Amanda Pomeroy-Stevens1,2, Alexis D'Agostino3,2, Nancy Adero4, Hannah Foehringer Merchant2, Abel Muzoora4, Ezekiel Mupere5, Edgar Agaba6, Lidan Du3,7. 1. SPRING Project, Arlington, VA, USA amanda_pomeroy@jsi.com. 2. John Snow Inc (JSI), Arlington, VA, USA. 3. SPRING Project, Arlington, VA, USA. 4. SPRING Project, Kampala, Uganda. 5. Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda. 6. FTF Innovation Lab for Nutrition, Tufts University, Boston, MA, USA. 7. Helen Keller International (HKI), New York, NY, USA.
Abstract
BACKGROUND: In 2010, Uganda began developing its first multisectoral nutrition plan, the Uganda Nutrition Action Plan (UNAP), to reduce malnutrition. While the UNAP signals high-level commitment to addressing nutrition, knowledge gaps remain about how to successfully implement such a plan. OBJECTIVE: We tracked the UNAP's influence on the process of priority setting and funding for nutrition from 2013 to 2015. METHODS: This study used a longitudinal mixed methods design to track qualitative and budgetary changes related to UNAP processes nationally as well as in 2 study districts. Qualitative changes were assessed through interviews, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation interviews. RESULTS: Important enabling factors named by stakeholders included identity, human resources, sustainable structures, coordination, advocacy, and adaptation of the UNAP to local needs. Evidence suggests that the UNAP facilitated improvements in the last 3 factors. We found no systematic increases in planned nutrition activities, nor did we find increases in allocations or expenditures for nutrition between fiscal years 2013-2014 and 2014-2015. Expenditure data were not always available for all funding mechanisms. In the 2 study districts, there was little flexibility within financing structures to allow for additional nutrition activities. CONCLUSIONS: Results suggest the UNAP has played an important role in strengthening the enabling environment for nutrition action. The next UNAP will need to translate these improvements into a greater number of nutrition activities and higher levels of funding at the national and subnational levels.
BACKGROUND: In 2010, Uganda began developing its first multisectoral nutrition plan, the Uganda Nutrition Action Plan (UNAP), to reduce malnutrition. While the UNAP signals high-level commitment to addressing nutrition, knowledge gaps remain about how to successfully implement such a plan. OBJECTIVE: We tracked the UNAP's influence on the process of priority setting and funding for nutrition from 2013 to 2015. METHODS: This study used a longitudinal mixed methods design to track qualitative and budgetary changes related to UNAP processes nationally as well as in 2 study districts. Qualitative changes were assessed through interviews, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation interviews. RESULTS: Important enabling factors named by stakeholders included identity, human resources, sustainable structures, coordination, advocacy, and adaptation of the UNAP to local needs. Evidence suggests that the UNAP facilitated improvements in the last 3 factors. We found no systematic increases in planned nutrition activities, nor did we find increases in allocations or expenditures for nutrition between fiscal years 2013-2014 and 2014-2015. Expenditure data were not always available for all funding mechanisms. In the 2 study districts, there was little flexibility within financing structures to allow for additional nutrition activities. CONCLUSIONS: Results suggest the UNAP has played an important role in strengthening the enabling environment for nutrition action. The next UNAP will need to translate these improvements into a greater number of nutrition activities and higher levels of funding at the national and subnational levels.