ed
MO
H/M
TCM
AA
IF, l
ocal
gov
ernm
ents
, Min
istr
y of
Justi
ce
and
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
36EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Obj
ecti
ve 3
: Pro
tect
hou
seho
lds
from
the
impa
ct o
f sho
cks
and
othe
r vu
lner
abili
ties
that
aff
ect t
heir
nut
riti
onal
sta
tus.
Stra
tegy
3.1
: Dev
elop
pre
pare
dnes
s pl
ans
for
shoc
ks.
Stre
ngth
en a
nd s
cale
up
earl
y w
arni
ng s
yste
ms
on fo
od a
nd
nutr
ition
info
rmati
on fr
om th
e co
mm
unity
to th
e na
tiona
l lev
el.
•Ea
rly
war
ning
sys
tem
in M
AA
IF s
tren
gthe
ned
(cap
acity
an
d eq
uipm
ent)
•N
utri
tion
info
rmati
on s
yste
m in
MO
H s
tren
gthe
ned
•N
ation
al n
utri
tion
surv
eilla
nce
syst
em e
stab
lishe
d
MO
H/M
AA
IF/
FNC
OPM
, loc
al g
over
nmen
ts, p
riva
te s
ecto
r,
deve
lopm
ent p
artn
ers,
CSO
s, a
cade
mia
Supp
ort a
nd p
rom
ote
urba
n fa
rmin
g to
ser
ve th
e m
ost
vuln
erab
le h
ouse
hold
s in
urb
an
area
s.
•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
-va
lue
ente
rpri
se in
urb
an a
nd p
eri-u
rban
are
as
MA
AIF
/MTC
MO
H, l
ocal
gov
ernm
ents
, dev
elop
men
t pa
rtne
rs, C
SOs,
pri
vate
sec
tor
Dev
elop
, pro
mot
e, a
nd
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
food
item
s to
pro
vide
dur
ing
emer
genc
ies
and
reco
very
pe
riod
s.
•Co
mpr
ehen
sive
pac
kage
of n
utri
tion
serv
ices
and
re
quir
emen
ts fo
r em
erge
ncie
s de
velo
ped
•Ti
mel
y im
plem
enta
tion
of c
ompr
ehen
sive
nut
ritio
n se
rvic
es in
em
erge
ncie
s
MO
H/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
nut
ritio
n se
rvic
es in
em
erge
ncie
s st
reng
then
ed
•N
utri
tion
pack
age
inte
grat
ed in
all
disa
ster
m
anag
emen
t pro
gram
mes
MO
H/O
PM/
MA
AIF
/MO
LGLo
cal g
over
nmen
ts, M
GLS
D, M
AA
IF, p
riva
te
sect
or, d
evel
opm
ent p
artn
ers,
CSO
s
Prom
ote
and
supp
ort
dive
rsifi
ed p
rodu
ction
of
drou
ght-
resi
stan
t cro
ps,
incl
udin
g ve
geta
bles
, and
ra
isin
g of
ani
mal
s to
lera
nt o
f he
at s
tres
s at
the
hous
ehol
d an
d co
mm
unity
leve
ls.
•In
crea
sed
prod
uctio
n of
dro
ught
-res
ista
nt c
rops
, in
clud
ing
vege
tabl
es, a
nd r
aisi
ng o
f ani
mal
s to
lera
nt
of h
eat s
tres
s
MA
AIF
MW
E, lo
cal g
over
nmen
ts, M
GLS
D, p
riva
te
sect
or, d
evel
opm
ent p
artn
ers,
CSO
s
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
37EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Carr
y ou
t sen
sitis
ation
pr
ogra
mm
es fo
r co
mm
uniti
es
to ra
ise
thei
r aw
aren
ess
of p
reve
ntion
, miti
gato
pm,
and
resp
onse
to r
isks
of
mal
nutr
ition
dur
ing
shoc
ks.
•In
crea
sed
awar
enes
s of
pro
per n
utri
tion
duri
ng s
hock
s O
PM/M
OH
/M
AA
IFM
OH
, MW
E, M
AA
IF, M
GLS
D, l
ocal
go
vern
men
ts, p
riva
te s
ecto
r, d
evel
opm
ent
part
ners
, CSO
s
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
to a
nd
supp
ort l
ivel
ihoo
ds fo
r th
e m
ost
vuln
erab
le h
ouse
hold
s an
d co
mm
uniti
es.
