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STUNTED: Little progress toward nutrition targets for children in Uganda

Caregiver assesses child’s malnutritional status  in Moroto.

Kampala, Uganda | THE INDEPENDENT | Uganda’s efforts to improve nutrition and meet health targets for children and adults remain stunted, as the country grapples with persistent malnutrition and dietary challenges.

Gertrude Namayanja, Principal Policy Analyst Office of the Prime Minister, highlights that despite the ambitious Uganda National Action Plan II, which aimed to reduce the prevalence of undernutrition, stunting, low birth weight, anaemia, and obesity, the country is falling short of its goals, raising alarm among health experts and policymakers.

“The plan was designed for the period between 2021 and 2025. With just months left to 2025, the available data indicates that we are off track and unlikely to meet the targets set,” Namayanja stated.

Namayanja announced the development during the National Nutrition Dialogue organized by the Office of the Prime Minister under the theme, “Strengthening Policy Decision-Making to Ensure Nutrition for All.”

An analysis of Uganda’s progress under the Uganda National Action Plan II reveals significant shortcomings. Out of 15 planned intervention areas, the country has achieved only three. According to the implementation report, the government has met just 20 percent of the outcome indicators, while 67 percent remain unachieved. Additionally, 13 percent of the indicators could not be assessed due to a lack of data.

For example, the report underscores the substantial challenges in addressing stunting and other forms of malnutrition among children under five in Uganda. In 2019, the stunting rate was 28.9 percent, with a target to reduce it to at least 19 percent by 2025. However, the current prevalence remains at 26 percent, indicating that at least one in three children in Uganda suffers from stunting, resulting in lifelong consequences.

Zakaria Fusheini, a nutrition expert at UNICEF, pointed out that while Uganda has made some progress in reducing stunting, the situation remains dire. Despite the percentage decline, the actual number of stunted children has remained constant over the years at approximately 2.2 million.

“If this figure is to decrease, critical investments in the nutrition sector are essential,” Fusheini emphasized during his keynote address at the National Nutrition Dialogue.

He noted that Uganda is currently reducing stunting at a rate of 3.5 percent per year. However, at this pace, the country will still have over 1.5 million stunted children by 2030. Fusheini stressed the need for Uganda to move beyond its comfort zone and increase its investment in nutrition to accelerate the reduction rate to at least 5.3 percent annually.

In its ambitious plan, Uganda had aimed to invest 3.28 trillion shillings to end malnutrition by 2025. However, while specific figures on the amount spent so far have not been disclosed, it was noted that the plan faced significant challenges related to planning and budgeting across various ministries and agencies.

These shortcomings have hindered progress, leaving millions of children at risk of malnutrition, which can result in stunted growth, impaired cognitive development, and reduced productivity, ultimately affecting the country’s human capital and economic potential.

According to available research, if Uganda had invested the planned 3.28 trillion shillings to combat malnutrition, the country could have not only eradicated malnutrition but also achieved a return on investment of up to 27.72 billion shillings.

The data also reveal a gender disparity in stunting, with boys more affected compared to girls. There are also significant disparities in malnutrition across Uganda, with rural areas experiencing higher rates of stunting and wasting compared to urban regions.

The Karamoja sub-region has the highest prevalence, where three in every ten children are underweight. Kigezi follows closely, with Toro and Ankole coming third and fourth, respectively. In contrast, Teso and Kampala regions perform relatively better.

Additionally, the report highlights a worrying rise in the prevalence of low birth weight, particularly in urban areas. Experts caution that this trend poses significant long-term health risks for children, emphasizing the urgent need for targeted interventions to improve maternal and child nutrition in both rural and urban settings.

Meanwhile, obesity among adult women and men continues to be a growing concern, as it is associated with an increased risk of chronic conditions such as diabetes and heart disease. Alarmingly, the report also reveals that five out of ten children in Kampala are obese, further underscoring the pressing need for comprehensive nutrition and health strategies.

Professor Charles Muyanja criticized government interventions, highlighting their failure to implement region-specific strategies to address the unique nutrition needs of various parts of the country.

“Each region has its unique challenges, but the interventions are generic. As a result, they fail to work effectively,” Muyanja said.

Professor Muyanja emphasized that improving food security and nutrition in Uganda begins with enhancing the livelihoods of its people. He urged for measures to tackle food loss and waste across different regions and advocated for systems that ensure better distribution of food from areas of surplus to areas of need.

“This must be a deliberate effort through proper planning, rather than just giving it lip service,” he added.

Yaron Wolman, UNICEF Representative on behalf of the Nutrition Development Partners in Uganda, advised that for Uganda to make greater progress, it needs to increase domestic financing for nutrition interventions, including the procurement of commodities needed for the treatment of severe acute malnutrition.

“Integrate nutrition into social protection systems and government programs such as UWEP (Uganda Women Empowerment Program), and SAGE (Senior Citizen Grant) to make them more responsive to the food and nutrition needs of the most vulnerable children and their families, including social transfers to protect children at highest risk of child food poverty,” Wolman noted.

He also emphasized the need for the government and all stakeholders to commit to tangible, evidence-based interventions that prioritize the most vulnerable and marginalized populations, stressing that it is imperative to translate dialogue into meaningful action.

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