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CALL TO ACTION THE REPUBLIC OF

NUTRITION CHALLENGES/ GAPS CALL FOR ACTION RESPONSIBLE GOVERNANCE AREA OFFICE DISTRICT LOCAL GOVERNMENT Coordination and Limited transport facilities Integration of nutrition activities with other departmental DNFP, CAO ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSE partnerships: (movement) to enable staff field activities. perform their nutrition related duties.

Limited coordination of Ensure functionality of the coordination structures at the nutrition activities at sub- district and sub county/town council level by institutionalizing county level mechanisms that foster regular engagements for joint planning, budgeting, monitoring and technical support Systems capacity building (functional, in achievement of health, nutrition and WASH supervision at subcounty level institutional and human capacities) indicators in subsequent FSNAs. Bi-annual FSNAs will be conducted to assess annual Systems capacity Lack of clarity on nutrition Orientation of nontraditional departments on nutrition DNFP, CAO, local government was supported progress. Building (functional, sensitive programming sensitive approaches/actions to ensure their implementation SAS to build the capacity of the coordination institutional and for the nontraditional in the district subcounty, division and municipality level. structures at district level and respective lower The Yumbe DNCC has been trained on nutrition Human capacities) departments (Community local governments to plan, budget, implement, governance and supported to use reporting Based Services, Education, and monitor multisectoral nutrition actions. 15 templates and monitoring tools previously Production) at district, staff District Nutrition Coordination Committee developed as part of the Standard Operating subcounty, division and (DNCC) were trained to develop their DNAPs Procedures for nutrition governance. The municipality level. while 195 staff from eleven sub counties and reporting templates and monitoring tools are one town council developed SNAPs and TNAPs currently in use by the district for program Policy and legal Yumbe DNAP not well District should align the DNAP 2020-25 with the Yumbe DDP District Planner respectively. implementation. framework aligned to the District III (2020-2025) The DNCC, SNCC, TNCC, MNCC and DiNCC Development Plans 2020- Policy development, implementation and conducts monthly monitoring and supervision 2025 MOYO legal framework visits and quarterly meetings to assess progress No existence of nutrition Disseminate SOPs for nutrition governance MoLG, OPM DISTRICT PROFILE LAMWO of program implementation KOBOKO The District Nutrition Coordination Committee governance resource Yumbe DistrictYUMBE was created in November 2000 POPULATION 272,707 of Yumbe district developed a District Nutrition materials for reference (e.g. from District. It is bordered by Action Plan (DNAP) aligned to the Uganda Finance and resource mobilisation SOPs) to the north, Moyo to the east, Yumbe to the 52% 48% Nutrition Action Plan II. The DNAP was also Female Male The DNCC was supported to develop annual Information Inadequate use of Building capacity of nutrition focal persons and nutrition Bio-stat, southeast, Arua to the south, Maracha to the approved by the District Council. workplans for implementation of multisectoral nutrition data & other programmers to make better use of nutrition data. District southwest and Koboko to the west. The district KITGUM management MARACHA ADJUMANI Eleven sub counties and one town council nutrition actions. The 2019/2020 annual workplan (monitoring, monitoring data within the Planner, DNFP covers a total area of 2,411sq km2, 80.01 percent Infants Orphans developed Subcounty Nutrition Action Plans was signed by the Chief Administrative Officer evaluation, departments. of which is arable, 17.08 percent forested, and 9.9 <1 year <18 years percent covered by water bodies and wetland. (SNAPs) and Town council Nutrition Action Plans and is under implementation. surveillance and 11,726 21,926 Yumbe is one of the refugee hosting districts. (TNAPs) respectively aligned to the Yumbe The Yumbe District Nutrition Action Plan research) The District has one county with twelve (12) Children Women of reproductive District Nutrition Action plan. (2020-2025) to support the implementation of AMURU Sub-counties,ARUA one (1) Town Council, 101 parishes under 5 years PADERage 15-49 years multisectoral nutrition actions was approved by Communication (for Negative cultural beliefs Community wide sensitization and dialogues on positive CBO, DHO and 636 village councils. The District has three 48,269 Information management (monitoring, the District Council. Nutrition behavior and practices that affect behavioral change on nutrition 55,087 AGAGO (3) upcoming Town Boards namely Midigo, evaluation, surveillance and research) change and practice) positive nutrition behavior Ten sub counties and one town council all Lomunga and Kuru. By May 1, 2017, the refugee ChildrenGULU in the communities Pregnant women Yumbe district was supported carry out a had their Nutrition Action plans approved by population had risen to 272,707. Refugees in the below 18 years expected Nutrition Causal Analysis (NCA) to understand their respective councils. Activities from their Advocacy (for Low funding for multi- Resource mobilization for funding of priority nutrition DNFP, district mainly come from South Sudan. They are 150,262 the food and nutrition security situation and to 13,635 workplan are being implemented in the district.. planning, budgeting sectoral nutrition activities interventions from nutrition stakeholders Administration hosted in Bidi bidi settlement area where they are explore the causal pathways for malnutrition in allocated plots of land to build homes and to farm. Adolescents Refugee and resource in the district. NWOYA 10-24 years the district. Data from the NCA will be/ is being Generate periodic advocacy and policy briefs for politicians population Communication for nutrition social behavior mobilization) ZOMBO Generally, the refugee and host communities used to support program implementation. change and Advocacy and district and LLG level as a tool to advocate for funding enjoy a cordial relationship, which offers a 94,902 272,707 OTUKE Yumbe was also supported to conduct a Food for nutrition. favorableNEBBI environment for doing business. 389 FAL groups, PDCs and CDOs were trained OYAM Security and Nutrition Assessments (FSNA). on the Key Family Care Practices and are KOLE FSNA data was not available previously supporting communities implement nutrition unavailable therefore this first FSNA data will sensitive actions. This publication was produced with the financial support of the European Union. Its contents are the sole responsibility of UNICEF be used as a baseline to compare progress 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: In order to improve coordination and partnerships, a stakeholder mapping was conducted in Yumbe district. Yumbe District Local Government has 25 stakeholders either overseeing or NUTRITION STATUS FSNA baseline (2019) Desired situation (2025) HEALTH INDICATORS FSNA baseline (2019) Desired situation (2025) implementing Nutrition specific and sensitive interventions as well as and creating an enabling environment for Nutrition implementation within the district. In total, 13 (52%) are for Nutrition specific, 11 (44%) are in Common childhood illnesses in Yumbe district include; Acute Nutrition sensitive and 2(4%) stakeholders for specific, sensitive and governance interventions. of households of households Respiratory 55% are food insecure 55% have food stocks 4% YUMBE DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION 30% Malaria 7% Diarrhea 1% Infections SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS All interventions

