CALL TO ACTION

THE REPUBLIC OF NUTRITION CHALLENGES/ GAPS CALL FOR ACTION RESPONSIBLE GOVERNANCE AREA OFFICE Moyo District Nutrition coordination committee The information generated from this study is (DNCC), eight (8) Sub counties and One Town important in designing context specific nutrition Coordination and Weak coordination mechanisms of Establish joint planning and budgeting and CAO/ DNFP MOYO DISTRICT LOCAL GOVERNMENT partnerships: nutrition actions at all levels. implementation of multi-sectoral nutrition actions council trained on multi sectoral nutrition interventions in the district and formulate amongst partners with the district; to reduce on ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSE implementation for improved nutrition customized action plans. duplication of resources and achieve sustainable outcomes. A Stakeholder Mapping and Capacity results. The district conducted quarterly DNCC meetings Assessment exercise was also conducted to Systems capacity Lack of clarity on nutrition sensitive Conduct in service training on nutrition sensitive CAO, Building (functional, programming for the non-traditional programming to Education, CBS and Production and support supervision activities aimed at examine institutional arrangements and capacity HODs, institutional and departments (CBS, Education, departments in the district such as Nutrition strengthening the accountability framework for to plan, budget and manage the multi-sector Human capacities) Production and others) Sensitive Agriculture, school feeding. SAS Multisectoral nutrition actions implemented in nutrition programs in Moyo district. Moyo district.. Policy development, Limited awareness on available Support the wide dissemination of DNFP, The Moyo DNCC has been trained on nutrition implementation and policies, guidelines that support sectoral(departmental) policies and guidelines such governance and supported to use reporting CAO, Systems capacity building (functional, legal framework Multisectoral nutrition action as National Health Policy (NHPII), Health Sector templates and monitoring tools previously Development Plan (HSDP II) 2015/16–2019/20, DEO, institutional and Human capacities) developed as part of the Standard Operating Integrated Early Childhood Development (NIECD) DCDO, Capacity of the district/sub county coordination Procedures for nutrition governance. The Policy (2016) , Presidential Initiative on healthy eating and healthy lifestyles (July, 2019) National structures was built; to plan, budget, implement, reporting templates and monitoring tools are DHO, Agriculture Policy (NAP) of 2013 and the Agriculture DPO and monitor Multisectoral nutrition actions. A currently in use by the district for program Sector Strategic Plan (2015/16-2020/20) and Food total of 150 technical staffs from 8 sub-counties implementation. Security Strategy, the Education Sector Strategic Plan (ESSP) (20017-2020) and Guidelines on Parent and one Town council were trained. DNCC/ The DNCC, SNCC and TNCC conducts monthly led School Feeding and Nutrition (2012),the Social SNCCs to develop nutrition action plans (DNAPs/ monitoring and supervision visits and quarterly SNAPs 2020-2025) and advocate for approval by Development Sector Plan (2015/16 - 2019/20),the meetings to assess progress of program National Community Development Policy for district/sub county councils. implementation. Uganda (2015) and the Water and Environment Sector Development Plan (2015/16-2019/20) and Policy development, implementation and Financial and resource mobilization the UNAP during joint multisectoral forums with legal framework the DNCC and IPs in the district A costed Multi-Sectoral Nutrition Annual Moyo DNAP not well aligned to the District should align the DNAP 2020-25 with the MOYO The District Nutrition Coordination Committee Workplan (FY 2019/20) was developed and District Development Plan 2020- Moyo DDP III (2020-2025) PROFILE LAMWO of Moyo district developed a District Nutrition approved through the office of the Chief 2025. YUMBE POPULATION 137,489 Action Plan (DNAP) aligned to the Uganda Moyo district is in the North-Western region/ Administrative Officer (CAO) to ensure Information Inadequate Mechanisms to foster Building capacity of nutrition focal persons and Bio-stat, Nutrition Action Plan 2. The DNAP was also West Nile region of Uganda. The Nile River forms implementation of Nutrition actions in the management sufficient information sharing nutrition programmers to make better use of 69,552 67,937 5.3 District Planner, it southern and eastern border, its approved by the District Council. district. (monitoring, between all partners