•In
crea
se in
vul
nera
ble
hous
ehol
ds r
ecei
ving
soc
ial
tran
sfer
s (c
ash,
food
, agr
icul
tura
l inp
uts)
M
GLS
D/
MA
AIF
/OPM
MFP
ED, l
ocal
gov
ernm
ents
, OPM
, pri
vate
se
ctor
, dev
elop
men
t par
tner
s, C
SOs
Dev
elop
and
impl
emen
t pr
ogra
mm
es fo
r sp
ecia
l soc
ial
assi
stan
ce a
nd fo
r liv
elih
ood
prom
otion
and
pro
tecti
on
in a
reas
with
hig
h le
vels
of
mal
nutr
ition
.
•Sp
ecia
l foo
d-ba
sed
prog
ram
mes
for
vuln
erab
le g
roup
s in
are
as w
ith h
igh
mal
nutr
ition
leve
ls d
esig
ned
nd
impl
emen
ted
•In
crea
sed
cove
rage
of l
ivel
ihoo
d pr
ogra
mm
es
MG
LSD
/M
AA
IFLo
cal g
over
nmen
ts, O
PM, M
OH
, pri
vate
sec
tor,
deve
lopm
ent p
artn
ers,
CSO
s
Adv
ocat
e fo
r an
d pr
omot
e sc
hool
feed
ing
prog
ram
mes
.•
Incr
ease
d aw
aren
ess
of th
e be
nefit
s of
nut
ritio
us
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
MO
ES/M
AA
IF/
MG
LSD
MO
H, l
ocal
gov
ernm
ents
, dev
elop
men
t pa
rtne
rs, C
SOs,
pri
vate
sec
tor,
MFP
ED
Man
age
case
s of
sev
ere
acut
e m
alnu
triti
on b
y in
tegr
ating
car
e in
to ro
utine
hea
lth s
ervi
ces
and
prov
idin
g fo
llow
-up
supp
ort a
nd
mon
itori
ng a
t the
hou
seho
ld
and
com
mun
ity le
vels
.
•In
crea
sed
num
ber
of h
ealth
faci
lities
with
sup
plie
s to
m
anag
e SA
M c
ases
•In
crea
sed
num
ber
of c
omm
uniti
es m
obili
zed
and
sens
itize
d on
SA
M m
anag
emen
t•
Incr
ease
d nu
mbe
r of
chi
ldre
n sc
reen
ed fo
r SA
M in
the
com
mun
ities
and
refe
rred
MO
HCS
Os,
NG
Os,
MO
ES
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
nu
triti
onM
GLS
DM
OH
, MA
AIF
, dev
elop
men
t par
tner
s
38EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Obj
ecti
ve 4
: Str
engt
hen
the
polic
y, le
gal,
and
insti
tuti
onal
fram
ewor
ks a
nd th
e ca
paci
ty to
eff
ecti
vely
pla
n, im
plem
ent,
mon
itor
, an
d ev
alua
te n
utri
tion
pro
gram
mes
.
Stra
tegy
4.1
: Str
engt
hen
the
polic
y an
d le
gal f
ram
ewor
ks fo
r co
-ord
inati
ng, p
lann
ing,
and
mon
itor
ing
nutr
ition
acti
viti
es.
Fast
-tra
ck th
e en
actm
ent o
f th
e Fo
od a
nd N
utri
tion
Bill,
w
hich
will
pro
vide
the
stat
utor
y m
echa
nism
for
esta
blis
hing
the
FNC
and
its s
ecre
tari
at.
•Fo
od a
nd N
utri
tion
Bill
enac
ted
NPA
/MA
AIF
MO
H, M
inis
try
of Ju
stice
and
Con
stitu
tiona
l A
ffai
rs, d
evel
opm
ent p
artn
ers
Revi
talis
e an
d le
galis
e th
e fu
nctio
nalit
y of
the
FNC
and
esta
blis
h its
sec
reta
riat
/co-
ordi
natin
g un
it.
•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
, MA
AIF
, NPA
, MG
LSD
, MTC
, pri
vate
se
ctor
, dev
elop
men
t par
tner
s, C
SOs
Revi
se th
e dr
aft U
gand
a Fo
od
and
Nut
ritio
n St
rate
gy to
alig
n it
with
the
prev
ailin
g na
tiona
l, re
gion
al, a
nd g
loba
l nut
ritio
n ag
enda
and
dis
sem
inat
e th
e st
rate
gy w
idel
y.
•Fo
od a
nd N
utri
tion
Stra
tegy
revi
sed
•Fo
od a
nd N
utri
tion
Stra
tegy
dis
sem
inat
ed w
idel
yFN
C se
cret
aria
tN
PA, M
TC, l
ocal
gov
ernm
ents
, pri
vate
sec
tor,
de
velo
pmen
t par
tner
s, C
SOs
Adv
ocat
e fo
r th
e en
actm
ent o
f by
-law
s an
d or
dina
nces
that
pr
omot
e nu
triti
on a
nd fo
od
secu
rity
at t
he d
istr
ict a
nd s
ub-
coun
ty le
vels
.
