CALL TO ACTION

NUTRITION CHALLENGES/ GAPS CALL FOR ACTION RESPONSIBLE GOVERNANCE AREA OFFICE THE REPUBLIC OF

Kole District Nutrition coordination committee unavailable therefore this first FSNA data will Coordination and Low engagement of district IPs in Conduct regular stakeholder mapping (biannually) DNFP, CAO partnerships: (DNCC), six (6) Sub counties and four (4) Town be used as a baseline to compare progress multi-sectoral nutrition activities. e.g. and orientation of new stakeholders on DNCC and LOCAL GOVERNMENT DNCC meetings and joint monitoring multisectoral nutrition implementation. council trained on multi sectoral nutrition in achievement of health, nutrition and WASH of activity implementation at district Establish joint planning and strategic coordination ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSE implementation for improved nutrition indicators in subsequent FSNAs. Annual FSNAs and subcounty level. outcomes. will be conducted to assess annual progress. mechanisms amongst partners with the district Over delegation of multi-sectoral to reduce on duplication of resources and achieve The district conducted quarterly DNCC meetings The Kole DNCC has been trained on nutrition work to the DNFP hence getting sustainable results and support supervision activities aimed at governance and supported to use reporting overwhelmed with tasks Orientation of DNCC members on their roles and strengthening the accountability framework for templates and monitoring tools previously responsibilities Multisectoral nutrition actions implemented in developed as part of the Standard Operating Systems Lack of clarity on nutrition sensitive Orientation of non-traditional departments on DNFP, CAO Kole district. Procedures for nutrition governance. The capacity Building programming for the nontraditional nutrition sensitive approaches/actions to ensure their reporting templates and monitoring tools are (functional, departments (Community Based implementation in the district. Systems capacity building (functional, currently in use by the district for program institutional and Services, Education, Production) Human capacities) institutional and Human capacities) implementation. Policy Kole DNAP not fully aligned with the District should align the DNAP 2020-25 with the Kole District Kole district local government was supported to The DNCC, SNCC and TNCC conducts monthly development, District Development Plans 2020-2025 DDP III (2020-2025) Planner, build the capacity of the coordination structures monitoring and supervision visits and quarterly implementation DNFP Limited awareness on available Support the wide dissemination of sectoral and at district level and respective lower local meetings to assess progress of program and legal framework policies, guidelines that support departmental policies and guidelines such as National governments to plan, budget, implement, and implementation. Multisectoral nutrition action Health Policy (NHPII), Health Sector Development monitor multisectoral nutrition actions. Plan (HSDP II) 2015/16–2019/20, Integrated Early Financial and resource mobilization Childhood Development (NIECD) Policy (2016) , A total of 120 technical staffs from 6 sub- Presidential Initiative on healthy eating and healthy counties and 4 Town councils were trained on A costed Multi-Sectoral Nutrition Annual lifestyles (July, 2019) National Agriculture Policy development of SNAPs. Workplan (FY 2019/20) was developed and (NAP) of 2013 and the Agriculture Sector Strategic approved through the office of the Chief Plan (2015/16-2020/20) and Food Security Strategy, DNCC/SNCCs to develop nutrition action plans Administrative Officer (CAO) to ensure the Education Sector Strategic Plan (ESSP) (20017- (DNAPs/SNAPs 2020-2025) and advocate for 2020) and Guidelines on Parent led School Feeding implementation of Nutrition actions in the approval by district/sub county councils. and Nutrition (2012),the Social Development Sector . Plan (2015/16 - 2019/20),the National Community DISTRICT PROFILE LAMWO Development Policy for Uganda (2015) and the Water KOBOKO The Kole District Nutrition Action Plan ((2020- YUMBE POPULATION 241,878 Policy development, implementation and and Environment Sector Development Plan (2015/16- Kole District is situated in the Northern part of 2025) to support the implementation of 3.3% legal framework 2019/20) and the UNAP during joint multisectoral Uganda, Lango sub-region between longitudes multisectoral nutrition actions was approved by forums with the DNCC and IPs in the district. 