Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 i Report
Food Security and Nutrition Assessment in Karamoja Sub-Region
NAKAPIRIPIRIT DISTRICT REPORT Nakapiripirit ii Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
IBFAN Uganda Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 iii Report
Acknowledgements
This report is the outcome of a collaborative well, to the senior district leadership that process and would not have been possible provided initial guidance for the analysis without the contribution of many of the report. individuals: Appreciation also goes to the International WFP & UNICEF are grateful to the Baby Food Action Network (IBFAN) that Government of Uganda and the people of was responsible for the overall field data Karamoja for the support provided during collection, analysis and report writing for the entire exercise, especially during data this round of the FSNA. collection across all the Karamoja districts. Last but not least, thanks goes to colleagues Appreciation is also extended to the from WFP field offices in Karamoja and the Ministry of Health and the District Health Regional Bureau; the team of supervisors Offices of Abim, Amudat, Kaabong, Kotido, and Enumerators; community leaders and Moroto, Nakapiripirit and Napak for village health teams who worked tirelessly supporting the assessment exercise and, as to assure quality for the whole exercise.
For more information related to analysis, data collection, tools and analysis software, please contact the AME Unit, World Food Programme Uganda, or IBFAN Uganda
Siddharth Krishnaswamy Head, AME Unit [email protected] Cecil De Bustos Nutrition Manager, UNICEF [email protected] Edgar Wabyona Programme Officer, AME [email protected] Saul Onyango Principal Investigator [email protected] Barbara Nalubanga Co-Investigator [email protected] Gerald Onyango M&E Manager, IBFAN Uganda [email protected]
For other information, please contact WFP Uganda, Country Director, Elkhidir DALOUM [email protected] UNICEF Uganda, Country Representative, Aida GIRMA [email protected] Nakapiripirit iv Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
Abbreviations
ADHO Assistant District Action Network Health Officer ITC In-patient Therapeutic Care ADRA Adventist Development Relief Agency IYCF Infant and Young Child Feeding
CAFH Community Action for Health LC Local Council
CAO Chief Administrative Officer MA Monitoring Assistant
CDO Community MAD Minimum Acceptable Diet Development Officer MCHN Maternal Child Health Nutrition cIYCF Community Infant and MDD Minimum Dietary Diversity Young Child Feeding MMF Minimum Meal frequency DCDO District Community Development Officer NAADS National Agriculture Advisory Services DEO District Education Officer NUSAF Northern Uganda DEWS District Early Warning System Social Action Fund DHI District Health Inspector OTC Out-patient Therapeutic Care DLG District Local Government SAM Severe Acute Malnutrition
DPMO District Production and SC Sub County Marketing Officer SCDO Subcounty Community DPT Diphtheria Development Officer
FCS Food Consumption Score TA Technical Assistance GAM Global Acute Malnutrition TLU Tropical Livestock Unit HDDS Household Dietary UGX Uganda Shillings Diversity Score UNICEF United Nations HIV Human Immune Virus Children’s Fund HOF Head of Finance UNWFP United Nations World IAS International Aid Services Food Programme
IBFAN International Baby Food WHO World Health Organization Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 v Report
Table of Contents
Acknowledgements iii 4. Food Utilization 9
Abbreviations iv 4.1: Food Consumption Score 9
Executive Summary v1 4.2: Dietary Diversity 9 Household Demographic Complementary 1. 1 4.3: 10 & Related Factors Feeding Practices 4.4: Disease Prevalence 10 1.1: Household Demographics 1 1.2: Mothers’ Level of Education 1 4.5: Immunization 11 Vitamin A Supplementation 1.3: School Attendance 2 4.6: 11 and Deworming 2. Food Availability 3 4.7: Household Water 12 Household Sanitation 2.1: Access to Land 3 4.8: 13 and Hygiene 2.2: Livestock Ownership 3 5. Stability 14 2.3: Cropping Practices 4 2.4: Household Food Stocks 4 5.1: Main Household Shocks 14 Food and Humanitarian 5.2: Livelihood Coping Strategies 14 2.5: 4 Assistance Food Security and 6. 15 3. Access to Food 6 Nutrition Outcomes
3.1: Income Earners and Sources 6 Nutritional Status of 6.1: 15 3.2: Household Debt 6 Women and Children Dependence on 3.3: 7 6.2: Food Security Classification 16 Markets for Food 3.4: Food Expenditure Share 8 7. Recommendations 17
Attendance at Abim FSNA 8. 21 Validation Workshop Nakapiripirit vi Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
Executive Summary
Nakapiripirit is one of the districts in the protocols/schedules; however, Karamoja sub-region faced with chronic Child Health Card retention food insecurity coupled with high levels was found to be a problem. of malnutrition that are of public health concern. The Food Security and Nutrition Trend in Food Consumption Score assessment was conducted in June Acceptable FCS Borderline FCS Poor FCS Linear (Acceptable FCS) 2017 covering all the 8 sub-counties of Linear (Poor FCS) Lorengedwat, Nabilatuk, Lolachat, Moruita, 80% 72% 71% Kakomongole, Nakapiripirit TC, Namalu 69% 55% 59% and Loregae reaching 765 households, 896 60% children below 5 years and 721 women of child bearing age. 40% 34% 36% 39% 28% 31% 20% 24% 25% 9% 20% 10% 11% Key Findings 0% 4% 4% 2012 2013 2014 2015 2016 2017 Regular school attendance by 62% boys and 53% girls; Trend in Prevalence of Global Acute Malnutriton
Most households had access 24% 20,4% to land (94%) and 92% of these, 20% 14,5% 14,6% 15,3% reported having cultivated food; 16% 13,1% 11,8% 12% 9,4% Only (62%) of households 8,3% 8% were registered under one or more Development Assistance 4% Programmes such as MCHN (56%), 0% 2010 2011 2012 2013 2014 2015 2016 2017 Food Aid (26%), School Feeding MAY/JUNE SEASON (16%) and NUSAF (15%);
Almost all households (83%) had access to relatively safe Just less than half (42%) of households water sources such as boreholes, were food insecure. The adjacent figure piped water through taps, shows Food Consumption Score over the protected wells and springs; 6-year period indicating stability in the trend of the acceptable FCS. The linear Measles and DPT3 Immunization, trend [adjacent figure] depicts stabilization Vitamin A supplementation within the range of 72% and 69% over the and Deworming coverages were years. high at 98%, 98%, 85% and 82% respectively following the national Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 vii Report
