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Uganda[2008–Present] At the request of USAID/Uganda, FANTA is helping to strengthen maternal and child health and nutrition (MCHN) programming in Uganda, build political interest in MCHN and develop a community-based nutrition program approach to reduce malnutrition among women and children. The project’s earlier work included providing technical assistance for the nutrition care and support of people living with HIV (PLHIV). Uganda National Action Plan 2011-2016: The Government of Uganda has developed a 5‑year Uganda Nutrition Action Plan (UNAP), a framework for addressing the country’s nutrition issues. The goal of this plan is to improve the nutrition status of all Ugandans, with emphasis on women of reproductive age, young children, and infants. The plan is intended to reduce the magnitude of malnutrition in Uganda and its impact on the individual, the household, the community, and the nation at large. The government also produced a short document targeted at district- and lower-level leaders to raise awareness of the nutrition situation in Uganda and to introduce the UNAP. Nutrition Situation Analysis: To inform development of a community-based approach, FANTA conducted a situation analysis to assess the nutrition problems, causes, activities, challenges and opportunities facing the country. The findings are available in the report, The Analysis of the Nutrition Situation in Uganda. FANTA also is drafting a desk review, which includes FANTA’s strategic mapping of the nutrition interventions in Uganda and results from preliminary field work conducted to better understand current nutrition practices, barriers and constraints, and partnerships in nutrition. Guidelines on Integrated Management of Acute Malnutrition (IMAM): In collaboration with the Ministry of Health (MOH), UNICEF, NuLife and other nutrition stakeholders, FANTA provided technical input to the Uganda Guidelines on IMAM (equivalent to Community-Based Management of Acute Malnutrition) and has developed monitoring and reporting tools for IMAM programs. Infant and Young Child Feeding (IYCF) Policy Guidelines and Counseling Tools: FANTA has been a key partner in completing the IYCF Policy Guidelines and counseling tools, a process spearheaded by the MOH. Based on evidence from the Uganda Demographic and Health Survey (DHS), FANTA advocated for the guidelines to focus on key IYCF issues that had been overlooked in the draft versions, particularly related to prelacteal feeds and specific complementary feeding issues. Nutrition-Focused Advocacy Package: FANTA, in partnership with WFP/Uganda and UGAN, developed a set of nutrition advocacy package that work to meet the need for harmonized messages to inform Ugandans that nutrition affects all sectors of society and is cross-cutting. The briefs have targeted advocacy messages using data from Uganda PROFILES spreadsheets. PROFILES is a process for nutrition policy analysis and advocacy that uses spreadsheet models to estimate the functional consequences of malnutrition in terms that policy makers understand and care about. In 2010, FANTA worked with partners, including WFP/Uganda, to update the sections of Uganda PROFILES that illustrate the cost of malnutrition in Uganda in terms of productivity, morbidity, and mortality, among other development outcomes, using 2006 Uganda Demographic and Health Survey (DHS) data. Promising Practices in Nutrition, Food Security and HIV Programming: The Regional Centre for Quality of Health Care (RCQHC) and FANTA reviewed nutrition, food security and HIV programs in Uganda, Kenya, Malawi, Tanzania and Zambia to identify and document promising practices to help understand what works, replicate successful approaches and incorporate lessons into programs. The findings are available in the report, Nutrition, Food Security and HIV: A Compendium of Promising Practices. Agriculture-Based Livelihood Strategies of PLHIV: FANTA worked with a Family Health International (FHI) project, Regional Outreach Addressing AIDS through Development Strategies (ROADS), in the border town of Busia, which straddles Uganda and Kenya, to review and document agriculture-based livelihood strategies that HIV-affected households and communities are adopting. FANTA documented results and lessons from the process, including approaches that were effective at strengthening livelihoods, in the report Strengthening Agricultural Technologies Among People Living With HIV: Lessons Learned in the Border Towns of Busia, Kenya and Busia, Uganda. FANTA helped strengthen PLHIV cluster livelihood activities and enhanced their access to new opportunities, including expanding successful livelihood practices to other PLHIV clusters in the ROADS project. Integrating Essential Nutrition Actions (ENA): FANTA provided technical assistance to UNICEF and RCQHC to integrate ENA--a set of seven interventions that promote nutrition and child survival--into the health sectors in Uganda and Malawi. In Uganda, where the ENA approach was being implemented by the MOH, UNICEF and the A2Z Project, FANTA collaborated A2Z and the Africa 2010 project to revise and update the BASICS ENA district health services checklist. FANTA also helped UNICEF/Uganda design a three-step process to implement ENA and provided guidance and comments on the development of a self-assessment tool (based on the ENA district health services checklist) that UNICEF used to determine technical and coverage gaps in health facilities. FANTA continues to work with partners in Uganda to develop community-based nutrition program approaches based on ENA. Girl Guides Anemia Prevention Badge Program: FANTA, RCQHC and the African Regional Office of the World Association of Girl Guides and Girl Scouts (WAGGGS) worked to expand coverage of anemia intervention packages in East and Southern Africa through a program to reach adolescent girls in Uganda, Rwanda and Swaziland. Through the Girl Guides Anemia Prevention Badge Project, Girl Guides can earn a badge in anemia prevention through educational programs and community involvement in anemia control. FANTA developed the Anemia Prevention Badge materials, including the Guiders’ manual, handbook and workbook. The materials were printed in English and French. FANTA, RCQHC and the Uganda Girl Guides Association then conducted a qualitative assessment of the program in Uganda. The assessment report discussed Girl Guides’ experiences in the program, including knowledge gained, community outreach and practical exercises performed to earn the badge, and what anemia prevention behaviors they currently practice. Uganda Action for Nutrition Congress: FANTA cosponsored the Uganda Action for Nutrition Congress entitled “Challenges, Successes and Opportunities to Improve Nutrition” and presented on topics such as the implementation successes and challenges of the Girl Guides Anemia Prevention Badge Program and harmonizing Food by Prescription and IMAM programs. The congress, which was attended by 358 international participants from 17 countries in Africa and beyond--including 128 Ugandans—was held outside Kampala in February 2009. Community-Based Nutrition and HIV Training Materials: ANSA, with FANTA support, developed nutrition and HIV training materials titled Nutrition Care for People Living With HIV: Training Guide for Community Health Workers. The materials help community- and home-based care providers and other community members and leaders provide nutrition education to PLHIV, assess nutritional status during home visits, and know when and how to make referrals to the health center. The materials were adapted from the Nutrition Care for People Living With HIV and AIDS: Training Manual for Community and Home-Based Care Providers, developed by the Regional Center for Quality of Health Care (RCQHC), FANTA, AED and USAID in 2008.
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