nutrition data. Female Male Av.household size DNFP northern border, and Yumbe and districts its evaluation, KITGUM Eight (8) sub counties and one town council Eight (8) sub counties and one town council Inadequate information sharing Creation of regular fora at district level specifically western border. Administratively, Moyo district is surveillance and between all partners on research, for sharing of information/data/results from various CAO, MARACHA ADJUMANI developed Subcounty Nutrition Action Plans and all had their Nutrition Action plans approved by research) divided into two Counties namely, West Moyo and Infants Orphans Town council Nutrition Action Plans respectively evaluation and surveillance work surveillance and research work conducted by the DNFP <1 year <18 years their respective councils. Activities from their carried out within the district district and Implementing Partners. Obongi. aligned to the Moyo District Nutrition Action workplan are being implemented in the district. 5,912 11,054 plan. Communication (for Inadequacy in the quality of diets of Identifying and use of Nutrition champions for DNFP, 8 SUB-COUNTIES 44 PARISHES Nutrition behavior children 6-23 months (low dietary positive behavior change communication. Administration Children Women of reproductive Communication for nutrition social behavior change and practice) diversity). 1 TOWN COUNCIL 242 VILLAGES AMURU under 5 years Information management (monitoring, ARUA PADERage 15-49 years change and Advocacy Poor Hygiene and sanitation Maintaining the training on nutrition packages The results from the National Housing and 24,336 evaluation, surveillance and research) practices across different departments such as training of 27,773 AGAGO A total of 225 PDCs, FAL Instructors and population survey for Moyo district indicated a A baseline food security and nutrition VHTs on nutrition and WASH, training of CDOs, total population of 137,489 of which 67,937 were Children Community Development officer were trained PDCs, FALs on KFCPs GULU Pregnant women assessment was conducted in Moyo, key on Key Family Care Practices as change agents males and 69,552 were females. Total number below 18 years expected findings of which have been used to inform Advocacy (for Lack of explicit budgets allocated for Conducting a budget expenditure analysis to CFO, DNFP, of households was 25,894 and the average for nutrition to enhance their ability to implement planning, budgeting 75,756 nutrition programming. The study will be nutrition actions /interventions identify available and funding gaps for nutrition DNFP, CAO, 6,874 and supervise Multisectoral nutrition actions at and resource actions. DEO, DCDO, household size was 5.3. Moyo district experienced conducted bi-annually to assess progress on sub county/ Town Council level. mobilization) DHO, DPO an influx of refugees from South Sudan starting Adolescents Refugee key nutrition indicators for evidence-based Low funding for multi-sectoral Resource mobilization for funding of priority from December 2016. Currently, ItulaNWOYA Sub County 10-24 years population nutrition activities in the district nutrition interventions in the district ZOMBO programming. FAL Instructors were trained on Key Family Care is a host to the refugee population totaling to 47,846 184,360 OTUKE Practices as change agents for nutrition through Nutrition activities not adequately Joint work planning, budgeting and implementation A Link Nutrition Causal Analysis (Link NCA) 184,360NEBBI (UNHCR, August 2017). integration of nutrition messages in their included in the sectoral work plans of multi-sectoral nutrition actions by departments OYAM was conducted to establish the various causal curriculum. KOLE pathways for malnutrition in Moyo district. 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: Moyo District Local Government has 38 stakeholders either overseeing or implementing Nutrition specific and sensitive interventions as well as and creating an enabling environment NUTRITION STATUS FSNA baseline (2019) Desired situation (2025) HEALTH INDICATORS FSNA baseline (2019) Desired situation (2025) for Nutrition implementation within the district. In total, 18 (47%) of stakeholders are for Nutrition specific, 15(40%) for Nutrition sensitive and five (13%) partners supporting all the interventions. Common childhood illnesses in Moyo district include; Acute of households of households Respiratory MOYO DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION are food insecure have food stocks 13% SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS 65% 34% Malaria Diarrhea Infections 30% 5% 3% All interventions

