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CALL TO ACTION THE REPUBLIC OF District Nutrition coordination structure, A Link Nutrition Causal Analysis was NUTRITION CHALLENGES/ GAPS CALL FOR ACTION RESPONSIBLE OFFICE the 7 Sub Counties (Ngoriet, Iriri, Lokopo, conducted to establish the various causal GOVERNANCE AREA Lotome, Matany, Lopeei, ), and 3 pathways for malnutrition in the district. The Coordination and Lack of updated department Through office of CAO, support CAO, NFP, NCC Town Councils (Matany, Kangole, Lorengecora) information generated from this study is partnerships: operation plans departments to come up with bi NAPAK DISTRICT LOCAL GOVERNMENT trained in multi sectoral nutrition implementation important in designing context specific nutrition annual or annual operation plans ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSE for improved nutrition outcomes. interventions in the districts and formulate inclusive of partner activities that customized action plans. clearly deliberate on Multisectoral Supported the district to conduct quarterly interventions District Nutrition Coordination Committee A Stakeholder Mapping and Capacity Systems Lack of clarity on nutrition sensitive Conduct in service training on CAO, PHRO, NCC meetings, and, joint monitoring and support Assessment exercise was conducted to capacity Building programming for the nontraditional nutrition sensitive programming to supervision activities to LLGs aimed at examine institutional arrangements and capacity (functional, departments (Community Based critical staff from key nontraditional strengthening the accountability framework for to plan, budget and manage the multi-sector institutional and Services, Education, Production, departments. Multisectoral nutrition actions implemented in nutrition programs in the district. Human capacities) Natural resources) the district. Policy and legal Low capacity of DLGs to interprete Provide technical support and on CAO, NCC, MOLG Annual briefs (Technical and Advocacy) have framework and implement the relevant legal job training to key decision makers A Multi-Sectoral Nutrition Annual Workplan been developed from relevant studies conducted policy and planning frameworks on the various legal, planning (FY 2019/20) was developed by the DNCC to guide the strategic coordination, planning, frameworks and how they impact and subsequently approved through the office budgeting, implementation and monitoring of on nutrition. of the Chief Administrative Officer to guide both nutrition specific and nutrition sensitive Limited or no dissemination of Disseminate to the DLG and LLG implementation of Nutrition actions in the interventions in the district, LLGs, and the legal, policy and planning cadres with regular updates on district. communities. frameworks to district and Lower current Legal, Policy and Planning Local Government Level frameworks during covenings or Through the DINU funding, the district (Nutrition any other platform available Secretariat) received a laptop and motorbike to Financial and resource mobilization enhace/ better the planning, implementation and Technical and financial support provided to Information Poor reporting mechanisms Support provision and orientation CAO, NCC, NFP management (departments) against nutrition of key department cadres on the monitoring of multi sectoral interventions in the the district in terms of logistics in the various (monitoring, actions at district level application and use of reporting district. trainings and studies aimed at improving the evaluation, tools to foster their use for records Systems capacity Building (functional, ability and capacity of the district to better surveillance and and analysis. coordinate, plan, budget, implement and monitor research) institutional and Human capacities) Poor appreciation of relevant Provide technical assistance for CAO, NCC, SAS, MOYO both nutrition specific and nutrition sensitive Capacity of the respective coordination nutrition evidence based data research and analysis to support NFP PROFILE LAMWO interventions to communities. generated at district and Lower generation of evidence to YUMBE POPULATION 266,800 structures built to plan, budget, implement, and Local Government levels. monitor Multisectoral nutrition actions. All the developed Nutrition Action Plans and better understand the linkages Napak District Local Government is located in Mid Annual workplan were costed and funding gaps between nutrition and other non- North - Eastern Uganda. It shares boarders with 154,211 27,048 Members of