Executive Summary
The prevalence of Global Acute Malnutrition The high proportion of female (GAM) was 11.8% in 2017 which according headed households (42%) coupled to WHO threshold is ‘serious/high’. with low levels of formal education (25%) among mothers were among The linear trend [adjacent figure] shows a the key underlying factors to the decrease from about 20.4% in 2011 to 11.8% continued high levels of malnutrition. in 2017. The sub-counties worst affected by According to analysis, the slow pace in malnutrition (both women and children) improvement of food security and nutrition included Kakomongole Moruita, and situation in the district could be attributed Lolachat while food insecurity was mainly to: observed in Lorengedwat, Namalu and Diminished food availability Kakomongole. as only 29% of households had food stocks and just less than half (47%) had no livestock; Recommendations Low access to food as households had Agriculture: limited incomes amidst increasing food prices that had prompted high Introduction of suitable cash and crop prevalence of debt (35%) borrowed promotion, especially rice, simsim, primarily to buy food (52%); G-nuts, watermelon; diversification of crops livestock [drought resistant and short Poor Infant and Young Child Feeding maturing, disease and pets tolerant and high (IYCF) practices with only 7% of yielding and palatable]; and post-harvest children meeting the Minimum handling and value addition; Acceptable Diet coupled with high prevalence of illnesses (85%) among Climate change: children, affecting their ability to Support and build irrigation structures; effectively utilize the food consumed; Livestock: Poor water and sanitation practices with nearly 54% of households Invest more in livestock development, having no toilet facilities and especially in terms of breed development only 17% using water at the and value addition; and recommended rate of 15 litres per person per day, all of which rendered Policies: gains in nutrition fragile; and Disseminate/focus on food security By- laws and Ordinances. Nakapiripirit viii Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
Executive Summary
Association between Nutrition and Household Food Security Indicators
Category Indicator Wasting Stunting Underweight
Gender of household head Mother’s education level Household Mother’s nutritional status by and social MUAC demographics Disability or chronic illness of household head Extremely Vulnerable Household Illness in the child Fever/malaria in the child Diarrhoea in the child Illness and health ARI/ cough in the child environment Quantity of water per person per day Access to toilets by the household Household Food Consumption patterns Household Dietary Diversity score Livestock ownership Household Food Food Expenditure Share Security Household dependence on the market Household Coping Strategy Index Household Food Security situation Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 1 Report
1. Household Demographic & Related Factors
1.1: Household Demographics 1.2: Mothers’ Level of Education Overall, based on the selected demographic There is an association between level of factors in Figure 1, Nakapiripirit district education and household income, which had higher proportion of female-headed could in-turn influence the household food households (42%), extremely vulnerable security, thus positive nutrition outcomes. households (21%), polygamous households There is also a significant relationship (51%) and those headed by persons living between the highest education level with disability or with chronic illnesses attained by the mother and household (13%) compared to the sub-region’s average. malnutrition. As shown in Figure 2, three- However, only 14% of the households were quarters of mothers in Nakapiripirit had registered under the Northern Uganda no formal education, 21% had attained Social Action Fund (NUSAF) compared to primary level and only 3% had secondary the sub-region’s average of 25%. level education. The proportions in Nakapiripirit district were not very different
Household Demographics NAKAPIRIPIRIT KARAMOJA from the average for the sub-region, with 60% 72% without any formal education and 22% 51% having attained primary level education. 50% 46% 42% 40%
30% Mothers' Education Level 30% 25% NONE Primary Secondary Tertiary 21% 20% 75 % 14% 14% 13% 80% 72 %
10% 6%
60% 0% Female-Headed EVF NUSAF Polygamous Disabled/ Chronic Ill 40%
Figure 1: Household Demographics, Nakapiripirit, 21 % 22 % June 2017 20% 3 % 5 % 1 % 1 % 0% NAKAPIRIPIRIT KARAMOJA Figure 2: Mothers’ Education Level, Nakapiripirit, June 2017 Nakapiripirit 2 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
1. Household Demographic & Related Factors
1.3: School Attendance Reasons for Irregular School Attendance There were 520 boys and 457 girls of primary school age selected from Other reasons Nakapiripirit district, with regular school 5% 10% 6% Child work for cash attendance being reported for 68% each. 4% Regular school attendance in Nakapiripirit 9% Domestic Household Chores district was higher than the sub-regional 4% 37% Early marriage average among boys and girls of 62% and 23% 53%, respectively. As illustrated in Figure 3, Not interested 4% inability to pay school fees, uniforms and 1% 2% Poor school/ teaching textbooks was cited as main reason for 10% facilities irregular attendance for half of the boys but Illness/ Handicap was the second main reason among boys 50% 35% Can't pay fees, (35%), after domestic household chores uniforms, textbooks that was mentioned by 37%. Illness and handicap was second main reason for boys (23%) and for 10% of the girls. Child work GIRLS BOYS for cash was cited by 6% and 4% of the girls and boys, respectively. Lack of interest in Figure 1: Household Demographics, Nakapiripirit, education was cited by 4% of the boys but June 2017 only 1% of the girls while early marriage was cited by 4% of the girls but was not an issue among the boys. Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 3 Report
2. Food Availability
2.1: Access to Land 2.2: Livestock Ownership Livestock ownership has been significantly associated malnutrition levels in the Table 1: Access to Agricultural Land household. As illustrated in Figure 4, more than half of households in Nakapiripirit Agricultural Land SUB COUNTY district (53%) reported ownership, which Access (%) was comparable to the sub-regional average Lorengedwat 97% of 54%. However, in terms of density 28% of Nabilatuk 92% Nakapiripirit households owned more than Lolachat 99% 2 Tropical Livestock Units (TLU), which was Kakomongole 95% only slightly higher than the sub-regional average of 23%. There was relatively higher Nakapiripirit T/C 75% density of livestock in the sub-counties Moruita 91% of Lolachat (42%), Moruita (41%) and Namalu 89% Lorengedwat (37%). Not surprising, 95% of Loregae 94% households in Nakapiripirit Town Council did not own any livestock at all and 5% had NAKAPIRIPIRIT 94% negligible numbers. KARAMOJA 87%