•By
-law
s an
d or
dina
nces
that
pro
mot
e nu
triti
on a
nd
food
sec
urity
dev
elop
ed a
nd e
nact
edFN
C/M
OLG
Loca
l gov
ernm
ents
, MO
H, M
AA
IF, M
TC, M
OES
, CS
Os,
dev
elop
men
t par
tner
s, M
FPED
Inte
grat
e nu
triti
on is
sues
in
to p
lans
and
bud
gets
at
all l
evel
s of
gov
ernm
ent b
y m
ains
trea
min
g nu
triti
on a
nd
crea
ting
vote
func
tions
for
nutr
ition
.
•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
/MFP
EDM
OH
, MA
AIF
, MTC
, MO
ES, M
GLS
D, M
WE,
M
OLG
, Pop
ulati
on S
ecre
tari
at, d
evel
opm
ent
part
ners
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
39EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Supp
ort t
he d
evel
opm
ent o
f nu
triti
on c
urri
cula
for
all l
evel
s of
edu
catio
n an
d tr
aini
ng.
•N
utri
tion
curr
icul
a in
pla
ce a
t all
leve
ls o
f edu
catio
nM
OES
Aca
dem
ia, M
OH
, MA
AIF
Adv
ocat
e fo
r es
tabl
ishm
ent
of lo
wer
- and
mid
dle-
cadr
e nu
triti
on c
ours
es in
the
educ
ation
str
uctu
re.
•Lo
wer
- and
mid
dle-
cadr
e nu
triti
on c
ours
es e
stab
lishe
dM
OES
MO
H, M
AA
IF, a
cade
mia
Revi
ew a
nd in
tegr
ate
nutr
ition
is
sues
in th
e ex
istin
g cu
rric
ula
of fo
rmal
and
non
-for
mal
ed
ucati
on a
nd in
pre
- and
in-
serv
ice
trai
ning
.
•N
utri
tion
issu
es in
tegr
ated
in c
urri
cula
MO
ESM
OH
, MA
AIF
, aca
dem
ia
Stra
tegy
4.2
: Str
engt
hen
and
harm
onis
e th
e in
stitu
tion
al fr
amew
ork
for
nutr
ition
from
the
loca
l to
the
cent
ral g
over
nmen
t lev
el.
Revi
ew th
e co
untr
y’s
curr
ent
insti
tutio
nal f
ram
ewor
k fo
r nu
triti
on a
nd im
plem
ent a
su
itabl
e on
e.
•Cu
rren
t ins
tituti
onal
fram
ewor
k re
view
ed•
Key
reco
mm
enda
tions
from
the
revi
ew im
plem
ente
dN
PA/O
PMM
OH
, MA
AIF
, MTC
, MO
ES, M
GLS
D, M
WE,
M
OLG
, Pop
ulati
on S
ecre
tari
at, d
evel
opm
ent
part
ners
Esta
blis
h an
inte
rim
mul
ti-se
ctor
al c
o-or
dina
tion
mec
hani
sm fo
r nu
triti
on
prog
ram
min
g an
d M
&E.
•M
ulti-
sect
oral
co-
ordi
natio
n m
echa
nism
in p
lace
NPA
MO
H, M
AA
IF, M
TC, M
OES
, MG
LSD
, MW
E,
MO
LG, P
opul
ation
Sec
reta
riat
, dev
elop
men
t pa
rtne
rs, C
SOs
Stre
ngth
en in
stitu
tiona
l ca
paci
ty fo
r nu
triti
on
prog
ram
min
g at
all
leve
ls in
all
sect
ors.
•N
utri
tion
foca
l per
sons
app
oint
ed o
r as
sign
ed in
ke
y m
inis
trie
s, d
epar
tmen
ts, a
nd a
genc
ies
and
loca
l go
vern
men
ts•
Nut
ritio
n co
-ord
inati
on s
truc
ture
s an
d co
mm
ittee
s at
th
e na
tiona
l and
loca
l gov
ernm
ent l
evel
s es
tabl
ishe
d
FNC
secr
etar
iat,
OPM
MO
H, M
WE,
MA
AIF
, MO
ES, M
GLS
D
40EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
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
es in
th
e co
untr
y.
Des
ign
and
impl
emen
t a
capa
city
-str
engt
heni
ng p
lan
for
nutr
ition
pro
gram
min
g at
the
natio
nal,
loca
l gov
ernm
ents
, an
d co
mm
unity
leve
ls.
