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Limoroto, Karamoja, Uganda District of Moroto

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Limoroto, Karamoja, Uganda District of Moroto Moroto district, Karamoja region, Uganda February – July 2016 Lysette Boucher Castel, NCA Analyst About this report The Nutrition Causal Analysis report presents the findings of an indepth investigation into the immediate, basic and underlying causes of under nutrition in Moroto district in Karamoja region of Uganda. The investigation process took the form of a mixed methods analysis combining qualitative and quantitative research methodologies to develop a comprehensive analysis of both the current and historical factors affecting under nutrition in Moroto district. The Link NCA study survey in Moroto district was recommended following a consultative process with various stakeholders financing nutrition programs in the Karamoja region of Uganda. The overall goal of the survey was to better understand the factors behind the chronic nature of acute malnutrition as well as explain factors underlying the deterioration in the nutrition situation reported by several food security and nutrition assessments conducted in the region during recent years. This report provides a summary of the findings of this assessment. It details the evolving livelihood context in Karamaoja and in particular in Moroto district over the past 10 years and its impact on food security and nutrition. It then outlines the key factors and causal pathways for under nutrition in two livelihood zones in Moroto district based on the findings of a literature review, a risk factor survey, a qualitative community survey and several multi-stakeholder workshops held in Moroto district during the first half of 2016. It then draws a set of recommendations developed through discussions by the communities involved in the survey and the technical experts in Moroto district to address the multiscetoral causes of under nutrition in the district. The Link NCA study was conducted by an expert Link NCA study analyst from Action Against Hunger with technical oversight from the ACF Nutrition and Health technical advisors and the Link NCA technical unit in Paris. The survey was supported by the United Nations Children’s Fund (UNICEF) and the United Nations World Food Program (UN WFP) with funding from the Department for International Development (DfiD). 2 Acknowledgements The Link NCA study study is the result of many links of collaboration. We firstly are grateful for their hospitality and patience to all the families that welcomed investigators in their homes in the 30 villages of the Moroto District. On the field, we wish to express our gratitude to twenty-four investigators who visited families in these villages: Atim Beatrice, Luke Logiro Ochen, Isaac Newton Bahati, Lotyang Francis Loumo, Lotukei Dean Rapheal, Akidi Jennifer, Bendicto Lomongin, Akao Immaculate, Mandella Eric Telep, Asio Mary Fortunate, Lemukol Lawrence, Emai Christine, Lokwang Hadija, Achayo Sarah, Kodet Leonard, Okure Alfred, Chuna Confort Emmanuel, Odoki Eric, Rose Mary, Opolot John Bosco Mod. Also, I express my gratitude to the qualitative enquiry team, to Frances Aiwa and to Marcheal Okello who translated all meetings of the qualitative enquiry. I would like to especially thank the TAG members in Moroto: Martin Onyona (CUAMM), Geoffrey Odongo (World Food Program), Rebecca Oketcho and Paul Troy (Concern Worldwide), and Ngolobe Martin (UNICEF) for sharing information and helping me prepare the initial workshop. Also, without the authorization and support of District Health Officer the Lin,k NCA could not have been realized. I am addressing my thanks to Dr. Lubega Abuxabi. Throughout the preparation and holding of both workshops and the data collection two persons constantly supported our efforts, Mr. Abiud Omwega from UNICEF and Mrs. Siti Halati from WFP. Their interest, their curiosity and their presence in these two workshops have enabled partners to provide a high quality Link NCA study. Their support has significantly contributed to the realization of this major study. Many thanks to the ACF Uganda team who had the concern to facilitate the work of the NCA team in Moroto. ACF Country Director, Mr. Duncan Bell, who was present at both workshops in Moroto, and Mrs. Claire Kimurahebwe, nutrition coordinator who ensured from start to end her role as coordinator and NCA focal point in Uganda. Bringing this investigation to completion in all its methodological dimensions became also possible thanks to the Link NCA study technical unit (ACF France), which has always accompanied us even when we were far away. Our thanks go to Mrs. Blanche Mattern. Also, we thank our focal point for Link NCA study in New York, Mrs. Angeline Grant and the other technical advisors: Mr. Daniel Rupp and Mr. Nicolas Villermot. The financial support for the Link NCA study in Moroto was provided by the UK Department for International Development (DFID) through UNICEF and WFP, we are grateful for their commitment and support to development in Karamoja and Uganda. Finally, on a personal note, I would like to thank a close friend, the sociologist Michalis Lianos, who read with care and perspicacity all the pages of this report. 3 Table of Contents About this report ......................................................................................................................................................................... 2 Acknowledgements ..................................................................................................................................................................... 3 Abbreviations and Acronyms ...................................................................................................................................................... 7 VHT: Village Health Team ................................................................................................................................................... 7 Executive summary ..................................................................................................................................................................... 8 Overview .................................................................................................................................................................................... 8 Study Objective .......................................................................................................................................................................... 8 Methodology and Link NCA approach .................................................................................................................................... 9 Limitations of the study ............................................................................................................................................................. 9 PART I ....................................................................................................................................................................................... 11 1.1. Introduction ..................................................................................................................................................................... 11 1.1.1. Context Information of Moroto District ................................................................................................................. 11 1.1.2 Why conduct a Link NCA study in Moroto District? ................................................................................................... 12 1.1.3 Main Study Objective.................................................................................................................................................. 13 Specific the NCA study sought to answer the following questions: .......................................................................................... 13 2.0 THE LINK NCA STUDY METHODOLOGY............................................................................................................................ 14 2.1 Overview of the Link NCA study Approach ................................................................................................................. 14 2.2 Study design ................................................................................................................................................................ 18 2.2.1 Initial Technical Experts Workshop ............................................................................................................................ 18 2.2.2 Field data collection ................................................................................................................................................... 18 2.2.3 Final Technical Expert Workshop............................................................................................................................... 18 2.3 Sampling procedures .................................................................................................................................................. 18 2.3.1 Sampling methodology ............................................................................................................................................. 18 2.3.2 Sample size calculation .............................................................................................................................................. 19 2.4 Data collection methods ............................................................................................................................................. 20 2.4.3 Data Collection ..........................................................................................................................................................
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