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Nabilatuk District Nutrition coordination designing context specific nutrition interventions THE REPUBLIC OF structure, the 3 Sub Counties (Lorengedwat, in the districts and formulate customized action CALL TO ACTION Lolachat, Nabilatuk), and 1 Town plans. Council(Nabilatuk) trained in multi sectoral NUTRITION ISSUE ACTION RESPONSIBLE A Stakeholder Mapping and Capacity GOVERNANCE AREA PERSON NABITALUK DISTRICT LOCAL GOVERNMENT nutrition implementation for improved nutrition Assessment exercise was conducted to ADVOCACY BRIEF ON STRENGTHENING NUTRITION GOVERNANCE FOR MULTI-SECTORAL RESPONSE outcomes. examine institutional arrangements and capacity Coordination and Poor supervision and coordination Advocate to the DLGs to adopt CAO, DNCC, DNFP partnerships: of nutrition sensitive activities regular support supervision to the Supported the district to conduct quarterly to plan, budget and manage the multi-sector implemented at community level by LLGs into their day to day activity District Nutrition Coordination Committee nutrition programs in the district. district staff M&E schedule to foster adoption meetings, and, joint monitoring and support and build capacity of LLG staff Annual briefs (Technical and Advocacy) have supervision activities to LLGs aimed at to support better multi sectoral been developed from relevant studies conducted strengthening the accountability framework for nutrition interventions. to guide the strategic coordination, planning, Multisectoral nutrition actions implemented in budgeting, implementation and monitoring of the district. Systems Poor appreciation of nutrition by Conduct in service training on CAO, DNCC, DNFP both nutrition specific and nutrition sensitive capacity Building non traditional sectors (Community nutrition sensitive programming to A Multi-Sectoral Nutrition Annual Workplan interventions in the district, LLGs, and (functional, Based Services, Education, critical staff from key nontraditional (FY 2019/20) was developed by the DNCC communities. institutional Production, Natural resources)) who departments. and subsequently approved through the office and Human expect nutrition to only be a health capacities) and production department related of the Chief Administrative Officer to guide Financial and resource mobilization indicator. implementation of Nutrition actions in the Technical and financial support provided to district. the district in terms of logistics in the various Policy and legal Limited awareness on available Support wide dissemination of CAO, DNFP, LC5, framework policies, guidelines that support existing legal policy and planning DNCC trainings and studies aimed at improving the Systems capacity Building (functional, Multisectoral nutrition action frameworks across departments ability and capacity of the district to better institutional and Human capacities) coordinate, plan, budget, implement and monitor Capacity of the respective coordination both nutrition specific and nutrition sensitive Information Lack of harmonized reporting Provide technical support on the CAO, DNFP, DNCC management tools on multi sectoral nutrition usage of reporting and supervision structures built to plan, budget, implement, and interventions to communities. (monitoring, programming in nontraditional tools for the nutrition coordination monitor Multisectoral nutrition actions. All the developed Nutrition Action Plans and evaluation, departments. committees (such Quarterly and surveillance and Annual Reporting tool, Annual Members of the DNCC were trained in Nutrition Annual workplan were costed and funding gaps research) workplan template, action point MOYO Governance as well as Nutrition Action Planning established to provide a basis for a resource tracking tool, standardized minute PROFILE POPULATIONLAMWO for the five-year period in an effort to streamline mobilization plan as well as, to strategically format amongst others) YUMBE 89,700 Multisectoral nutrition activities at DLG level. facilitate efficient and effective finance planning, is located in North Eastern monitoring and liquidation of Multisectoral Finance and Low partner participation in district Improve coordination of the CAO, DNCC, DNFP Uganda, Karamoja sub-region in Pian County. 16,611 Policy development, implementation and nutrition interventions. resource budget review conferences timing of key sector reviews and It is located about 344km from City. Households mobilization legal framework mobilisation to allow for cross Nabilatuk District was curved out of Nakapiripirit KITGUM Communication for nutrition social behavior participation, discussions and MARACHA ADJUMANI A Five-year Nabilatuk District Nutrition Action information sharing among related District in July 2018. It is bordered by Nakapiripirit Infants Women of reproductive change and Advocacy <1 year age 15-49 years Plan (DNAP) approved (2020-2025) by the sectors as well as stakeholders. District in the East and south, in District council for operation as a district guide 225 PDCs members were trained on Key Family the north, in the West and North 4,757 22,327 regarding multi sectoral nutrition programming. Care Practices as change agents for nutrition Communication Poor community WASH practices Develop and promote community CAO, DNCC, DNFP West, in south west. Nabilatuk has 3 sub (for Nutrition Children People with based nutrition initiatives including AMURU 148 VHTs were trained on Key Family Care behaviour change micro nutrient supplementation & countiesARUA and 1 town council, however there are under 5 years PADERdisabilities >2 years Information management (monitoring, and practice) deworming, promotion of maternal more 2 new established sub counties, 25 parishes Practices as change agents for nutrition 19,581 11661 AGAGO evaluation, surveillance and research) and young child feeding practices, and 95 villages. 