•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
, and
M&
E st
reng
then
ed
•N
utri
tion
capa
city
of c
omm
unity
-bas
ed r
esou
rce
pers
ons
stre
ngth
ened
FNC
secr
etar
iat
MO
H, M
AA
IF, M
TC, M
OES
, MG
LSD
, MW
E,
MO
LG, P
opul
ation
Sec
reta
riat
, dev
elop
men
t pa
rtne
rs
Esta
blis
h a
food
and
nut
ritio
n M
&E
syst
em fo
r tr
acki
ng
perf
orm
ance
of n
utri
tion
indi
cato
rs a
nd 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•
Prog
ress
of i
mpl
emen
tatio
n an
d pe
rfor
man
ce o
f U
NA
P pe
riod
ical
ly r
epor
ted
on
FNC
secr
etar
iat
MO
H, M
AA
IF, M
FPED
, MTC
, loc
al g
over
nmen
ts,
deve
lopm
ent p
artn
ers,
MO
ICT,
aca
dem
ia
Cond
uct a
nati
onal
food
and
nu
triti
on s
urve
y to
est
ablis
h up
-to-
date
nut
ritio
n ba
selin
e m
onito
ring
indi
cato
rs.
•Ba
selin
e fo
od a
nd n
utri
tion
surv
ey c
ondu
cted
FNC
secr
etar
iat
MO
H, M
AA
IF, M
FPED
, MTC
, loc
al g
over
nmen
ts,
deve
lopm
ent p
artn
ers,
MO
ICT,
aca
dem
ia
Cond
uct p
erio
dic
dist
rict
-leve
l fo
od a
nd n
utri
tion
surv
eys
in
vuln
erab
le a
reas
and
am
ong
vuln
erab
le p
opul
ation
s.
•D
istr
ict s
peci
fic s
urve
ys c
ondu
cted
FNC
secr
etar
iat/
loca
l go
vern
men
ts
MO
H, M
AA
IF, M
FPED
, MTC
, dev
elop
men
t pa
rtne
rs, M
OIC
T, a
cade
mia
Und
erta
ke m
id-t
erm
and
end
-of
-ter
m im
pact
eva
luati
ons
of
the
UN
AP.
•U
NA
P im
pact
eva
luati
ons
cond
ucte
dFN
C se
cret
aria
tM
OH
, MA
AIF
, MFP
ED, M
TC, l
ocal
gov
ernm
ents
, de
velo
pmen
t par
tner
s, M
OIC
T, a
cade
mia
Stre
ngth
en d
istr
ict-
leve
l foo
d an
d nu
triti
on s
urve
illan
ce
syst
ems.
•D
istr
ict f
ood
and
nutr
ition
sur
veill
ance
sys
tem
s es
tabl
ishe
d an
d ca
paci
ty s
tren
gthe
ned
FNC
secr
etar
iat/
MO
H/M
AA
IF
Loca
l gov
ernm
ents
, MO
ES, M
TC, d
evel
opm
ent
part
ners
, CSO
s
Stra
tegy
4.4
: Enh
ance
ope
rati
onal
rese
arch
for
nutr
ition
.
Cond
uct f
orm
ative
rese
arch
on
best
pra
ctice
s fo
r nu
triti
on.
• F
orm
ative
res
earc
h st
udie
s on
bes
t pra
tcic
es fo
r nu
triti
on c
ondu
cted
M
AA
IF/M
OH
NPA
, aca
dem
ia, l
ocal
gov
ernm
ents
, de
velo
pmen
t par
tner
s, C
SOs,
MFP
ED
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
41EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
Rese
arch
, doc
umen
t, a
nd
diss
emin
ate
findi
ngs
on p
ositi
ve
indi
geno
us d
ieta
ry p
racti
ces.
•Po
sitiv
e in
dige
nous
die
tary
pra
ctice
s re
sear
ched
, do
cum
ente
d, a
nd d
isse
min
ated
MA
AIF
Dev
elop
men
t par
tner
s, a
cade
mia
Com
pile
food
com
posi
tion
data
for
all f
oods
con
sum
ed in
U
gand
a.
•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 a
nd
nutr
ition
res
earc
h
MO
H/M
AA
IFN
PA, a
cade
mia
, loc
al g
over
nmen
ts,
deve
lopm
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 s
cale
d up
NPA
MO
H, M
AA
IF, l
ocal
gov
ernm
ents
, MO
LG,
MG
LSD
, MO
ES, M
TC, d
evel
opm
ent p
artn
ers,
CS
Os,
aca
dem
ia
Obj
ecti
ve 5
: Cre
ate
awar
enes
s of
and
mai
ntai
n na
tion
al in
tere
st in
and
com
mit
men
t to
impr
ovin
g an
d su
ppor
ting
nut
riti
on
prog
ram
mes
in t
he c
ount
ry.
