LAMWO

KITGUM

NWOYA

AMURU

GULU

PADER

AGAGO

KOBOKO

ARUA

ADJUMANI

ZOMBO

YUMBE

MOYO

NEBBI

MARACHA

OYAM

OTUKE

KOLE

ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSEPADER DISTRICT LOCAL GOVERNMENT

CALL TO ACTIONNUTRITION GOVERNANCE AREA

CHALLENGES/ GAPS CALL FOR ACTION RESPONSIBLE OFFICE

Coordination and partnerships:

Weak coordination of multi-sectoral nutrition activities in the district and LLG level.

Establish joint planning and strategic coordination mechanisms amongst partners with the district to reduce on duplication of resources and achieve sustainable results.

CAO/ DNFP

Delayed implementation of nutrition activities in the district

Creating a schedule/ calendar of events and timely invitations for nutrition activities in the district.

DNFP

Systems capacity Building (functional, institutional and Human capacities)

Lack of clarity on nutrition sensitive programming for the non-traditional departments (CBS, Education, Production)

Conduct in service training on nutrition sensitive programming to the following service departments (Production, Education and CBS)

DNFP, CFO

Policy development, implementation and legal framework

Limited awareness on available policies, guidelines that support Multisectoral nutrition action

Support the wide dissemination of sectoral(departmental)policies and guidelines such as National Health Policy (NHPII), Health Sector Development Plan (HSDP II) 2015/16–2019/20, Integrated Early Childhood Development (NIECD) Policy (2016) , Presidential Initiative on healthy eating and healthy lifestyles (July, 2019) National Agriculture Policy (NAP) of 2013 and the Agriculture Sector Strategic Plan (2015/16-2020/20) and Food Security Strategy, the Education Sector Strategic Plan (ESSP) (20017-2020) and Guidelines on Parent led School Feeding and Nutrition (2012),the Social Development Sector Plan (2015/16 - 2019/20),the National Community Development Policy for Uganda (2015) and the Water and Environment Sector Development Plan (2015/16-2019/20) and the UNAP during joint multisectoral forums with the DNCC and IPs in the district

DNFP, CAO, DEO, DCDO, DHO, DPO

DNAP not well aligned to the District Development Plans 2020-2025.

District should align the DNAP 2020-25 with the Pader DDP III and UNAP II

District Planner

Information management (monitoring, evaluation, surveillance and research)

Lack of harmonized reporting tools on multi-sectoral nutrition programming

Support wide roll out of the Nutrition Governance SOPs and other related tools in all the departments in the district.

District Planner, DNFP

Lack of a district-based nutrition dash board to collect multi-sectoral nutrition information to be used by DNCC/SNCC for nutrition programming.

District should advocate for creation of a nutrition dash board to collect multi-sectoral nutrition information to be used by DNCC/SNCC for nutrition programming.

DNFP, CAO

Communication (for Nutrition behavior change and practice)

Sedentary lifestyle of men in the community

Nutrition and health education to the community on benefits of physical activity. Identifying and use of Nutrition champions for positive behavior change

DNFP, DHO

Advocacy (for planning, budgeting and resource mobilization)

Lack of explicit budgets allocated for nutrition actions /interventions.

Conducting a budget expenditure analysis to identify available and funding gaps for nutrition actions.

CFO, District Planner

Low funding for multi-sectoral nutrition governance.

Pader District Nutrition coordination committee (DNCC), 18 Sub counties and three (3) Town councils trained on multi sectoral nutrition implementation for improved nutrition outcomes.

The district conducted quarterly DNCC meetings and support supervision activities aimed at strengthening the accountability framework for Multisectoral nutrition actions implemented in Pader district.

Systems capacity building (functional, institutional and Human capacities)

The District Nutrition Coordination Committee of Pader district developed a District Nutrition Action Plan (DNAP) aligned to the Uganda Nutrition Action Plan II. The DNAP was also approved by the District Council.

A total of 15 staff members of District Nutrition Coordination Committee (DNCC) and 240 technical staffs from 18 sub-counties and 3 Town councils were trained on development of SNAPs.

DNCC/SNCCs to develop nutrition action plans (DNAPs/SNAPs 2020-2025) and advocate for approval by district/sub county councils.

