CALL TO ACTION THE REPUBLIC OF NUTRITION CHALLENGES/ GAPS CALL FOR ACTION RESPONSIBLE Nutrition coordination committee Otuke was also supported to conduct a Food GOVERNANCE AREA OFFICE (DNCC), seven (7) Sub counties and One Security and Nutrition Assessments (FSNA). OTUKE DISTRICT LOCAL GOVERNMENT Coordination and Weak coordination mechanisms of Partner mapping required to know who DNFP, CAO Town council trained on multi sectoral nutrition FSNA data was not available previously partnerships: nutrition actions at all levels. is where and doing what. DNCC/SNCC ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSE implementation for improved nutrition unavailable therefore this first FSNA data will members need to be oriented on their outcomes. be used as a baseline to compare progress roles and responsibilities in achievement of health, nutrition and WASH The district conducted quarterly DNCC meetings Establish joint planning and strategic indicators in subsequent FSNAs. Annual FSNAs and support supervision activities aimed at coordination mechanisms amongst will be conducted to assess annual progress. strengthening the accountability framework for partners in the district to reduce on Multisectoral nutrition actions implemented in The Otuke DNCC has been trained on nutrition duplication of resources and achieve sustainable results Otuke district. governance and supported to use reporting templates and monitoring tools previously Systems capacity Lack of clarity on nutrition sensitive Orientation of non-traditional DNFP, CAO Systems capacity building (functional, developed as part of the Standard Operating Building (functional, programming for the non-traditional departments on nutrition sensitive institutional and Human capacities) Procedures for nutrition governance. The institutional and departments (CBS, Education, approaches/actions for-example reporting templates and monitoring tools are Human capacities) Production and others) training in nutrition sensitive agriculture Otuke district local government was supported and School feeding guidelines to currently in use by the district for program to build the capacity of the coordination ensure their implementation in the implementation. structures at district level and respective lower district. local governments to plan, budget, implement, The DNCC, SNCC and TNCC conduct monthly Policy development, Otuke DNAP not well aligned to the District should align the DNAP 2020-25 District Planner and monitor multisectoral nutrition actions. monitoring and supervision visits and quarterly implementation and District Development Plans 2020-2025. with the Otuke DDP III (2020-2025) meetings to assess progress of program legal framework A total 15 staff members of District Nutrition implementation. Limited awareness on available Support wide dissemination of DNFP Coordination Committee (DNCC) were trained policies, guidelines that support sectoral(departmental)policies to develop their DNAPs while of 135 technical Multisectoral nutrition action. and guidelines such as the newly Financial and resource mobilization staffs from 7 sub-counties and one Town council developed SOPs and the UNAP during were trained on development of SNAPs. The DNCC was supported to develop annual joint multisectoral meetings with the DNCC/ SNCC and IPs in the district workplans for implementation of multisectoral DISTRICT PROFILE DNCC/SNCCs to develop nutrition action plans nutrition actions. The 2019/2020 annual workplan Information Lack of nutrition governance resource Provide reporting and supervision District Planner, (DNAPs/SNAPs 2020-2025) and advocate for Otuke District which was formedMOYO in 2010 from the then was signed by the Chief Administrative Officer management materials for reporting of multi-sectoral tools for the nutrition coordination DNFP approval by district/sub county councils. KOBOKO is mainly occupied by the Lango ethnic LAMWO and is under implementation. (monitoring, nutrition activities (e.g. SOP tools) committees (such terms of references, YUMBE POPULATION 105,617 evaluation, standard agenda, action point tracking group. It is located in Northern part of Uganda, Lango Policy development, implementation and The Nutrition Action Plan ((2020- surveillance and tool, standardized minute format sub-region. The district is bordered