Livestock Ownership
2% 5% High Livestock 10% 15% 10% 13% 12% Most households (94%) reported having 11% 23% (> 5 TLU) 22% 7% 15% access to land for agriculture production. 12% 10% 16% 16% Slightly high 27% (2.1 -5 TLU) 15% 13% 11% 18% The findings were below those of the 13% 10% 14% 6% Low 11% 11% sub-regional average of 87%. The sub- 10% (0.5 -2 TLU) 8% 18% 95% 32% counties of Lolachat (99%), Lorengedwat Negligible 16% 63% (<0.5 TLU) (97%), Kakomongole (95%) and Loregae 56% 60% 5% 50% 47% (91%) recorded the highest proportion of 45% NONE 24% 23% households having access to land while not surprisingly households from the Nakapiripirit T/C had the lowest (75%), which could be attributed to its urban status. Figure 4: Livestock Ownership, Nakapiripirit District, June 2017 Nakapiripirit 4 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
2. Food Availability
Overall, only 8% of the selected households was planted by highest proportion of reported having no constraints at all in households in Nakapiripirit Town Council, relation to livestock production. The main followed by Namalu sub-county. The main constraint mentioned was parasites or constraint to crop production cited by 59% diseases (57%), followed by shortage of of households was the drought and low pasture/ feeds (12%) and theft (11%) whilst rainfall, followed by inadequate seeds and 8% mentioned lack of veterinary services. tools (16%), sickness or physical inability and land conflicts (5% each).
2.3: Cropping Practices 2.4: Household Food Stocks Overall, 92% of the selected households in Nakapiripirit district reported having Only 29% of households in cultivated staples and legumes with a Nakapiripirit district reported food range from 75% in Nakapiripirit Town stocks at the time of assessment, Council to 98% in Lolachat sub-county. As slightly higher in Nakapiripirit illustrated in Figure 5, sorghum was the Town Council (50%) but lower in crop grown by most households (76%), Lorengedwat sub-county (18%); followed by maize and beans. Agricultural production was comparatively higher in The main source of food stocks Nakapiripirit Town Council and Namalu was own production for 31% of sub-county. Lolachat sub-county had the households and markets for 67%; highest proportion of households that gifts and distribution, each 1%; planted sorghum (99%) whilst Nakapiripirit Of the households with stock, 1% had Town Council and Moruita sub-county had between 3 and 5 bags of 50 kilograms; the lowest. However, maize was grown by 13% had between 1 and 2 bags; most households in Nakapiripirit Town whilst 86% had less than 1 bag; and Council and the sub-counties of Moruita and Namalu. Beans as a source of protein The estimated mean days of stock for households in Nakapiripirit Crops Grown district was only 4 days with a range from 2 days in Nakapiripirit 7% 8% Town Council to 5 days each in Other 2% 1% 50% Lolachat, Kakomongole, Moruita 10% 1% 3% 2% 19% 87% 0% 37% 16% 23% Beans and Namalu sub-counties. 0% 0% 8% 1% 44% 3% 0% 2% 1% 1% 33% 28% 34% 17% 0% 47% Cassava 55% 0% 84% Maize 93% 98% 97% 99% 93% 95% 2.5: Food and Humanitarian 76% 65% Sorghum Assistance 39% 7% 3% Overall more than one-third of households in Nakapiripirit district (38%) were not registered under any Development Programmes. MCHN reached 56% of Figure 5: Main Crops Cultivated in Nakapiripirit District, June 2017 households, followed by Food aid rations that reached 26%, School Feeding (16%), Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 5 Report
2. Food Availability
WASH (15%) and NUSAF (15%). Nakapiripirit As illustrated in Figure 6, only 26% of the Town Council (55%) had comparatively sampled households from Nakapiripirit more households that did not receive district had received assistance from any assistance while Loregae sub-county UNWFP in the 6 months prior to the had the fewest households (33%). Food assessment through Food Aid and only 5% Aid and WASH reached more households households had received Cash. All sub- in Nabilatuk sub-county; MCHN and the counties equally received Food Aid ranging School Feeding programme reached more from 21% in Moruita to 29% in Nabilatuk. in Nakapiripirit T/C, Lolachat, Nakapiripirit Cash was received by households in Loregae, T/C, Namalu sub-county, while NUSAF Nabilatuk and Lolachat sub-counties. The reached comparatively more households decision in relation to handling of the food in Moruita and Lorengedwat sub-county. was mainly made by the women at 91% of households, the women and men together took the decision at 2% of households Food Consumption Score whilst the decision in the remaining 7% 0% 5% 4% was made by the men. 12 % 13 % 9% 11 % 14 % 11 % 22 % 15 % 22 % 30 % 20 % 21 % 18 % 29 % 22 % Poor
Borderline 89 % 81 % Acceptable 66 % 69 % 65 % 68 % 69 % 58 % 56 %
Figure 6: Food and Humanitarian Assistance, Nakapiripirit District Nakapiripirit 6 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
3. Access to Food
3.1: Income Earners Loregae (15%), Namalu (14%), and Sources Kakomongole (12%) while lowest were Lorengedwat, Moruita and Overall only 19% of households in Nakapiripirit Town Council at Nakapiripirit district did not have any 9%, 6% and 2%, respectively; income earner at all, which slightly higher than the average of 16% in the sub-region. The most important source of As illustrated in Figure 7, Namalu sub- income reported for 31% of the county (95%) and Nakapiripirit Town selected households in Nakapiripirit Council (90%) had comparatively more district was Agricultural wage households with at least one income labour, especially from Nabilatuk earner, whilst Lorengedwat sub-county and Lolachat sub-counties; (72%) had the lowest. The findings suggest The next most important source of relatively better economic access to food in income was Food crop production/ Namalu sub-county and the Town Council sales (25%), especially for sub- due to the higher proportion of income counties of Lolachat and Namalu; and earners. The third most important source Household Income Earners of income was sale of firewood/ charcoal (24%), especially in the sub- counties of Nabilatuk and Lolachat.