Policy development, implementation and legal framework

The District Nutrition Coordination Committee of Pader district developed a District Nutrition Action Plan (DNAP) aligned to the Uganda Nutrition Action Plan II. The DNAP was also approved by the District Council.

All the 18 sub counties and 3 Town councils were supported to develop Sub-County Nutrition Action Plans (SNAPs) and these were approved by their respective councils

A Multi-Sectoral Nutrition Annual Workplan (FY 2019/20) was developed and approved through the office of the Chief Administrative Officer (CAO) to ensure implementation of Nutrition actions in the district.

Information management (monitoring, evaluation, surveillance and research)

Pader district was supported carry out a Nutrition Causal Analysis (NCA) to understand the food and nutrition security situation and to

explore the causal pathways for malnutrition in the district. Data from the NCA will be/ is being used to support program implementation.

Pader was also supported to conduct a Food Security and Nutrition Assessments (FSNA). FSNA data was not available previously unavailable therefore this first FSNA data will be used as a baseline to compare progress in achievement of health, nutrition and WASH indicators in subsequent FSNAs. Bi-annual FSNAs will be conducted to assess annual progress.

The Pader DNCC has been trained on nutrition governance and supported to use reporting templates and monitoring tools previously developed as part of the Standard Operating Procedures for nutrition governance. The reporting templates and monitoring tools are currently in use by the district for program implementation.

Financial and resource mobilization

A costed Multi-Sectoral Nutrition Annual Workplan (FY 2019/20) was developed and approved through the office of the Chief Administrative Officer (CAO) to ensure implementation of Nutrition actions in the district.

The Pader District Nutrition Action Plan ((2020-2025) to support the implementation of multisectoral nutrition actions was approved by the District Council.

A total of 18 sub counties and three town council all had their Nutrition Action plans approved by their respective councils. Activities from their workplan are being implemented in the district.

Communication for nutrition social behavior change and Advocacy

A total of 52 PDCs, FAL Instructors and Community Development officer were trained on Key Family Care Practices (KFCPs) as change agents for nutrition to enhance their ability to implement and supervise Multisectoral nutrition actions at sub county/ Town Council level.

FAL Instructors were trained on Key Family Care Practices as change agents for nutrition through integration of nutrition messages in their curriculum.

DISTRICT PROFILEPader District is situated in Northern Uganda, Acholi sub-region between longitudes 33 degrees West and 34 Degrees East and latitude 20 degrees South and 40 Degrees North. The District is bordered by Kitgum District in the North, Agago District in the East, Omoro District in the West, Oyam District in the Southwest and Lira District in the South.

Pader District has 1 County (Aruu) with two constituencies of Aruu and Aruu North; 3 Town Councils; 18 Sub-Counties; 64 Parishes and 650 Villages. The 2014 National Population and Housing Census estimated the district population at 189,600. Agriculture is the main backbone of the district and cash crops grown mainly include; cotton, ground nuts, sun flower, rice, tobacco, soya beans and simsim.

DEVELOPMENT INITIATIVEFOR NORTHERN UGANDA

EUROPEAN UNION

POPULATION 189,600

18 SUB-COUNTIES3 TOWN COUNCILS

64 PARISHES650 VILLAGES

Source: Uganda National Population and Housing Census 2014

Women of reproductive age 15-49 years

38,299

Pregnant women expected

9,480

Infants <1 year

8,153

Orphans <18 years

15,244

Children below 18 years

104,470

Adolescents 10-24 years

65,981

Children under 5 years

33,559

This publication was produced with the financial support of the European Union. Its contents are the sole responsibility of UNICEF and do not necessarily reflect the views of the European Union.

THE REPUBLIC OF UGANDA

35%12%

NUTRITION GOVERNANCE ACTIVITIES SUPPORTED IN THE DISTRICTCoordination and Partnerships

Stakeholder mapping: Pader District Local Government has 5 stakeholders either overseeing or implementing Nutrition specific and sensitive interventions as well as and creating an enabling environment for Nutrition implementation within the district. In total, one is for Nutrition specific, 2 for Nutrition sensitive and 2 stakeholders for specific, sensitive and governance interventions.

