164 BRENDA SHENUTE NAMUGUMYA


The focus here is on the use of advocacy to foster sustainable partnerships and implement nutrition strategies in Sub-Saharan Africa.


Nutrition Institutions and Policies in Uganda Uganda, like most countries with a high burden of malnutrition, has seen limited progress in reducing the levels of maternal and child malnutrition over the past two decades. In a 2010 report, FANTA-2 explains that the most common forms of malnutrition in Uganda were chronic malnutrition and micronutrient deficien- cies—in particular, deficiencies in iron (prevalence of 73 percent among under- fives and 49 percent among women of reproductive age) and vitamin A (20 percent among under-fives). Although micronutrient deficiencies have a major impact on health, growth, and physical development, they rarely have visible symptoms; much of the malnutrition in Uganda is thus a hidden problem. Malnutrition is a key contributor to childhood mortality in Uganda, as an underlying cause of around 150 childhood deaths every day. The long-term economic impact of this level of stunting—coupled with high levels of iron-deficiency anemia, iodine-deficiency disorders, and low birth weight—is estimated at US$310 million annually due to lost productivity, representing a 4.1 percent reduction in Uganda’s gross domestic product (FANTA-2 2010). Improving nutrition outcomes forms a core component in the health sector


strategies highlighted in the Uganda National Minimum Health Care Package of the Health Sector Strategic Plan II (Ministry of Health 2005). Implementation of preventative approaches such as integrated management of childhood illness, immu- nization, health education, and promotion emphasizes control of communicable diseases and school and environmental health. This is reinforced by the range of nutrition initiatives funded by foreign donors either independently or through the sectors of health and agriculture. However, the scale of implementation and budget allotted is inadequate for sustainably impacting national indicators. Steps have been taken to create a policy environment conducive to addressing Uganda’s nutrition and food security challenges. A review of several key policy documents setting the development priorities and strategies of the Government of Uganda—including the master development framework, the National Development Plan—shows that nutrition is included as a development concern. As in many other developing countries, however, the implementation of these strategic documents tends to be poor. There are several reasons for this, both general and nutrition-specific.


1. In Uganda there is no formal mechanism to coordinate nutrition activities among the various public and private entities that should be involved. Malnutrition is


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