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
y.
Dev
elop
and
impl
emen
t a
nutr
ition
com
mun
icati
on
stra
tegy
.
•N
utri
tion
com
mun
icati
on s
trat
egy
deve
lope
dD
evel
opm
ent
part
ners
M
OH
, MA
AIF
, CSO
s
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
.
•A
nnua
l pol
icy
stat
emen
ts p
rodu
ced
•Q
uart
erly
pol
icy
brie
fs p
rodu
ced
MA
AIF
/MO
HN
PA, l
ocal
gov
ernm
ents
, MO
LG, M
GLS
D,
MO
ES, M
TC, d
evel
opm
ent p
artn
ers,
CSO
s
Com
mem
orat
e nu
triti
on-r
elat
ed
even
ts a
nd ta
ke a
dvan
tage
of
othe
r op
port
uniti
es ts
o ra
ise
the
profi
le o
f nut
ritio
n.
•N
ation
al, r
egio
nal,
and
inte
rnati
onal
food
and
nu
triti
on e
vent
s co
mm
emor
ated
MO
H/M
AA
IFLo
cal g
over
nmen
ts, M
OLG
, MG
LSD
, MO
ES,
MTC
, dev
elop
men
t par
tner
s, C
SOs,
MO
ICT
42EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
sEx
pect
ed O
utpu
tsLe
ad A
genc
yO
ther
Par
tici
pant
s
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
nutr
ition
com
mun
icati
on
stra
tegy
•Pr
inte
d an
d di
ssem
inat
ed s
trat
egy
Food
and
N
utri
tion
Secr
etar
iat
MA
AIF
, MO
H, M
OES
Dev
elop
and
impl
emen
t a
com
preh
ensi
ve a
nd s
usta
inab
le
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
, MA
AIF
Prod
uce
and
publ
ish
an a
nnua
l re
port
on
the
stat
e of
the
food
se
curi
ty a
nd n
utri
tion
situ
ation
in
the
coun
try.
•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
, MA
AIF
, loc
al g
over
nmen
ts, M
OLG
, M
GLS
D, M
OES
, MTC
, dev
elop
men
t par
tner
s,
CSO
s
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
43EN
D M
ALN
UTR
ITO
N N
OW
AN
NEX
II: I
mp
lem
enta
tio
n C
ost
Mat
rix
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
Obj
ecti
ve 1
: Im
prov
e ac
cess
to a
nd u
tilis
ation
of s
ervi
ces
rela
ted
to m
ater
nal,
infa
nt, a
nd y
oung
chi
ld n
utri
tion
.
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 y
oung
chi
ldre
n.
Prom
ote
and
supp
ort h
ealth
and
nut
ritio
n ed
ucati
on to
incr
ease
the
leve
l of
awar
enes
s of
goo
d nu
triti
on.
140
160
180
200
250
930
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 an
d w
omen
.20
01,
500
3,00
04,
500
6,00
015
,200
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
routi
ne h
ealth
ser
vice
s.96
71,
047
1,33
21,
879
1,59
66,
821
Prom
ote
utilis
ation
of a
nten
atal
and
pos
t-na
tal c
are
serv
ices
am
ong
all
preg
nant
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
and
supp
ort 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 th
roug
h in
crea
sed
know
ledg
e, u
se o
f saf
e w
ater
, and
han
d-w
ashi
ng p
racti
ces
at th
e ho
useh
old
leve
l.10
012
010
010
010
052
0
44EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
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
and
nor
ms
that
impa
ir th
e nu
triti
on o
f w
omen
, inf
ants
, and
you
ng c
hild
ren.
200
250
300
350
400
1,50
0
Subt
otal
– O
bjec
tive
15,
087
7,19
910
,392
13,3
9913
,706
49,7
83
Obj
ecti
ve 2
: Enh
ance
con
sum
ption
of 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
the
hous
ehol
d le
vel.
Prom
ote
prod
uctio
n an
d co
nsum
ption
of d
iver
sifie
d nu
triti
ous
food
s at
the
hous
ehol
d an
d co
mm
unity
leve
ls.
317
657
857
1,05
71,
257
4,14
6
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
the
natio
nal a
nd lo
cal g
over
nmen
t lev
els.
6075
9010
512
045
0
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 l
ocal
food
pro
cess
ing
and
valu
e ad
ditio
n at
the
hous
ehol
d an
d co
mm
unity
leve
ls.
