the republic of uganda uganda nutrition action … 1. uganda nutrition...this action plan to address...

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

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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

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LIST OF FIGURESFigure 1. Malnutrition’s Impact on Productivity during the Life Cycle and across Generations 2Figure 2. Prevalence of Stunting, Underweight, and Wasting among Young Children in Uganda, by Age in Months 3Figure 3. National Trends in the Prevalence of Malnutrition among Children under 5 7Figure 4. 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

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Foreword

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

Adequate nutrition is a prerequisite for human development and socioeconomic well-being. The Government of Uganda is committed to fulfilling the constitutional obligation of ensuring food and nutrition security for all Ugandans. This 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.

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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

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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,

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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 …………………….

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Acronyms and Abbreviations

BMI Body mass indexCAADP Comprehensive Africa Agriculture Development ProgrammeCSO Civil Society OrganisationFNC Food and Nutrition CouncilHIV Human Immunodeficiency 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

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Executive Summary

Nutrition plays a crucial role in the socioeconomic development of any country. Malnutrition accounts for about 35 percent of deaths among children under 5 years old around the world. Stunting, severe wasting, and intrauterine growth retardation are the major contributors to child mortality, accounting for about 2 million deaths annually. Malnutrition is the major cause of morbidity for all age groups, accounting for 11 percent of the disease burden globally. In addition, iron deficiency is the leading cause of maternal mortality, accounting for 20 percent of the estimated 536,000 deaths worldwide. About 43 percent of all deaths among children under 5 occur in Africa. According to the Uganda Demographic and 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

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• Increase national economic productivity, both physical and intellectual, by about UShs 130 billion per year at present value

• Provide a strong return on public investment: For every UShs 1,000 invested, about UShs 6,000 worth of increased productivity will result from reduced child stunting, improved maternal health, enhanced micronutrient intake, and improved nutrition care

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

The 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.

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PART I: OVERVIEW

1. Introduction

Malnutrition is a major development concern in Uganda, affecting all regions of the country and most segments of the population. The current levels of malnutrition hinder Uganda’s human, social, and economic development. Although the country has made tremendous progress in economic growth and poverty reduction over the past 20 years, its progress in reducing malnutrition remains very slow. The ultimate objective of the Uganda Nutrition Action Plan (UNAP) is to ensure that all Ugandans are properly nourished so 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.

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• 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



Higher maternal mortality

Inadequate foetal nutrition

Inadequate infant nutrition

lower educational attainment,

restricted economic potential,

shortened life

Reduced physical labour capacity,

lower educational attainment



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

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Note: Includes children below -2 standard deviations from the WHO Child Growth Standards UDHS 2006

Wasted Underweight

The window of opportunity outside the womb



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



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.



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.



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

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2001

2006



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.



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:



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.



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




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




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



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



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.



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.



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.



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.



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.



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.



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



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.



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.



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,



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



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



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.



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



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.



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

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4



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.



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