Metu

LOW BIRTH WEIGHT Lefori Moyo 10% 38 Laropi Difule IMMUNISATION (DPT3) VIT A SUPPLEMENTATION (12-23mo) STAKEHOLDERS 10% 100% 85% overseeing / implementing Itula STUNTING interventions 70% 80% 18% ANAEMIA IN WOMEN 20% 33% Gimara <=14 interventions 12% 40% 47% 15 - 19 interventions DEWORMING (12-23 mo) Nutrition specific Nutrition sensitive Aliba >=20 interventions Source: Food Security and Nutrition Assessment in 10 ANAEMIA IN CHILDREN 78% WASTING districts of Northern Uganda and West Nile 2019, Makerere 4% 62% 100% University School of Public Health. INTERVENTIONS TARGET GROUP MOYO 4% 25% Promote, protect & support breastfeeding Pregnant and lactating women, 0% Adolescents girls 10-19Y Promote age appropriate complementary feeding Mothers / caregivers 75% INFANT AND YOUNG CHILD FEEDING PRACTICES FSNA baseline (2019) Desired situation (2025) NUTRITION GOVERNANCE practices Promote optimal nutrition Children with special needs 0-11 months 0% Min. acceptable diet Min. diet diversity (6-23mo) Min. meal frequency WHAT IS NUTRITION GOVERNANCE AND WHY IS IT IMPORTANT? Promote adolescent nutrition Adolescents (Boys & Girls) 0% Vitamin A supplementation Children 6-59 months, Postpartum women 100% 14% 25% 39% Good nutrition governance entails making adequate policy decisions in a timely manner, committing the necessary Iron and Folic Acid supplementation Pregnant women (15-49) 0% 40% financial and organizational resources to their effective implementation, i.e. ensuring that benefits reach most of the population, preferably the most vulnerable. It also entails a sustained political commitment to ensure that nutrition Outpatient management of acute malnutrition Children 0-59 months, Pregnant women (15-49) 25% programs and policies can withstand threats and constraints from changes in district leadership, political and Inpatient management of acute malnutrition Children 0-59 months, Pregnant women 30% Continued breast feeding (2yr) Exclusive breast feeding Breast feeding within first 1 hour socioeconomic upheavals (Solon 2007). Management of moderate acute malnutrition (MAM) Children 0-59 months 40% 50% 68% 65% Provide deworming tablets for children Children 12-59 months 75% NUTRITION GOVERNANCE FRAMEWORK Deworming for pregnant women Pregnant women (15-49Yrs) 100% 80% 80% 80% PILLARS OF GOVERNANCE IPT of malaria (IPT and IPTs2) for pregnant women Pregnant women (15-49Yrs) 75% Diarrhea treatment with ORS & Zinc Children 0-59 months 65% Intersectoral Cooperation Long lasting insecticide treated nets. (LLINs) Pregnant & lactating women, children 80% WASH STATUS FSNA baseline (2019) Desired situation (2025) Treatment of malaria All 80% Policy Technical Recommended vaccines in the national schedule by Children 0-59 months, Pregnant women 75% Frame Sustainable Funding Capacity Nutrition recommended age Works Outcomes

Monitoring Promote PMCT / EMCT of HIV Pregnant & lactating women 15-49 years with HIV 75%

Stakeholders Vertical Partnership Building 75% Frame work

Information Provide ARV medication All HIV +ve incld. Pregnant & lactating women 15-49Yrs Financial and Communication Management Coordination Coordination and Policy and legal

System Capacity with HIV Resource Mobilization LATRINE COVERAGE SAFE WATER ACCESS Advocacy Diet therapy into routine disease management Children 12-59 months with special needs 0% 98% 98% (Nutrition Behavior Change. Advocacy) Prevention and Management of diet –related NCDs Women of reproductive age 15-49Yrs 25%

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