72% 76% 77% 76% 82% 85% 81% 90% 95% Earner One 3.2: Household Debt or more Household debt was declared by NONE 35% of selected households in
28% 24% 23% 24% Nakapiripirit district, with a range 18% 15% 19% 10% 5% from 17% in Moruita sub-county to 50% in Lolachat sub-county;
Out of the households that had Figure 7: Income Earners in Nakapiripirit District, debts, 34% were required to pay June 2017 interest, with none for all the households in Moruita sub-county Out of all selected households in and highest proportion of households the district, the highest proportion in Lolachat and Kakomongole of declared income sources were sub-counties (42% each); from Lolachat sub-county (23%), followed by Nabilatuk (18%), Main source of credit for all debts Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 7 Report
3. Access to Food
and loans in the district included: and Lorengedwat sub-counties (67% and Relatives (38%), Bank/ Credit 65%, respectively) whilst debt for health Institution/ Micro-credit project expenses was highest in Moruita sub- (25%), Money lender (17%) and county (36%). It was mainly households Traders/ Shop-keeper (13%); and from Lolachat sub-county that incurred debt to cater for school/ education costs. Average amount of debt in Nakapiripirit was UGX 82,947, lowest in Lorengedwat sub-county (UGX 29,025) and highest in Loregae sub- 3.3: Dependence on county (UGX 130,821). Average Markets for Food interest was UGX 17,681, lowest High dependence on markets for food in Lorengedwat sub-county and imply high vulnerability to food insecurity highest in Loregae sub-county. due to exposure to price fluctuations Whereas debt is not necessarily bad for that are typically high during the lean households since it can potentially be season, given the limited incomes and used to augment agricultural production earning potential among the households. and other income generating activities, it As illustrated in Figure 9, overall, 59% of is indicative of stress when used to meet households in the district were heavily essential household needs, including dependent upon markets, especially from for purchase of food. As illustrated in Nakapiripirit Town Council and Namalu Figure 8, the main reason put forward by sub-county. Dependence on markets for more than half (52%) of households’ debt food was lowest in Lolachat sub-county in Nakapiripirit district was for buying (45%) and Loregae (53%). food, followed by health expenses (21%), School/ Education costs (10%), Agricultural inputs (9%) and Investing for business Market Dependance (2%). Incurring debt by households for purchase of food was highest in Nabilatuk
45% 57% 53% Main Reaons for Debt 60% 61% 62% 59% High (>75%) 80% 76% 4% 8% 4% 3% 2% Moderate (50- 15% 7% 8% 14% 8% 9% Invest for 75%) 7% 18% 14% 10% Business 9% 10% 15% 12% 25% 44% Low (<50%) 10% Agricultural 38% 38% 21% 21% Inputs 37% 30% 35% 29% 29% 35% 36% School/ 23% 20% 23% Education Costs 11% 5% 9% 9% 6% 3% 0% 3% 1% 65% 67% Health Expenses 58% 50% 52% 43% 43% 36% 38% Buy Food
Figure 9: Dependence on Markets for Food Nakapiripirit, June 2017
Figure 8: Main Reasons for Debt in Nakapiripirit District, June 2017 Nakapiripirit 8 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
3. Access to Food
3.4: Food Expenditure Share Food Expenditure Categories The Food Expenditure Share refers to the percentage of total household expenditure 10% 27% 34% 33% 31% 34% Severely that is allocated to food. The higher the 38% 39% 42% 25% Insecure percentage of total expenditure allocated by 5% 9% 10% 12% 11% Moderately the household to food, the greater the food 9% 21% 20% 11% 14% Insecure 19% insecurity. For instance, households that 22% 15% 12% 24% 19% spent <50% of total household expenditure 19% Marginally Secure on food were regarded as food secure; 50 - 47% 45% 35% 37% 38% 38% 34% 36% <65% as marginally food secure; 65 - <75% 25% Food Secure as moderately food insecure; and >75% as severely food insecure. As illustrated in Figure 10, one quarter (45%) of households in Nakapiripirit district had Food Expenditure Share >65%, especially from Figure 10: Food Expenditure Share in Nakapiripirit the sub-counties of Namalu (56%), Lolachat District, June 2017 (47%) and Moruita (50%). The lowest proportion of households under the food insecure category was from Kakomongole sub-county (32%). The finding households spending proportionately more on food than the other essential non-food items indicated very high likelihood of food access challenges. Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 9 Report
4. Food Utilization
4.1: Food Consumption 4.2: Dietary Diversity As illustrated in Figure 11, out of the As illustrated in Figure 12, 0nly about one selected households in Nakapiripirit out of every ten households (11%) in the district, 69% had Food Consumption district were within the category of High Score in the ‘acceptable’ category, with Dietary Diversity Score (HDDS) above the highest proportion of households in 6, especially within Nakapiripirit Town Moruita and Namalu sub-counties (89% Council and the sub-counties of Lolachat and 81%, respectively). Kakomongole sub- and Namalu. In the Medium category of county registered the highest proportion above 4.5 were 53% of the households, of households under the category of ‘poor’ with more from Namalu and Moruita sub- Food Consumption Score. Other sub- counties. Diet with higher diversity was counties with higher than the district more common in Namalu and Moruita average of ‘poor’ category included Loregae, sub-counties, followed by Nakapiripirit Nabilatuk and Lorengedwat. Town Council. Lorengedwat sub-county registered the lowest proportion of households with medium and high
Food Consumption Score categories of dietary diversity followed by
0% Nabilatuk sub-county. 5% 4% 12 % 13 % 9% 11 % 14 % 11 % 22 % 15 % 22 % 30 % 20 % 21 % 18 % 29 % 22 % Household Dietary Diversity Poor
Borderline 3% 5% 8% 7% 9% 89 % 15% 15% 11% 81 % Acceptable 20% 66 % 69 % 65 % 68 % 69 % 58 % 56 % 37% High (HDDS >6) 44% 48% 53% 53% 74% 52% 55% Medium (>4.5HDDS<6) 65% Low (HDDS <4.5)
58% 47% 45% 38% 36% 33% 30% 23% Figure 11: Food Consumption Scores 15% Nakapiripirit, June 2017