Kerwa

LOW BIRTH WEIGHT Kei Midigo 11% IMMUNISATION (DPT3) VIT A SUPPLEMENTATION (12-23mo) 25 10% STAKEHOLDERS Kochi STUNTING 99% 86% overseeing / implementing Romogi interventions Apo 26% ANAEMIA IN WOMEN 70% 80% Kuru 20% Kululu Odravu 35% Drajini <=14 interventions 12% DEWORMING (12-23 mo) 44% 52% Ariwa 15 - 19 interventions Source: Food Security and Nutrition Assessment in 10 Nutrition sensitive Nutrition specific >=20 interventions ANAEMIA IN CHILDREN 82% WASTING districts of Northern Uganda and West 2019, Makerere 4% 7% 100% University School of Public Health. 4% 25% INTERVENTIONS TARGET GROUP YUMBE Promote, protect and support breast feeding Pregnant and lactating women, Adolescents Girls (10-19Yrs) INFANT AND YOUNG CHILD FEEDING PRACTICES FSNA baseline (2019) Desired situation (2025) NUTRITION GOVERNANCE Promote age appropriate complementary feeding Mothers / caregivers 75% practises Min. acceptable diet Min. diet diversity (6-23mo) Min. meal frequency WHAT IS NUTRITION GOVERNANCE AND WHY IS IT IMPORTANT? Promote optimal nutrition Children with special needs 0-11 months Promote adolescent nutrition Adolescents (Boys & Girls) 20% 28% 37% Good nutrition governance entails making adequate policy decisions in a timely manner, committing the necessary Vitamin A supplementation to children Children 0-59 months, postpartum women 100% 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 Iron and Folic supplementation Pregnant women (15-49) 95% programs and policies can withstand threats and constraints from changes in district leadership, political and Outpatient management of acute malnutrition Children 0-59 months, Pregnant women (15-49) 30% Continued breast feeding (2yr) Exclusive breast feeding Breast feeding within first 1 hour socioeconomic upheavals (Solon 2007). Inpatient management of acute malnutrition Children 0-59 months, Pregnant women 25% 64% 55% 42% NUTRITION GOVERNANCE FRAMEWORK Management of moderate acute malnutrition (MAM) Children 0-59 months 25% 80% 80% 80% Provide deworming tablets to children (1-14yrs) Children 12-59 months 75% PILLARS OF GOVERNANCE Deworming for pregnant women Pregnant women (15-49yrs) 100% IPT of malaria (IPT and IPTs2) for Pregnant women Pregnant women (15-49yrs) Intersectoral Cooperation 65% WASH STATUS FSNA baseline (2019) Desired situation (2025) Diahorrea with ORS & Zinc Children 0-59 months Long lasting insecticide treated nets (LLINs) Pregnant & Lactating women, Children 75% Policy Technical Frame Treatment of malaria All 75% Capacity Sustainable Funding Nutrition Works Outcomes Recommended vaccines in the national schedule by Children 0-59 months, Pregnant women 75% Monitoring recommended age

Stakeholders Vertical Partnership Building Frame work Information Financial and Promote PMCT /EMCT of HIV Pregnant & Lactating mothers 15-49years with HIV 75% Communication Management Coordination Coordination and Policy and legal System Capacity Resource Mobilization Provide ARV medication All HIV +VE incld Pregnant & Lactating mothers 50% LATRINE COVERAGE SAFE WATER ACCESS Advocacy Diet therapy into routine disease therapy Children 12-59 months with special needs (Nutrition Behavior Change. Advocacy) 78% 93% Prevention and Management of diet-related NDCs Women of reproductive age 15-49yrs 25%

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