Tackling nutrition challenges with good governance in Nebbi District
UNICEF is funding governance training to ensure nutrition issues trickle down to communities
Three in 10 children in Nebbi are stunted.
Over half of the children are anaemic.
60 per cent of the households do not have food stocks.
According to the 2019 Food Security and Nutrition Assessment for northern Uganda, nutrition is a challenge in Uganda, but predominantly in the West Nile where the multiple nutrition indicators are lower than in other regions. Stunting in 2019 for example was three times higher than the national average and was particularly prevalent in Nebbi. However, since the introduction of a multisectoral food security and nutrition project in 2016, the outcomes are improving: anaemia in children has reduced by 5 per cent, by 7 per cent in women and severe wasting is under 1 per cent. Nebbi also has been ranked second best performing among the 15 districts in which the programme is running. This performance is attributed to good governance.
“We are using a collaborative leadership approach,”
Cascading nutrition awareness
With funding from the European Union, UNICEF through the Development Initiative for Northern Uganda elaborately trains district and sub county nutrition coordination committees on nutrition governance, after which the teams develop nutrition action plans to enhance good nutrition outcomes in the region.
According to the UNICEF Nutrition Officer, Amos Hashaka Ndugutsye, UNICEF is funding governance training to ensure that issues of nutrition trickle down to schools, health centres and the community.
Enhancing Nutrition by example
“I used to think that nutrition only related to health but when I discovered that it is for everyone I started eating appropriately and became a champion here in the office, at home and in the neighbourhood,” Paska Kwiyocwiny Manano, the District Labour Officer reveals.
Every member of the district and sub county leadership is encouraged to set up a kitchen garden with vegetables and where possible a bigger one with micro nutrient-rich foods such as orange fleshed potatoes and bio fortified beans. The leadership team members have become champions of nutrition interventions in the district.
“It is not good to advocate for good nutrition then suffer malnutrition yourself. It must begin with you.”
At the entrance of the Erussi Sub County headquarters is a model kitchen garden. With a diameter of about two metres, the garden of green leafy vegetables and onions is elevated with bricks to guard against flooding and partitioned with a stone-laid trench to ease access for weeding and drainage of water. Though the sub county garden was intended solely for demonstration, the community members often harvest the vegetables for home consumption.
A similar garden is replicated at multiple households in the sub county. “When they saw what was at the office, they went home and replicated the same,” Paska concludes. ”The community follows its leaders.” Resultantly, there also is growing involvement of men in day to day nutrition practices like ensuring that children feed on a balanced diet.
Decentralizing nutrition governance
“We are taking nutrition to the doorstep of households,” reveals the district planner. The district leaders are the starting point for the nutrition education which they then spread to the sub county nutrition coordination committees which cascade the information to the village health teams (VHTs) and school nutrition committees, who then finally transfer this further down to the communities. The VHTs also conduct home visits and referrals, in partnership with the local council, and the nearest health centre. The same structure is being utilized for nutrition monitoring as well as community sensitization on the corona virus disease (COVID-19).
The leadership is adapting solutions to fit the local environment, such as promoting cultural agronomics like the use of manure, mulching, building clay-based energy savers and using seedlings from locally grown trees. To enhance sustainability, the leadership is pursuing the formalization and registration of farmers groups so as to link them to other support entities.
The results of good governance are evident: in December 2019, Nebbi was ranked second best performing in nutrition indicators among the 15 districts on the programme. At Nyaravur Sub County, the leadership team achieved over 90 per cent of the activities in the nutrition action plan despite the COVID-19 restrictions and financial constraints.
Additionally, Nyaravur Health Centre III emerged best in service delivery in the district due to team excellence. Eric Abedikane the Community Development Officer notes that “Nutrition is an issue that affects us all so we are defying the odds, particularly financial constraints, to ensure we have a healthy community.”
To ensure sustainability of nutrition programming the district leadership has integrated nutrition in all the sectoral and departmental workplans.