Figure 12: Household Dietary Diversity Nakapiripirit, June 2017 Nakapiripirit 10 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
4. Food Utilization
4.3: Complementary (MMF), much higher in the Feeding Practices age categories 6 – 11 months and 12 – 17 months (70% and Around the age of 6 months, an infant’s 65%, respectively); and need for energy and nutrients starts to exceed what is provided by breast milk. Complementary foods are necessary to Only 7% of children met the Minimum meet energy and nutrient requirements Acceptable Diet (MAD), higher in the age to promote adequate growth. Overall, category of 12 – 17 months (17%). only 67% of infants 6 – 8 months of age in Nakapiripirit district received solid, semi- solid or soft foods during the day prior to 4.4: Disease Prevalence the assessment, which was lower than the sub-regional average of 74%. As illustrated Only about 15% of all the selected in Figure 14, feeding of infants and young households in Nakapiripirit district children aged 6 – 23 months was far below reported no childhood illness within 2 the recommended infant and young child weeks preceding the assessment (Figure feeding (IYCF) practices. The findings also 14). Fever/ malaria was the most common showed feeding practices for children aged illness (68%), followed by acute respiratory 12 – 17 months were relatively better than tract infections/ cough (50%), diarrhoea for those aged 6 – 11 months, but much (39%) and skin diseases (10%), whilst only better than those 18 – 23 months: 6% reported eye disease. Overall, the highest prevalence of illness was reported Complementary Feeding Practices by the households from Nakapiripirit Town Council, where Fever/ malaria, ARI/ cough and diarrhoea were most reported. Skin Minimum 17% disease was comparatively more common Acceptable 11% Diet in Loregae sub-county whilst eye disease Minimum was more of a problem to Lolachat sub- Meal county and Nakapiripirit Town Council. 65% Frequency 70% 7% Minimum Dietary Childhood Illnesses 24% Diversity 4% 11 % 22% 7% 11 % 12% 8% 5% 6% Eye Disease 6% 11 % 2% 5% 2% 6% 10 % 61 % 11 % 4% 9% 12 % 5% 5% 10 % 6 - 11 12 - 17 18 - 23 6 - 23 13 % Skin Disease 42 % 39 % 33 % 38 % 37 % 42 % 34 % 39 % MONTHS Diarrhoea 68 % Figure 13: Complementary Feeding Practices in 48 % 47 % 46 % 40 % 56 % 64 % 51 % 50 % ARI/ Cough
Nakapiripirit Fever/ Malaria 60 % 69 % 74 % 56 % 71 % 64 % 66 % 68 % 82 % NONE Only 8% of children 6 – 23 months 23 % 18 % 12 % 15 % 24 % 13 % 13 % 15 % met the Minimum Dietary Diversity 0% (MDD), but higher in the age category 12 – 17 months (22%);
Only 24% of children 6 – 23 months Figure 14: Prevalence of Disease, Nakapiripirit
met the Minimum Meal Frequency District, June 2017 Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 11 Report
4. Food Utilization
4.5: Immunization from Child Health Cards was higher in the sub-counties of Lorengedwat and Moruita, The third dose of Pentavalent/ DPT vaccine and Nakapiripirit Town Council. is given at 14 weeks of age and its coverage reflects effectiveness of the immunisation programme. As summarised in Figure 15, overall 98% of the children had received 4.6: Supplementation DPT3 with verifiable evidence from the and Deworming Child Health Card available for 61% but Vitamin A supplements is provided every 6 for 37% being based on the mother’s or months to children between the age of 6 and caretaker’s report. The highest proportions 59 months. Out of the selected households, of children were in Lolachat and Namalu 85% of the children aged 6 to 59 months had sub-counties where virtually all children received vitamin A supplements within the had been immunized, whilst the lowest previous six months, 53% had Child Health was in Moruita sub-county (92%). Cards for verification while 32% was based on mother’s or caretaker’s report (Figure 16). The highest was the sub-counties of DPT 3 and Measles Vaccination Lorengedwat and Kakomongole (94% and 80%
65% 65% 66% 65% 91%, respectively) whilst those below the 63% 63% 62% 60% 61% 56% 58% 60% 55% 55% 54% district average included Moruita, Loregae 52% 52% 49% 51% 47% 45% 46% 45% 43% 43% and Namalu (84, 80% and 77%, respectively). 44% 43% 40% 38% 36% 38% 37% 40% 35% 35% 34% 34% 31%
20% Vitamin A and Deworming
60% 57% 56% 56% 54% 53% 54% 53% 51% 52% 52% 0% 49% 50% 48% 48% 46% 45% 46% 46% 45% 43% 43% 44% 39% 40% 39% 40% 35% 31% 32% 32% 30% 29% 30% 27% DPT 3 YES, with Card DPT 3 YES, without Card MEASLES YES, with Card MEASLES YES, without Card 26% 21% 20% 20% Figure 15: Measles and DPT3 Immunisation Coverage, June 2017 0%
Measles vaccination is carried out at 9
months of age and overall 98% of children Vitamin A YES, with Card Vitamin A YES, without Card Deworming YES, with Card Deworming YES, without Card in the district had been immunised, 58% of them with verifiable evidence on the Figure 16: Vitamin A and Deworming Coverage, June Child Health cards and 40% based on the 2017 mother’s or caretaker’s report. The range was from 94% in Moruita sub-county to Medicines for treatment of intestinal 100% each in Nakapiripirit Town Council worms is provided every 6 months to and sub-counties of Lorengedwat and children aged between 12 and 59 months. Kakomongole. Nakapiripirit district Overall, 82% of the sampled children aged registered a proportion slightly higher 12 to 59 months had received de-worming than the sub-regional average of 96%. The medicines within the 6 months preceding proportion of children without evidence Nakapiripirit 12 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
4. Food Utilization
the assessment with verifiable evidence for drinking water. Of those who treated their 50%. The highest was in Nakapiripirit Town water, the majority (95%) boiled while 2% Council (94%) and those below the district used chlorination method. average included the sub-counties of Lolachat (81%), Namalu (73%), Moruita and Loregae (79% each). Lack of Child Health Utilisation of Water Cards was most marked in Nakapiripirit 5% 10% 7% 7% 8% 10% 10% 9% 11% 7% 20% 5% Town Council, Lorengedwat and Moruita 6% 9% 12% 10% 11% sub-counties. 0% 20 lpppd