the DNCC were trained in Nutrition established to provide a basis for a resource traditional departments 6 districts namely: Kotido in the North, Abim and children <18 years households Governance as well as Nutrition Action Planning mobilization plan as well as, to strategically Finance and Poor mechanisms for district Strengthen upward and downward CAO, DNCCs, SAS, Otuke in the North West, Katakwi in the West, KITGUM for the five-year period in an effort to streamline Resource Multisectoral coordination and accountability mechanisms by PC MARACHA ADJUMANI facilitate efficient and effective finance planning, Amuria in the south west, Moroto in the East and Infants Women of reproductive mobilization) Multisectoral nutrition activities at DLG level. monitoring and liquidation of Multisectoral accountability towards set implementing recommendations Nakapiripirit in the South. The district lies between <1 year age 15-49 years deliverables nutrition interventions. latitudes 1o53’N, 3o05’N and Longitudes 33o38’E, 9,072 53,894 Policy development, implementation and Lack of budget allocations across Strengthen capacities of mandated CAO, LC5, Finance 34o56’E. It has a total area of 4,978 square legal framework sectors to scale up high impact local government units to efficiently committee for Children People with Communication for nutrition social behavior kilometers. By 2018 the population projection (fromAMURU Multisectoral nutrition actions. mobilise and equitably allocate and Council, HODs, NFP ARUA under 5 years PADERdisabilities >2 years A Five-year Napak District Nutrition Action Plan change and Advocacy utilise local revenue and resources 2014 census profiles) was 266,800 of which 154,211 (DNAP) approved (2020-2025) by the District are children below 18 years of age. 50,692 21,078 AGAGO 369 PDCs were trained on Key Family Care Communication Lack of social communication Provide technical support to CAO, NFP, DNCC council for operation as a district guide regarding Practices as change agents for nutrition (for Nutrition and marketing interventions the district to build and use The district has 7 sub counties 3 town council and GULUChildren Formal education level multi sectoral nutrition programming. behaviour change implemented at DLG, LLG and Technology-Driven Platforms, such 634 VHTs were trained on Key Family Care 35 parishes. The district is endowed with 1 hospital 6-12 years of household head and practice) community level to address the as community participatory videos, (NGO established), 6 HC III, and 7 HC IIs. Only Information management (monitoring, Practices as change agents for nutrition issue of Low Dietary Diversity IEC materials, applications, and 60,831 24.4% 43% of the Households are 5 km or more to the 15.6% Primary, O’level 5.7%, Other 3.1% evaluation, surveillance and research) 9 Community Development officer were social networking to empower local communities and frontline workers nearest health facility (whether public or private). trained on Key Family Care Practices as change NWOYA A baseline Food Security and Nutrition and to create home-grown nutrition ZOMBO 65+ years agents for nutrition to enhance their ability to The district also has 11 primary schools, and 29 Source: Uganda National Population Assessment was conducted in Napak, key champions that will advocate OTUKE implement and supervise Multisectoral nutrition against malnutrition and poor ECD centres. 10,672 and Housing Census 2014 findings of which have been used to inform NEBBI actions at sub county/ Town Council level. behavioural practices that lead to nutrition programming. The study will be OYAM malnutrition KOLE conducted annually to assess progress on key 33 FAL Instructors were trained on Key Family indicators for evidence based programming. Care Practices as change agents for nutrition This publication was produced with the financial support of the European Union. Its contents are the sole responsibility through integration of nutrition messages in of UNICEF and do not necessarily reflect the views of the European Union. DEVELOPMENT INITIATIVE their curriculum. FOR NORTHERN UGANDA EUROPEAN UNION NUTRITION GOVERNANCE ACTIVITIES SUPPORTED IN THE DISTRICT A stakeholder and mapping exercise was conducted where it was found that, Napak District Local Government has 40 stakeholders either overseeing or implementing Nutrition specific and sensitive interventions as well NUTRITION, WASH AND HEALTH STATUS OF THE DISTRICT as and creating an enabling environment for Nutrition implementation within the district. In total, 8 (20%) are