100
500
600
700
800
2,70
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 the
ho
useh
old
and
com
mun
ity le
vels
.50
100
140
180
1,00
01,
470
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 an
d co
nsum
ption
of i
ndig
enou
s fo
ods
to e
nhan
ce d
ieta
ry
dive
rsifi
catio
n.60
7080
9010
040
0
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
45EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
Stra
tegy
2.2
: Enh
ance
pos
t-ha
rves
t han
dlin
g, s
tora
ge, a
nd u
tilis
ation
of n
utri
tiou
s fo
ods
at th
e ho
useh
old
and
farm
leve
ls.
Prom
ote
and
supp
ort a
dopti
on o
f pos
t-ha
rves
t han
dlin
g an
d st
orag
e te
chno
logi
es a
t the
hou
seho
ld a
nd c
omm
unity
leve
ls.
6010
020
030
040
01,
060
Prov
ide
an e
nabl
ing
envi
ronm
ent t
o th
e pr
ivat
e se
ctor
to m
anuf
actu
re,
mar
ket,
and
dis
trib
ute
appr
opri
ate
post
-har
vest
han
dlin
g an
d st
orag
e te
chno
logi
es.
…40
050
020
2094
0
Stra
tegy
2.3
: Pro
mot
e th
e co
nsum
ption
of n
utri
ent-
enha
nced
food
s.
Prom
ote
prod
uctio
n of
forti
fied
com
mon
sta
ples
by
loca
l man
ufac
ture
rs.
100
625
750
875
1,00
03,
350
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
thro
ugh
incr
ease
d aw
aren
ess
of th
eir
bene
fits.
2010
015
010
080
450
Supp
ort l
ocal
pro
ducti
on o
f rea
dy-t
o-us
e th
erap
eutic
and
com
plem
enta
ry
food
s.13
050
060
070
080
02,
730
Subt
otal
– O
bjec
tive
21,
227
3,77
74,
817
5,12
76,
777
21,7
26
Obj
ecti
ve 3
: Pro
tect
hou
seho
lds
from
the
impa
ct o
f sho
cks
and
othe
r vu
lner
abili
ties
that
aff
ect t
heir
nut
riti
onal
sta
tus.
Stra
tegy
3.1
: Dev
elop
pre
pare
dnes
s pl
ans
for
shoc
ks.
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 th
e co
mm
unity
to th
e na
tiona
l lev
el.
100
150
250
300
350
1,15
0
Supp
ort a
nd p
rom
ote
urba
n fa
rmin
g to
sev
e th
e m
ost v
ulne
rabl
e ho
useh
olds
in
urb
an a
reas
.50
2,10
03,
100
4,15
04,
150
13,5
50
Dev
elop
, pro
mot
e, a
nd im
plem
ent i
n a
timel
y fa
shio
n a
com
preh
ensi
ve
pack
age
of n
utri
tion
serv
ices
and
food
item
s to
pro
vide
dur
ing
emer
genc
ies
and
reco
very
per
iods
.60
120
6060
6036
0
Mak
e in
tegr
ation
of n
utri
tion
in d
isas
ter
man
agem
ent p
rogr
amm
es
man
dato
ry.
4040
4040
4020
0
46EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
Prom
ote
and
supp
ort d
iver
sifie
d pr
oduc
tion
of d
roug
ht-r
esis
tant
cro
ps,
incl
udin
g ve
geta
bles
, and
rais
ing
of a
nim
als
tole
rant
of h
eat s
tres
s th
e ho
useh
old
and
com
mun
ity le
vels
.60
4040
4040
220
Carr
y ou
t sen
sitis
ation
pro
gram
mes
for
com
mun
ities
to ra
ise
thei
r aw
aren
ess
of p
reve
ntion
, miti
gatio
n, a
nd re
spon
se to
ris
ks o
f mal
nutr
ition
dur
ing
shoc
ks.
5080
8050
5031
0
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
to a
nd s
uppo
rt li
velih
oods
for
the
mos
t vul
nera
ble
hous
ehol
ds a
nd c
omm
uniti
es.
150
2,00
03,
000
4,00
05,
000
14,1
50
Dev
elop
and
impl
emen
t pro
gram
mes
for
spec
ial s
ocia
l ass
ista
nce
and
for
livel
ihoo
d pr
omoti
on a
nd p
rote
ction
in a
reas
with
hig
h le
vels
of m
alnu
triti
on.
350
350
350
350
350
1,75
0
Adv
ocat
e fo
r an
d pr
omot
e sc
hool
feed
ing
prog
ram
mes
.40
4040
4040
200
Man
age
case
s of
sev
ere
acut
e m
alnu
triti
on b
y in
tegr
ating
car
e in
to ro
utine
he
alth
ser
vice
s an
d pr
ovid
ing
follo
w-u
p su
ppor
t and
mon
itori
ng a
t the
ho
useh
old
and
com
mun
ity le
vels
.