INTERVENTIONS TARGET GROUP PADER

Promote, protect and support breast feeding Pregnant and lactating womenAdolescents Girls (10-19Yrs)

Promote age appropriate complementary feeding practises

Mothers / caregivers 50%

Promote optimal nutrition Children with special needs 0-11 months

Promote adolescent nutrition Adolescents (Boys & Girls)

Vitamin A supplementation to children Children 0-59 months, postpartum women 100%

Iron and Folic supplementation Pregnant women (15-49) 75%

Outpatient management of acute malnutrition Children 0-59 months, Pregnant women (15-49) 25%

Inpatient management of acute malnutrition Children 0-59 months, Pregnant women 25%

Management of moderate acute malnutrition (MAM)

Children 0-59 months 25%

Provide deworming tablets to children (1-14yrs) Children 12-59 months 75%

Deworming for pregnant women Pregnant women (15-49yrs) 100%

IPT of malaria (IPT and IPTs2) for Pregnant women Pregnant women (15-49yrs) 50%

Diahorrea with ORS & Zinc Children 0-59 months 55%

Long lasting insecticide treated nets (LLINs) Pregnant & Lactating women, Children 75%

Treatment of malaria All 75%

Recommended vaccines in the national schedule by recommended age

Children 0-59 months, Pregnant women 50%

Promote PMCT /EMCT of HIV Pregnant & Lactating mothers 15-49years with HIV 75%

Provide ARV medication All HIV +VE incld Pregnant & Lactating mothers 60%

Diet therapy into routine disease therapy Children 12-59 months with special needs

<14 interventions 15 - 19 interventions > 20 interventions

NUTRITION, WASH AND HEALTH STATUS OF THE DISTRICT

WASH STATUS

VIT A SUPPLEMENTATION (12-23mo)IMMUNISATION (DPT3)

DEWORMING (12-23 mo)

LATRINE COVERAGE SAFE WATER ACCESS

HEALTH INDICATORS

13% 2%Malaria Diarrhea

NUTRITION GOVERNANCE

WHAT IS NUTRITION GOVERNANCE AND WHY IS IT IMPORTANT?Good nutrition governance entails making adequate policy decisions in a timely manner, committing the necessary financial and organizational resources to their effective implementation, i.e. ensuring that benefits reach most of the population, preferably the most vulnerable. It also entails a sustained political commitment to ensure that nutrition programs and policies can withstand threats and constraints from changes in district leadership, political and socioeconomic upheavals (Solon 2007).

60%96%

56%

68% 81%

80%70%

100%

80% 87%

Desired situation (2025)

Desired situation (2025)

Desired situation (2025)

Desired situation (2025)FSNA baseline (2019)

FSNA baseline (2019)

FSNA baseline (2019)

FSNA baseline (2019)

INFANT AND YOUNG CHILD FEEDING PRACTICES

STUNTING

WASTING

Min. acceptable diet

Continued breast feeding (2yr)

Min. diet diversity (6-23mo)

Exclusive breast feeding

Min. meal frequency

Breast feeding within first 1 hour

LOW BIRTH WEIGHT

ANAEMIA IN WOMEN

ANAEMIA IN CHILDREN

23%

4%

3%

49%

11%

71%

25%

49%

6%

20%

4%

80%

40%

80% 80%

65%25%

10%

NUTRITION STATUS

60% 46%of households are food insecure

of households have food stocks 20%

40%40%

Nutrition specific

All interventionsNutrition specific

5 STAKEHOLDERS

overseeing / implementing interventions

PolicyFrameWorks

TechnicalCapacity

Stakeholders

Sustainable Funding

Intersectoral Cooperation

VerticalCoordination

NutritionOutcomes

Monitoring Ad

voca

cy

PILLARS OF GOVERNANCE

Syst

em C

apac

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uild

ing

Info

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ion

Man

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ent

Fina

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l and

Reso

urce

Mob

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tion

Com

mun

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(Nut

ritio

n Be

havi

or C

hang

e. A

dvoc

acy)

Coor

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and

Part

ners

hip

Polic

y an

d le

gal

Fram

e w

ork

NUTRITION GOVERNANCE FRAMEWORK

Source: Institute of Development studies (IDS), 2013 Source: Nutrition Stakeholder Mapping for Uganda Report. 2019

PADER DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS

Angagura

LagutiAcholibur

Latanya

Pajule

Ogom

Pader TCLapul

Pader

Puranga

Awere

Atanga

Source: Food Security and Nutrition Assessment in 10 districts of Northern Uganda and West Nile 2019, Makerere University School of Public Health.

Common childhood illnesses in Pader district include;