124,439 117,439 population A Five-year Kole District Nutrition Action Plan 320 East and 340 East and latitude 20 North and the District Council. Female Male growth rate (DNAP) FY 2020-2025 was approved by the Information Inadequate utilization of nutrition data Build capacity of nutrition focal persons and nutrition District 3o North. Kole District in Northern Uganda shares management and other monitoring data for (decision programmers to make better use of nutrition data at Planner, council for operation as a district guide Six sub counties and four town council all a boundary with in the West and (monitoring, making, planning and program district and sub- county levels. Bio-stat MARACHA ADJUMANI Infants Orphans regarding multi sectoral nutrition programming. had their Nutrition Action plans approved by North, in the East and District in evaluation, improvement) <1 year <18 years their respective councils. Activities from their the South. Administratively, the District has Four All six (6) sub counties and 4 Town councils surveillance and Lack of nutrition related indicators in District to advocate for addition of nutrition indicators workplan are being implemented in the district. research) (4) Town Councils (Ayer, Bala, Akalo and ) 10,401 19,447 were supported to develop Sub-County Nutrition the Performance Based Budgeting in the PBB by output. and six Sub-counties (Akalo, Bala, Ayer, Aboke, Action Plans (SNAPs) and these were approved (PBB) at DLG level by program output. Children Women of reproductive Communication for nutrition social behavior Okweredot and Alito), 41 parishes disaggregated AMURU under 5 years by their respective councils. Communication Nutrition is under-looked to not to be a Regular district nutrition fora are required to sensitize DNFP, DHO ARUA PADERage 15-49 years change and Advocacy (for Nutrition public health concern. leaders and politicians about the significance of per sub-county and 692 villages/cells. 42,812 48,859 behavior change nutrition. Continuous nutrition education in health AGAGO Information management (monitoring, A total of 126 PDCs, FAL Instructors and 6 SUB-COUNTIES 41 PARISHES and practice) facilities and community Children evaluation, surveillance and research) Community Development officer were trained GULU Pregnant women Low Dietary Diversity in children Promote and support the implementation of 4 TOWN COUNCIL 692 VILLAGES below 18 years on Key Family Care Practices (KFCPs) as change expected Kole district was supported carry out a Nutrition below ages of 6-23 months, community-based nutrition actions such as agents for nutrition to enhance their ability to Kole District covers a total area of 2,847 square 133,275 Causal Analysis (NCA) to understand the food community based supplementary feeding program 12,094 implement and supervise Multisectoral nutrition kilometers of which 9% is under open swamps and nutrition security situation and to explore the Advocacy Lack of explicit budgets allocated for Conducting a budget expenditure analysis to identify CFO, Planner Adolescents Source: Uganda National actions at sub county/ Town Council level. and water. Forest cover is 15% while about 74% is causal pathways for malnutrition in the district. (for planning, nutrition actions /interventions available and funding gaps for nutrition actions. NWOYA 10-24 years Population and Housing budgeting ZOMBO suitable for arable farming. Subsistence agriculture Data from the NCA will be/ is being used to FAL Instructors were trained on Key Family Care Resource mobilization for unfunded nutrition priorities Census 2014 and resource with animal husbandry is the main economic 84,174 OTUKE support program implementation. Practices as change agents for nutrition through mobilization) Political interference in implementation Involvement of politicians in monitoring of multi- DNFP activity inNEBBI the district. integration of nutrition messages in their Kole was also supported to conduct a Food of multi-sectoral nutrition interventions sectoral nutrition activities in the district. OYAM curriculum. in the district. KOLE Security and Nutrition Assessments (FSNA). FSNA data was not available previously This publication was produced with the financial support of the European Union. Its contents are the sole responsibility of UNICEF DEVELOPMENT INITIATIVE and do not necessarily reflect the views of the European Union. 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: Kole District Local Government has 16 stakeholders either overseeing or implementing Nutrition specific and sensitive interventions as well as and creating an enabling environment for Nutrition NUTRITION STATUS FSNA baseline (2019) Desired situation (2025) HEALTH INDICATORS FSNA baseline (2019) Desired situation (2025) implementation within the district. In total, six of stakeholders are for Nutrition specific, three for Nutrition sensitive, three partners for governance and four supporting all the interventions. Common childhood illnesses in Kole district include; Acute of households of households Respiratory 18.5% 18.5% KOLE DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION are food insecure have food stocks SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS. 55% 28% 30% Malaria 5% Diarrhea 3% Infections Nutrition sensitive Governance