15 – <20 lpppd 85% 87% 87% 88% 4.7: Household Water 78% 80% 81% 79% 83% <15 lpppd As illustrated in Figure 17, about 83% of households in Nakapiripirit district obtained water from relatively safe sources comprising of boreholes, piped water and protected wells/ springs, which was lower than the sub-region’s average of 90%. Safe Figure 18: Amount of Water used in Households, water sources was utilized by comparatively June 2017 more households especially in Nakapiripirit Town Council and the sub-counties of The recommended amount of water for Loregae, Lolachat and Nabilatuk. Namalu basic household hygiene and sanitation sub-county (40%), Lorengedwat (33%) and is at least 15 litres per person per day. Moruita (31%) had the highest proportion As illustrated in Figure 18, about 83% of of households that obtained water from households in Abim district reported use less safe sources such as open well/ spring of less than 15 litres of water per person and surface water. Only 6% of the selected per day that was much higher than 76% households reported treatment of their average in the sub-region. The sub- counties of Nabilatuk and Loregae (79% Chart Title each) registered the lowest proportion of
3% 0% 2% households that utilised little quantities of 7% 1% 12% 1% 18% 19% 25% 12% 26% 5% Surface Water water. The highest water use of more than 5% 35% 5% 2% 5% Open Well/ 20 litres per person per day was registered 8% 21% Spring mainly by the households in Nakapiripirit 1% Protected 13% Town Council (20%). 97% 97% Well/ Spring 80% 74% 78% Piped with Tap 68% 65% 70% Borehole 45%
Figure 17: Sources of Household Water in Nakapiripirit, June 2017 Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 13 Report
4. Food Utilization
4.8: Household Sanitation and Hygiene Household Toilet Facilities
5% There were more than half (54%) of 13% 10% 9% 13% 10% 13% 22% 22% households in Nakapiripirit district that 18% did not have any toilet facilities, which was 20% YES, 41% 33% Shared 50% slightly lower than the sub-region’s average 35% 49% of 58%. As illustrated in Figure 19, among 49% YES 91% the selected households in the district that 77% had toilet facilities, 13% were being shared 67% NONE 50% 54% 44% 40% 38% with other households. The lack of toilet 29% facilities was more prominent in the sub- counties of Moruita (91%), Lorengedwat (77%) and Lolachat (67%) but lowest in Kakomongole sub-county (29%). Figure 19: Amount of Water used in Households, More than half of the households (52%) June 2017 had pit latrines but the open pit without a super structure, which is of a lower quality constituted the main type of toilet facility for 44% of the selected households in the district. Open pits were more common in Loregae and Lolachat sub-counties, reported by 57% and 54% respectively, of the households with toilet facilities. Nakapiripirit 14 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
5. Stability
5.1: Main Household Shocks 5.2: Livelihood Coping Strategies As illustrated in Figure 20, only 3% of the As illustrated in Figure 21, about one out selected households in Nakapiripirit district of five households in Nakapiripirit district reported having experienced no difficulty (19%) did not apply any coping strategies, or shock within the 30 days preceding the more especially from Nakapiripirit Town assessment. Sickness/ Disease was cited Council (30%) and Nabilatuk sub-county by the largest proportion of households (29%). More than half of households (41%), followed by high food prices (32%) (57%) were in emergency coping mode, and floods/ drought (14%). Nakapiripirit especially those from Namalu sub-county Town Council had the largest proportion (73%). Emergency coping was lowest in of households affected by high food prices Nakapiripirit Town Council (50%), where (55%) whilst Moruita sub-county had the none of the households reported was highest proportion of households that reported under the crisis coping mode. mentioned floods/ drought (30%) and sickness/ diseases was the main problem cited by largest proportion of households in Namalu sub-county (46%). Loss of crops due to rodents was a problem mentioned Livelihood Coping Strategies by most households from Moruita sub- county. 20% 42% 53% 50% 55% Emergency 61% 59% 68% 30% 68% Coping Main Household Shocks Crisis 22% Coping 0% 20% 3% 1% 5% 7% 5% 15% 23% 7% 14% 1% 17% Stress Crop Loss 8% 13% 19% 11% 13% 12% Coping 40% 6% 9% 38 43% Sickness/ 3% 15% % 43% 37% 41% 4% 8% NONE 41% 30% 46% Disease 29% 30% 18% 20% 19% 19% 12% 15% 14% 0% Floods/ 10% Drought 15% 14% 2% 14% 25% 15% 30% High Food 55% Prices 29% 42% 41% 33% 27% 32% 28% 14% NONE Figure 21: Livelihood Coping Strategy in 6% 8% 0% 1% 4% 0% 0% 1% 3% Nakapiripirit, June 2017
Figure 20: Main Households Household Shocks in Nakapiripirit, June 2017 Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 15 Report
6. Food Security and Nutrition Outcomes
6.1: Nutritional Status of with higher prevalence of overweight and Women and Children obesity included Kakomongole, Moruita and Loregae. It is noteworthy that Loregae sub-county had the double burden of a) Women of Child-bearing Age underweight and overweight among the women. There is an association between malnutrition of the mother and the nutritional status of under-five children. b) Under-five Children As illustrated in Figure 22, 47% of sampled women in Nakapiripirit district were The severe acute and global acute underweight, which was higher than the malnutrition outcomes for under-five sub-regional average of 39%. Lorengedwat children are summarized and illustrated in and Loregae sub-counties registered Figure 23, key findings were as follows: the highest proportions of underweight Severe Acute Malnutrition (SAM) for women (57% and 49%, respectively), with Nakapiripirit district was at 2.0%, with Nabilatuk and Lolachat among those above highest proportion in Kakomongole sub- the district average. Moruita sub-county county (7.1%) but lowest in Lorengedwat had the lowest proportion of underweight sub-county and Nakapiripirit Town Council women (30%). On the hand other side, (0%). Only Kakomongole sub-county Nakapiripirit Town Council registered was above the critical level of 2%, whilst the highest proportion of overweight and Nabilatuk sub-county registered 2.4%; obese women (12%). Other sub-counties