by Lira District on 3% the West, Abim to the East, District to the legal framework 2025) to support the implementation of research) amongst others). population growth rate South and Agago and Pader Districts to the North and multisectoral nutrition actions was approved by Having a Nutrition governance file with Otuke District Nutrition Coordination Committee Amuria and Napak Districts to the South East. The KITGUM the District Council. all relevant reference documents MARACHA ADJUMANI developed a Five-year District Nutrition Action District covers approximately a total area of 1,548.7 Infants Orphans Plan (DNAP) FY 2020-2025 was approved by the Seven sub counties and one town council all Communication (for Negative cultural beliefs and practices Community wide sensitization and CBO, DHO km2. Otuke was pronounced a district on 17 July 2010. <1 year <18 years District council for operation as a district guide had their Nutrition Action plans approved by Nutrition behavior that affect positive nutrition behavior in dialogues on positive behavioral The district is comprised of a Town Board (Adwari) 4,542 8,492 regarding multi sectoral nutrition programming. their respective councils. Activities from their change and practice) the communities. change on nutrition. workplan are being implemented in the district. 7 SUB-COUNTIES 36 PARISHES Children Women of reproductive All seven (7) sub counties and 1 Town council Low Dietary Diversity in children below Use of selected nutrition champions AMURU under 5 years age 15-49 years were supported to develop Sub-County Nutrition ages of 6-23 months. for positive behavior change 1 TOWNARUA COUNCIL 474 VILLAGES PADER Communication for nutrition social behavior 18,694 Action Plans (SNAPs) and these were approved communication. 21,335 AGAGO change and Advocacy Okwang Sub-County has the highest population in by their respective councils. Advocacy (for Low funding for multi-sectoral nutrition Resource mobilization from DNFP, CAO the District, while Otuke Town Council has the lowest. Children A total of 140 PDCs, FAL Instructors and planning, budgeting activities in the district implementing partners and other Pregnant women Otuke has 17 health facilities including 1 HC IV, 6 HC below 18 years expected Information management (monitoring, Community Development officer were trained and resource stakeholders for infrastructural support mobilization) and skills enhancement at district and IIIs and 10 HC IIs. It also has 88 academic institutions 58,195 on Key Family Care Practices (KFCPs) as change 5,281 evaluation, surveillance and research) lower local government levels. including 3 Tertiary, 8 secondary, 64 Primary and 13 agents for nutrition to enhance their ability to Otuke district was supported carry out a Nursery schools. There are 250 religious institutions Adolescents Source: Uganda National implement and supervise Multisectoral nutrition Generate periodic advocacy and policy 10-24 years Nutrition Causal Analysis (NCA) to understand including; 1 Catholic Church, 100 C.O.U,NWOYA 141 Population and Housing actions at sub county/ Town Council level. briefs for politicians and district and ZOMBO the food and nutrition security situation and to LLG level as a tool to advocate for Pentecostal churches and 8 Islamic institutions. There 36,755 Census 2014 OTUKE explore the causal pathways for malnutrition in FAL Instructors were trained on Key Family Care funding for nutrition. are 10 marketsNEBBI in the district. the district. Data from the NCA will be/ is being Practices as change agents for nutrition through OYAM KOLE used to support program implementation. integration of nutrition messages in their curriculum. This publication was produced with the financial support of the European Union. Its contents are the sole responsibility of UNICEF and do not necessarily reflect the views of the European Union. DEVELOPMENT INITIATIVE FOR NORTHERN UGANDA EUROPEAN UNION NUTRITION GOVERNANCE ACTIVITIES SUPPORTED IN THE DISTRICT NUTRITION, WASH AND HEALTH STATUS OF THE DISTRICT Coordination and Partnerships Stakeholder mapping: Otuke District Local Government has 14 stakeholders either overseeing or implementing Nutrition specific and sensitive interventions as well as and creating an enabling environment for NUTRITION STATUS FSNA baseline (2019) Desired situation (2025) HEALTH INDICATORS FSNA baseline (2019) Desired situation (2025) Nutrition implementation within the district. In total, six (42%) of stakeholders are for Nutrition specific, four (29%) for Nutrition sensitive, four (29%) partners supporting all the intervention. Common childhood illnesses in Otuke district include; of households of households 29% are food insecure have food stocks OTUKE DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION 85% 2.9% 7% Malaria 2% Diarrhea All interventions SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS

Okwang Adwari Ogor LOW BIRTH WEIGHT 14 5% STAKEHOLDERS Olilim IMMUNISATION (DPT3) VIT A SUPPLEMENTATION (12-23mo) Alango overseeing / implementing Ogwette 10% interventions STUNTING 80% 54% Otuke Town Council 70% 80% 20% ANAEMIA IN WOMEN 20% 13% 29% 42% 12% <14 interventions 15 - 19 interventions > 20 interventions DEWORMING (12-23 mo) Nutrition sensitive Nutrition specific Source: Food Security and Nutrition Assessment in 10 ANAEMIA IN CHILDREN 50% INTERVENTIONS TARGET GROUP OTUKE WASTING districts of Northern Uganda and West Nile 2019, Makerere 6% 26% 100% University School of Public Health. Scale up coverage of optimal breast feeding practises* Pregnant and lactating women, Adolescents Girls (10-19Yrs) 25% 4% Promote infant and young child feeding practices* Mothers / caregivers 50% Promote optimal nutrition among pregnant women and Children with special needs 0-11 months INFANT AND YOUNG CHILD FEEDING PRACTICES FSNA baseline (2019) Desired situation (2025) NUTRITION GOVERNANCE lactating mothers Promote appropriate adolescent nutrition Adolescents (Boys & Girls) Scale up & sustain effective coverage of vitamin A Children 6-59 months, postpartum women 100% Min. acceptable diet Min. diet diversity (6-23mo) Min. meal frequency WHAT IS NUTRITION GOVERNANCE AND WHY IS IT IMPORTANT? supplementation to children 6-59 months* 3% 4% 20% Good nutrition governance entails making adequate policy decisions in a timely manner, committing the necessary Iron and Folic Acid supplementation to pregnant women* Pregnant women (15-49) 75% 40% financial and organizational resources to their effective implementation, i.e. ensuring that benefits reach most of the Outpatient management of severe acute malnutrition Children 0-59 months, Pregnant women (15-49 ) 25% population, preferably the most vulnerable. It also entails a sustained political commitment to ensure that nutrition without medical complication* programs and policies can withstand threats and constraints from changes in district leadership, political and Inpatient management of severe acute malnutrition with Children 0-59 months, Pregnant women 25% Continued breast feeding (2yr) Exclusive breast feeding Breast feeding within first 1 hour socioeconomic upheavals (Solon 2007). medical complication 25% 80% 61% Management of moderate acute malnutrition (MAM)* Children 0-59 months 25% NUTRITION GOVERNANCE FRAMEWORK Provide deworming tablets to children (1-14yrs)* Children 12-59 months 75% 80% 80% 80% Deworming for pregnant women * Pregnant women (15-49yrs) 100% PILLARS OF GOVERNANCE Intermittent prevention of malaria (IPT3???) for Pregnant Pregnant women (15-49yrs) 75% women Intersectoral Cooperation WASH STATUS FSNA baseline (2019) Desired situation (2025) Scale up and sustain effective coverage ORS-Zinc for Children 0-59 months 55% diahorrea* Policy Technical Frame Scale up and sustain coverage of long lasting insecticide Pregnant & Lactating women, Children 55% Capacity Sustainable Funding Nutrition Works Outcomes treated nets (LLINs) Monitoring Treatment of malaria All 75%

Stakeholders Vertical Partnership Building Frame work Information Financial and Communication Management Coordination Coordination and Sustain universal coverage of available routine Children 0-59 months, Pregnant women 50% Policy and legal System Capacity

Resource Mobilization immunization services Advocacy LATRINE COVERAGE SAFE WATER ACCESS Provide comprehensive EMCT services Pregnant & Lactating mothers 15-49years with HIV 75% 90% 82% (Nutrition Behavior Change. Advocacy) Provide ARV medication to HIV +VE All HIV +VE include Pregnant & Lactating mothers 75%

80% 87% Source: Institute of Development studies (IDS), 2013 Source: Nutrition Stakeholder Mapping for Uganda Report. 2019