9 Community Development officer were hygiene and sanitation and child GULUChildren A baseline Food Security and Nutrition trained on Key Family Care Practices as change care The main Ethnic group is the Pian who are Formal education level 6-12 years of household head Assessment was conducted in Nabilatuk, key agents for nutrition to enhance their ability to predominantly agro-pastoralist. There are 16 findings of which have been used to inform implement and supervise Multisectoral nutrition primary schools (Government Aided, 3 Secondary 23,454 31.5% nutrition programming. The study will be 21.2% Primary, O’level 6.5%, Other 3.8% actions at sub county/ Town Council level. schools, ECD center 17, FAL centers 35, VSALS-, conducted annually to assess progress on key 70 FAL Instructors were trained on Key Family SACC). The district has 1 HCIV, 2HCIIs,NWOYA 3HCIIs (one 60+ years indicators for evidence based programming. ZOMBO Source: Uganda National Population is PNPF) and 190 VHTs. 12 Protected valley tanks. OTUKE Care Practices as change agents for nutrition 4,485 and Housing Census 2014 A Link Nutrition Causal Analysis was conducted through integration of nutrition messages in NEBBI to establish the various causal pathways for their curriculum. OYAM malnutrition in the district. The information KOLE generated from this study is important in 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 A stakeholder and mapping exercise was conducted where it was found that, Nabilatuk District Local Government has 5 stakeholders either overseeing or implementing Nutrition specific and sensitive interventions as well NUTRITION, WASH AND HEALTH STATUS OF THE DISTRICT as and creating an enabling environment for Nutrition implementation within the district. In total,1 (20%) is for Nutrition specific, 2(40%) is for nutrition sensitive intervention, 1(20%) is for both Specific and sensitive interventions and 1 (20%) implement all the interventions including governance interventions. NUTRITION STATUS FSNA baseline (2018) Desired situation (2020) HEALTH INDICATORS FSNA baseline (2018) Desired situation (2025) 20% NABILATUK DISTRICT MAP SHOWING DISTRIBUTION OF NUTRITION SPECIFIC, NUTRITION SENSITIVE AND GOVERNANCE INTERVENTIONS Common childhood illnesses in Nabilatuk district include; Nutrition specific Acute of households of households Respiratory are food insecure have food stocks 41% 59% 63% Malaria 35% Diarrhea 39% Infections 20% Nabilatuk Nutrition specific 5 LOW BIRTH WEIGHT & sensitive STAKEHOLDERS overseeing / implementing 22.3% IMMUNISATION (DPT3) VIT A SUPPLEMENTATION (12-23mo) interventions Nabilatuk TC 10% 83.9% STUNTING 87% 70% 80% <=14 interventions 32.2% ANAEMIA IN WOMEN 20% 40% 15 - 19 interventions All interventions Nutrition sensitive 20% 60% >=20 interventions 12% DEWORMING (12-23 mo) INTERVENTIONS TARGET GROUP NABILATUK Source: Food Security and Nutrition Assessment in 8 WASTING ANAEMIA IN CHILDREN 88% Scale up coverage of optimal breast feeding practices Pregnant and lactating women, Adolescents Girls districts of Karamoja 2018, Makerere University School (10-19Yrs) 100% of Public Health. 11.5% 76% Promote infant and young child feeding practises Mothers / caregivers 25% 4% 25% Promote optimal nutrition Children with special needs 0-11 months Promote appropriate adolescent nutrition Adolescents (Boys & Girls) NUTRITION GOVERNANCE Scale up and sustain effective coverage Vitamin A supplementation Children 6-59 months, postpartum women 100% INFANT AND YOUNG CHILD FEEDING PRACTICES FSNA baseline (2018) Desired situation (2025) to children 6-59months WHAT IS NUTRITION GOVERNANCE AND WHY IT IS IMPORTANT FOR NUTRITION OUTCOMES Iron and Folic supplementation to pregnant Pregnant women (15-49) 50% Min. acceptable diet Min. diet diversity (6-23mo) Min. meal frequency Outpatient management of acute malnutrition without medical Children 0-59 months, Pregnant women (15-49 ) 25% 8.2% 14.8% 35% Good nutrition governance entails making adequate policy decisions in a timely manner, committing the necessary complication financial and organizational resources to their effective implementation, i.e. ensuring that benefits reach most of the Inpatient management of acute malnutrition with medical Children 0-59 months, Pregnant women 25% 40% population, preferably the most vulnerable. It also entails a sustained political commitment to ensure that nutrition complication programs and policies can withstand threats and constraints from changes in district leadership, political and Management of moderate acute malnutrition (MAM) Children 0-59 months 25% socioeconomic upheavals (Solon 2007). Provide deworming tablets to children (1-14yrs) Children 12-59 months 50% Continued breast feeding (2yr) Exclusive breast feeding Breast feeding within first 1 hour Deworming for pregnant women Pregnant women (15-49yrs) 100% 65% 93% 92% NUTRITION GOVERNANCE FRAMEWORK Intermittent Prevention Treatment of malaria (IPT3???) for Pregnant Pregnant women (15-49yrs) 50% 80% 80% 80% women PILLARS OF NUTRITION GOVERNANCE Scale up and sustain effective coverage of ORS-Zinc for diahorrea Children 0-59 months 50% Scale up and sustain coverage of long lasting insecticide treated Pregnant & Lactating women, Children 55% Intersectoral Cooperation nets (LLINs) FSNA baseline (2019) Desired situation (2025) WASH STATUS Treatment of malaria All 60%

Policy Sustain universal coverage of available routine immunization Children 0-59 months, Pregnant women 25% Technical Frame Capacity Sustainable Funding Nutrition services Works Outcomes Promote EMCT services Pregnant & Lactating mothers 15-49years with HIV 50% Monitoring Provide ARV medication to HIV+Ve All HIV +VE incld Pregnant & Lactating mothers 50% Stakeholders Partnership

Vertical Building Frame work Information Financial and Communication Management Coordination and 15-49years with HIV

Coordination Policy and legal System Capacity Resource Mobilization Diet therapy into routine disease therapy Children 12-59 months with special needs LATRINE COVERAGE SAFE WATER ACCESS Advocacy Prevention and Management of diet-related NDCs Women of reproductive age 15-49yrs 25% 16% 81% (Nutrition Behavior Change. Advocacy)

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