Maternal Malnutrition Obese Under-five Malnutrition Overweight 2% 0% 20.0% Underweight 20% 19.3% 2% 2% 6% 6% 0% 1% 3% 1% 0% 8% 1% 1% 18% 6% 2% 0% 16% 2% 4% 14% 11.8% 4% 13.5% 57% 12% 12.0% 48% 48% 49% 9.3% 44% 47% 47% 10% 10% 41% 39% 8% 7.1% 30% 8.3% 6% 3.7% 4% 5.4% 1.8% 2.4% 2.0% 2% 2% 0.8% 1.7% 0% 0% 0.9% 0% Severe Acute Global Acute
Kakomongole Lolachat Loregae Lorengedwat Moruita Figure 22: Malnutrition Level among Mothers in Nabilatuk Nakapiripirit T/C Namalu NAKAPIRIPIRIT Nakapiripirit District Figure 23: Prevalence of Acute Malnutrition in Nakapiripirit, June 2017 Nakapiripirit 16 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
6.Food Security and Nutrition Outcomes
Global Acute Malnutrition (GAM) for Kakomongole, Lolachat, Loregae, Nakapiripirit district was at 11.8%, with Moruita and Nabilatuk. highest proportion in the sub-counties of Kakomongole (20.0%) and Moruita (19.3%) but lowest in Nakapiripirit Town Council 6.2: Food Security (3.7%). The sub-counties of Kakomongole, Classification Lolachat, Moruita and Namalu were above the critical level of 10%. The Food Security Index that combines the Food Expenditure, Food Consumption The stunting and underweight outcomes for Score and Livelihood coping strategies under-five children has been summarized showed that only 58% of households in and illustrated in Figure 24, key findings Nakapiripirit district were food secure were as follows: (Food secure + Marginally food secure
Under-five Malnutrition categories) whilst 42% were Food Insecure. The findings showed that Nakapiripirit 40% 38.4% district had slightly less food insecure 35% 31.1% 34.8% 29.4% 30.2% households than their counterparts in the 30%30% 27.1% 30.1% 30.4% sub-region recorded at 57%. There were 25% 22.8% 23.4% 27.2% 22.8% more food insecure households registered 20% 22.5% 20% 22.6% 14.8% 19.6% 15% in the sub-counties of Lorengedwat (57%), 11.1% 14.8% 10% Namalu (41%) and Kakomongole (50%).
5% On the other hand, lowest proportion of
0% food insecure households were registered Stunting Underweight in Nakapiripirit Town Council (40%). Kakomongole Lolachat Loregae Lorengedwat Moruita Nevertheless, Nakapiripirit Town Council Nabilatuk Nakapiripirit T/C Namalu NAKAPIRIPIRIT had the highest proportion of households Figure 24: Prevalence of Stunting and Underweight in the district within the category of in Nakapiripirit ‘severely food insecure’ (20%).
Stunting for Nakapiripirit district was at 23.4%, with the highest proportion Food Consumption Score in Kakomongole sub-county (38.4%) 0% 5% 4% 12 % 13 % 9% 11 % 14 % 11 % and lowest in Nakapiripirit Town 22 % 15 % 22 % 30 % 20 % Council (14.8%). The sub-counties of 21 % 18 % 29 % 22 % Kakomongole, Lolachat and Loregae Poor
were above the critical level of 30%, Borderline 89 % whilst Lorengedwat and Nabilatuk 81 % Acceptable 66 % 69 % 65 % 68 % 69 % were at 30.1% and 30.4%, respectively; 58 % 56 % Underweight for Nakapiripirit district was at 30.2%, with the highest proportion in Kakomongole sub-county (29.4%) and lowest in Nakapiripirit Town Council (11.1%). The sub-counties above Figure 25: Final Food Security Classification for Nakapiripirit, June 2017 the critical level of 20% included Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 17 Report
Recommendations
Food Availability monitoring of animal diseases; 1. Strengthen effective extension 3. Construct water catchment areas services to cover all villages in the in all villages for the households district that include promotion to obtain water for cultivation and of two planting seasons in wet feeding their animals especially belt zones and the following: during the dry seasons, and advocate for establishment or strengthening • Improving knowledge and skills of irrigation to supplement rainfall; among farmers on growing of disease/drought resistant 4. Sensitize the communities and and high yielding crops; influence their practices on:
• Setting up demonstration centres • Growing fast maturing crops for farmers, supplying genuine such as pumpkins, sweet farming inputs such as seeds potatoes and pawpaw; and ensuring quality assessment • Food storage for future of the seeds distributed; consumption and better • Diversification of production storage technologies; through mixed farming with • Proper use of foods during the focus on legumes, locally harvest season and reduced available fruits and vegetables; selling so that some is left to • Control of pests and diseases take households through to such as army worms; the next harvest season;
• Post-harvest handling • Value addition to the practices such as proper commonly grown crops; use of foods during harvest • Role of gender in crop season, storage technologies production; and and preservation; and • Use of modern family planning • Use of more efficient methods to reduce the household agricultural equipment. size and thus contribute towards 2. Support re-stocking of animals in food security in the households. communities where cultivation 5. Promote research to support has failed, create a data-base the district obtain other high for monitoring the re-stocking yielding crop varieties, educate the activities and strengthen communities on climate change and veterinary services, including seasons, and strengthen the District Nakapiripirit 18 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
7. Recommendations
Early Warning Systems (DEWS); 12. Reduce sell of food crops by advocating for introduction of 6. Put in place a clear land cash crops as alternative crops for ownership policy and advocate sale to generate income; and for dialogue among communities to settle land conflicts; 13. Advocate for the initiation or strengthening of NAADS 7. Set up District Land Board to address pilot project in the district. the challenges related to land ownership, promote dialogue to address the on-going land conflicts and put in place interventions to Recommendations increase effective land utilization; for Accessibility