Alito LOW BIRTH WEIGHT 16 Aboke Okwerodot 10% IMMUNISATION (DPT3) VIT A SUPPLEMENTATION (12-23mo) STAKEHOLDERS overseeing / implementing Ayer STUNTING 10% 98% 57% interventions Kole TC

70% 80% Ayer 15% ANAEMIA IN WOMEN <14 interventions Bala 20% 23% 15 - 19 interventions 25% 38% Akalo 12% > 20 interventions DEWORMING (12-23 mo) All interventions Nutrition specific Source: Food Security and Nutrition Assessment in 10 ANAEMIA IN CHILDREN 49% WASTING districts of Northern Uganda and West Nile 2019, Makerere 100% INTERVENTIONS TARGET GROUP KOLE 4% 67% University School of Public Health. Scale up coverage of optimal breast feeding practises Pregnant and lactating women, 4% 25% Adolescents Girls (10-19Yrs) Promote infant and young child feeding practices Mothers / caregivers 50% Promote optimal nutrition among pregnant women and lactating Children with special needs 0-11 months INFANT AND YOUNG CHILD FEEDING PRACTICES FSNA baseline (2019) Desired situation (2025) NUTRITION GOVERNANCE mothers Promote appropriate adolescent nutrition Adolescents (Boys & Girls) Min. acceptable diet Min. diet diversity (6-23mo) Min. meal frequency WHAT IS NUTRITION GOVERNANCE AND WHY IS IT IMPORTANT? Scale up & sustain effective coverage of vitamin A Children 0-59 months, postpartum women 100% supplementation to children 6-59 months 6% 21% 21% 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% financial and organizational resources to their effective implementation, i.e. ensuring that benefits reach most of the 40% Outpatient management of severe acute malnutrition without 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 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 71% 66% 49% 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% PILLARS OF GOVERNANCE Deworming for pregnant women* Pregnant women (15-49yrs) 100% Intermittent prevention of malaria (IPT3???) for Pregnant women Pregnant women (15-49yrs) 75%

Intersectoral Cooperation Scale up and sustain effective coverage ORS-Zinc for diahorrea Children 0-59 months 55% FSNA baseline (2019) Desired situation (2025) WASH STATUS Scale up and sustain coverage of long lasting insecticide treated Pregnant & Lactating women, Children 55% Policy nets (LLINs) Technical Frame Capacity Sustainable Funding Nutrition Treatment of malaria All 75% Works Outcomes Sustain universal coverage of available routine immunization Children 0-59 months, Pregnant women 50% Monitoring services

Stakeholders Vertical Partnership Building Frame work Information Financial and Communication Management Coordination Coordination and 75%

Policy and legal Provide comprehensive EMCT services Pregnant & Lactating mothers 15-49years with HIV System Capacity Resource Mobilization Advocacy Provide ARV medication to HIV +VE All HIV +VE incld Pregnant & Lactating mothers 75% LATRINE COVERAGE SAFE WATER ACCESS Diet therapy into routine disease therapy Children 12-59 months with special needs (Nutrition Behavior Change. Advocacy) 88% 89% Prevention and Management of diet –related NCDs Women of reproductive age 15-49Yrs 35% 80% 87% Source: Institute of Development studies (IDS), 2013 Source: Nutrition Stakeholder Mapping for Uganda Report. 2019