Prom
ote
soci
al p
rote
ction
inte
rven
tions
for
impr
oved
nut
ritio
n.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
Obj
ecti
ve 4
: Str
engt
hen
the
polic
y, le
gal,
and
insti
tuti
onal
fram
ewor
ks a
nd th
e ca
paci
ty to
eff
ecti
vely
pla
n, im
plem
ent,
mon
itor
, and
eva
luat
e nu
triti
on
prog
ram
mes
.
Stra
tegy
4.1
: Str
engt
hen
the
polic
y an
d le
gal f
ram
ewor
ks fo
r co
-ord
inati
ng, p
lann
ing,
and
mon
itor
ing
nutr
ition
acti
viti
es.
Fast
-tra
ck e
nact
men
t of t
he F
ood
and
Nut
ritio
n Bi
ll, w
hich
will
pro
vide
the
stat
utor
y m
echa
nism
for
esta
blis
hing
the
FNC
and
its s
ecre
tari
at.
3030
……
…60
Revi
talis
e an
d le
galis
e th
e fu
nctio
nalit
y of
the
FNC
and
esta
blis
h its
sec
reta
riat
/co
-ord
inati
ng u
nit.
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
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
47EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
Revi
se th
e dr
aft U
gand
a Fo
od a
nd N
utri
tion
Stra
tegy
to a
lign
it w
ith th
e pr
evai
ling
natio
nal,
regi
onal
, and
glo
bal n
utri
tion
agen
da a
nd d
isse
min
ate
the
stra
tegy
wid
ely.
…90
…11
0…
200
Adv
ocat
e fo
r en
actm
ent o
f by-
law
s an
d or
dina
nces
that
pro
mot
e nu
triti
on a
nd
food
sec
urity
at t
he d
istr
ict a
nd s
ub-c
ount
y le
vels
.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 b
y m
ains
trea
min
g nu
triti
on a
nd c
reati
ng v
ote
func
tions
for
nutr
ition
.10
012
014
014
012
062
0
Supp
ort t
he d
evel
opm
ent o
f nut
ritio
n cu
rric
ula
for
all l
evel
s of
edu
catio
n an
d tr
aini
ng.
100
125
150
175
200
750
Adv
ocat
e fo
r es
tabl
ishm
ent o
f low
er- a
nd m
iddl
e-ca
dre
nutr
ition
cou
rses
in
the
educ
ation
str
uctu
re.
100
125
150
175
200
750
Revi
ew a
nd in
tegr
ate
nutr
ition
issu
es in
the
exis
ting
curr
icul
a of
form
al a
nd
non-
form
al e
duca
tion
and
pre-
and
in-s
ervi
ce tr
aini
ng.
100
125
150
175
200
750
Stra
tegy
4.2
: Str
engt
hen
and
harm
onis
e in
stitu
tion
al fr
amew
ork
for
nutr
ition
from
the
loca
l to
the
cent
ral g
over
nmen
t lev
el.
Revi
ew th
e co
untr
y’s
curr
ent i
nstit
ution
al fr
amew
ork
for
nutr
ition
and
im
plem
ent a
sui
tabl
e on
e.
6060
……
…12
0
Esta
blis
h an
inte
rim
mul
ti-se
ctor
al c
o-or
dina
tion
mec
hani
sm fo
r nu
triti
on
prog
ram
min
g an
d M
&E.
20
2224
2628
120
Stre
ngth
en in
stitu
tiona
l cap
acity
for
nutr
ition
pro
gram
min
g at
all
leve
ls in
all
sect
ors.
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, m
onit
or, a
nd e
valu
ate
food
and
nut
riti
on p
rogr
amm
es.
Des
ign
and
impl
emen
t a c
apac
ity-s
tren
gthe
ning
pla
n fo
r nu
triti
on
prog
ram
min
g at
the
natio
nal,
loca
l gov
ernm
ent,
and
com
mun
ity le
vels
.50
6070
8090
350
Nut
ritio
n hu
man
reso
urce
cap
acity
str
engt
heni
ng p
roje
ct50
400
600
800
400
2,25
0
48EN
D M
ALN
UTR
ITO
N N
OW
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11–2
016
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
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 a
food
and
nut
ritio
n M
&E
syst
em fo
r tr
acki
ng p
erfo
rman
ce o
f nu
triti
on in
dica
tors
and
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
food
and
nut
ritio
n su
rvey
to e
stab
lish
up-t
o-da
te n
utri
tion
base
line
mon
itori
ng in
dica
tors
.50
075
095
070
068
03,
580
Cond
uct p
erio
dic
dist
rict
-leve
l foo
d an
d nu
triti
on s
urve
ys in
vul
nera
ble
area
s an
d am
ong
vuln
erab
le p
opul
ation
s.50
075
095
070
068
03,
580
Und
erta
ke m
id-t
erm
and
end
-of-
term
impa
ct e
valu
ation
of t
he 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
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 fo
r nu
triti
on.