8. Educate and support the 1. Advocate to the ministry/department communities on: responsible for road construction and maintenance to improve the • Introduction of weather resistant road networks in the district; variety of crops and improved seeds with high yields; 2. Improve food accessibility the following, among others: • Good storage methods and post-harvest handling; • Establish community markets at each sub-county • Group marketing concepts; and to support diversification of household incomes; • Diversification of foods grown and consumed. • Educate and support communities on Income 9. Advocate for By-laws or ordinances to Generation Activities; limit the indiscriminate sale of food; • Build community level business 10. Sensitize and involve men as the competence and skills; land-owners and key decision- makers, on the following: • Advocate for commercialization of agriculture; • Production and storage of food at the household level; • Introduce Community/ Village Savings and Loans • Joint participation in Associations to facilitate decision-making; and agriculture loans for farmers; • Joint ownership of household • Scale up the food/cash for assets e.g. land, livestock etc. work programmes; and 11. Advocate for the establishment of • Advocate for the formation granaries at household and silos of cooperatives to support at community levels to ensure storage and purchase of food security and sensitize the food at fair prices. communities on their importance, including cereal bulking; Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 19 Report
7. Recommendations
3. Encourage households to and strengthen community have separate gardens of sensitization and education on food and cash crops; the following among others:
4. Advocate for support from the • Different foods and their UNWFP to provide food assistance functions in the body; to persons living with HIV; and • Proper child caring and 5. Strengthen livelihood programs such health seeking behaviours; as Income Generation Activities at community level and advocate • Good feeding practices among for increased funding to promote children and women; and agriculture mechanization. • Utilization of safe water in the households.
Recommendations for Utilization 5. Intensify supervision of the implementing partners as well 1. Encourage health workers to as strengthen coordination and strengthen integrated child days’ reporting among development activities, improve documentation partners like UNICEF, WFP, Save and make use of child health the Children etc. for improved cards for every service provided health and nutrition situation; to children below age of 5 years; 6. Advocate for support from 2. Strengthen the functionality of Out the district leadership on: Patient Therapeutic Care (OTC) and • Population growth control; and In-patient Therapeutic Care (ITC) sites so that all malnourished children are • Prevention and control of efficiently and effectively managed; diseases at community level including those related to HIV. 3. Mobilize support in the form of grants to establish model sanitation 7. Educate the community and train villages such as the initiative started VHTs as well as peer mothers on in 2 villages of Loroo sub-county, nutrition, sanitation and hygiene, Amudat district and in addition: dietary diversification and monitoring of the immunization schedules; • Strengthen community sensitization and education 8. Strengthen the nutrition programmes on hygiene and toilet usage; e.g. Community Infant and Young Child Feeding (cIYCF) by the District • Repair all broken-down Health Department with support boreholes to enable access from partners like UNICEF, Save the to clean water; and children and WFP, to specifically • Promote water harvesting address poor feeding habits; during the wet season. 9. Increase access to health and 4. Establish By-laws to facilitate nutrition services through reduction on alcohol consumption mobile clinics and sustainable Nakapiripirit 20 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
7. Recommendations
integrated outreaches to: Recommendations on • Improve disease prevention Demographic Factors and management; 1. Improve regular school attendance of children by: • Strengthen and scale-up nutrition screening; and • Advocating for establishment community schools and posting • Improve the Community of teachers to such schools; Based Supplementary Feeding Programme. • Provide sanitary pads to school girls to reduce of absenteeism; 10. Advocate for support from the UNWFP to continue the MCHN • Strengthening the school programme for improved maternal feeding programmes; and child nutrition outcomes. • Holding dialogue with caregivers at village level to emphasize the importance of education; Recommendations on Stability • Development of a tool to track 1. Support the communities to absent pupils and teachers by the correctly predict the cultivation District Education department; periods, encourage relocation to more productive areas and put in • Strengthening supervision place rapid response to disasters; in schools; and
• Advocating for By-laws on education ordinance.
2. Include nutrition education in the Adult Literacy Classes. Nakapiripirit District Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 21 Report
7. Recommendations
Attendance at Nakapiripirit FSNA Validation Workshop
No. Name Title Department Contact
Secretary 1 Aaron Yoyo Joseph Ndlg 0785613335 For Health 2 Anyakun P. Jovic Sas Loregae 0772694551 3 Bullon Nicodemus Sas Kakomongole 0774772834 4 Tokoi Godfrey Planner Ndgl 0779438273 5 Aleper Yohannes Sagal S/C Chief Nabilatuk 0777002430 6 Oswan Odeke Damascus For Rdc D/Diso 0782425658 7 Dr. Anguzu John Dho Ndgl 0772595048 8 Korobe Raymond Deo Ndgl 0775025222 9 Waiswa Peter Biostatistician Ndgl 0782424191 10 Malingat Constance Sno Ndgl 0782750972 11 Lorika Ronnie Sas Moruita 0783141483 12 Nayor Teddy Grace Sas Lorengodwat 0783293097 13 Joseph Ndawula Ma Un Wfp- Nakaps 0782678004 14 Onyona Marion Nutrition Officer Cwamm- Nakaps 0779252534 15 Akurat Goreti Secretary Ndgl 0782025347 16 Irene Birabwa Nutritionist Afi- Nakaps 0703165848 Dr. Kaltuya Dominic Production/ 17 Dpo 0772335483 Lokeris Marketing Community 18 Denis Athiyo Dcdo 0772578462 Based/ Ndlg 19 Agwang Martha Acao Administration 0782707996 20 Losure Emma Dht Ndgl 070822784 Nakapiripirit 22 Food Security and Nutrition Assessment in Karamoja Sub-Region - July 2017 District Report
7. Recommendations
For more information related to analysis, data collection, tools and analysis software, please contact:
AME Unit, World Food Programme Uganda, or IBFAN Uganda