for Nutrition specific, 25 (62.5%) are in Nutrition sensitive and 3 (8%) are for both Specific and sensitive interventions and 4 (10%) implement all the 3(8%) including governance interventions. FSNA baseline (2018) Desired situation (2025) FSNA baseline (2018) Desired situation (2025) NUTRITION STATUS HEALTH INDICATORS NAPAK DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION 20% SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS Common childhood illnesses in Napak district include; Nutrition specific of households of households Acute 55% are food insecure 36% have food stocks Respiratory 29% Malaria 16% Diarrhea 36% Infections 40 Lopei LOW BIRTH WEIGHT 8% Lokopo Ngoleriet Governance STAKEHOLDERS overseeing / implementing 22.6% Matany IMMUNISATION (DPT3) VIT A SUPPLEMENTATION (12-23mo) interventions 10% Lorengecora STUNTING 10% Lotome 74% 69.3% All interventions Napak TC <=14 interventions 35.8% ANAEMIA IN WOMEN 70% 80% Iriri 20% 8% 62.5% 15 - 19 interventions 36% Nutrition specific Nutrition sensitive >=20 interventions 12% & sensitive DEWORMING (12-23 mo) WASTING ANAEMIA IN CHILDREN 80.3% Source: Food Security and Nutrition Assessment in 8 INTERVENTIONS TARGET GROUP NAPAK 8.6% 100% districts of Karamoja 2018, Makerere University School Scale up coverage of optimal breast feeding practices Pregnant and lactating women, 44% of Public Health. Adolescents Girls (10-19Yrs) 4% 25% Promote infant and young child feeding practises Mothers / caregivers 50% Promote optimal nutrition Children with special needs 0-11 months NUTRITION GOVERNANCE Promote appropriate adolescent nutrition Adolescents (Boys & Girls) INFANT AND YOUNG CHILD FEEDING PRACTICES FSNA baseline (2018) Desired situation (2025) Scale up and sustain effective coverag5e Vitamin A Children 6-59 months, postpartum women 100% supplementation to children 6-59months Min. acceptable diet Min. diet diversity (6-23mo) Min. meal frequency WHAT IS NUTRITION GOVERNANCE AND WHY IT IS IMPORTANT FOR NUTRITION OUTCOMES Iron and Folic supplementation to pregnant Pregnant women (15-49) 75% Good nutrition governance entails making adequate policy decisions in a timely manner, committing the necessary Outpatient management of acute malnutrition without medical Children 0-59 months, Pregnant women (15-49 ) 25% 30% 9.5% 2.8% complication financial and organizational resources to their effective implementation, i.e. ensuring that benefits reach most of the 40% population, preferably the most vulnerable. It also entails a sustained political commitment to ensure that nutrition Inpatient management of acute malnutrition with medical Children 0-59 months, Pregnant women 25% complication programs and policies can withstand threats and constraints from changes in district leadership, political and Management of moderate acute malnutrition (MAM) Children 0-59 months socioeconomic upheavals (Solon 2007). Continued breast feeding (2yr) Exclusive breast feeding Breast feeding within first 1 hour Provide deworming tablets to children (1-14yrs) Children 12-59 months 70% 65% 97% 74.2% NUTRITION GOVERNANCE FRAMEWORK Deworming for pregnant women Pregnant women (15-49yrs) 100% Intermittent Prevention Treatment of malaria (IPT3???) for Pregnant Pregnant women (15-49yrs) 75% 80% 80% 80% women PILLARS OF NUTRITION GOVERNANCE Scale up and sustain effective coverage of ORS-Zinc for diahorrea Children 0-59 months 55% Scale up and sustain coverage of long lasting insecticide treated Pregnant & Lactating women, Children 55% Intersectoral Cooperation nets (LLINs) FSNA baseline (2018) Desired situation (2025) WASH STATUS Treatment of malaria All 75% Policy Technical Sustain universal coverage of available routine immunization Children 0-59 months, Pregnant women 50% Frame Sustainable Funding Capacity Nutrition services Works Outcomes

Monitoring Promote EMCT services Pregnant & Lactating mothers 15-49years with 75%

Partnership HIV

Stakeholders Building Frame work Information

Vertical Financial and Communication Management Coordination and

Coordination Policy and legal System Capacity Provide ARV medication to HIV+Ve All HIV +VE incld Pregnant & Lactating mothers 70% Resource Mobilization 15-49years with HIV LATRINE COVERAGE SAFE WATER ACCESS Advocacy

(Nutrition Behavior Change. Advocacy) Diet therapy into routine disease therapy Children 12-59 months with special needs 60% 81% Prevention and Management of diet-related NDCs Women of reproductive age 15-49yrs 25% 80% 87% Source: Institute of Development studies (IDS), 2013 Source: Nutrition Stakeholder Mapping Report for Uganda (OPM, 2019)