300
400
400
500
500
2,10
0
Rese
arch
, doc
umen
t, a
nd d
isse
min
ate
findi
ngs
on p
ositi
ve in
dige
nous
die
tary
pr
actic
es.
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
food
and
nut
ritio
n in
terv
entio
ns.
5050
5050
5025
0
Colla
te a
nd s
hare
rese
arch
find
ings
and
bes
t pra
ctice
s fo
r sc
alin
g up
food
and
nu
triti
on in
terv
entio
ns in
Uga
nda.
2020
2020
2010
0
Subt
otal
– O
bjec
tive
43,
855
6,29
27,
729
8,83
68,
343
35,0
55
Obj
ecti
ve 5
: Cre
ate
awar
enes
s of
and
mai
ntai
n na
tion
al in
tere
st in
and
com
mit
men
t to
impr
ove
and
supp
ort n
utri
tion
pro
gram
mes
in th
e co
untr
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
y.
Dev
elop
and
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 fo
od s
ecur
ity a
nd n
utri
tion
situ
ation
. 50
5865
7380
325
Uga
nda
Nut
riti
on A
ction
Pla
n 20
11-2
016
49EN
D M
ALN
UTR
ITO
N N
OW
Inte
rven
tion
s
USh
s m
illio
ns
2011
–12
2012
–13
2013
–14
2014
–15
2015
–16
TOTA
L
Com
mem
orat
e nu
triti
on-r
elat
ed e
vent
s an
d ta
ke a
dvan
tage
of o
ther
adv
ocac
y ev
ents
.30
037
545
052
560
02,
250
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 n
utri
tion
com
mun
icati
on s
trat
egy.
Dev
elop
and
impl
emen
t a c
ompr
ehen
sive
and
sus
tain
able
nut
ritio
n ad
voca
cy
plan
.1,
000
1,00
01,
000
1,00
01,
000
5,00
0
Prod
uce
and
publ
ish
an a
nnua
l rep
ort o
n th
e st
ate
of th
e fo
od s
ecur
ity a
nd
nutr
ition
situ
ation
in th
e co
untr
y.50
100
120
140
160
570
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
50 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016
ANNEX III: Reviewed Documents
African Union. 2005. Africa Regional Nutrition Strategy, 2005–2015.
Food and Agriculture Organization (FAO). 2008. The State of Food Insecurity in the World 2008.
Food and Nutrition Technical Assistance II Project. 2010. Analysis of the Nutrition Situation in Uganda.
Government of Uganda. 2003. The Uganda Food and Nutrition Policy.
———. 2004. The Uganda Food and Nutrition Strategy and Investment Plan. Draft.
Horton, S. et al. 2010. Scaling Up Nutrition Roadmap: What Will It Cost?
MOH. 1999. The Health Policy of Uganda.
———. 2010. Health Sector Strategic Plan (HSSP III). Draft.
———. 2010. The Five-Year Maternal, Infant and Young Children Nutrition Action Plan 2010–2015.
NPA. 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.
Uganda Action for Nutrition. 2010. Malnutrition – Uganda is paying too high a price. Advocacy briefs.
51END MALNUTRITION 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 Authority
Prof 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 Authority
Ms Julia Tagwireyi Senior Nutrition Advisor to Country Director
World Food Programme
Mr Geoffrey Ebong Programme & Policy Advisor World Food Programme
Dr Robert Mwadime Regional Senior Nutrition Advisor Food and Nutrition Technical Assistance II Project
Ms Namugumya Brenda Shenute
Public Nutrition Specialist Regional Centre for Quality of Health Care
Dr Elizabeth Madraa Stakeholder Ministry of Health
Mr Todd Benson Senior Research Fellow International Food Policy Research Institute
Ms Agnes Chandia Baku Acting Head, Nutrition Unit Ministry of Health
Mr Bambona Alex Head, Home Economics and Nutrition Section
Ministry 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 Fund
Ms Beatrice Okello Technical Officer Food and Agriculture Organisation
Dr Geoffrey Bisoborwa Technical Officer World Health Organisation
Daniel Mugulusi Under Secretary Ministry of Gender, Labour and Social Development
Elizabeth Imagara Principal Policy Analyst Ministry of Local Government
Nancy Adero Nutritionist/Dietician World Food Programme
Mr Alex Mokori Public Nutrition Specialist Regional Centre for Quality of Health Care
52 END MALNUTRITION NOW
Uganda Nutrition Action Plan 2011–2016