Beyond Paper Realities? Assessing Nutrition Policy Integration in Uganda

Over the past decade, various Sub Saharan Africa governments have invested in integrated nutrition strategies that transcend the boundaries of single policy sectors to accelerate and sustain reduction in malnutrition. The aim of these strategies is to foster concerted policy efforts across relevant ministries. However, previous research suggests that many integrated strategies never proceed beyond paper realities. Therefore, our qualitative study uses a novel policy integration perspective to assess the extent to which nutrition concerns have been integrated into sectoral policy outputs of the Ugandan national government, which has been an early adopter of elaborate nutrition strategies. Policy integration dimensions we included in the assessment are policy goals, instruments and subsystems involved. The assessment covers the policies of eight Ugandan ministries for the period 2000-2017. Preliminary results show an increase and diversification of nutrition policy goals, instruments and subsystems addressing malnutrition over the years. The diversification of goals and instruments has been particularly visible in the health and agriculture sectors. Management of infant, young child and maternal undernutrition is the main focus of the policy objectives across all ministries; mainly financially supported by international donor agencies. Procedural instruments including in-service personnel capacity and skills development, technical guidelines, information sharing fora using mass media are commonly mentioned. In addition to collaborating with other government ministries, international donor agencies have a vital role in financing nutrition activities. The comparative study highlights the variations in integration of nutrition concerns across ministries, thereby contributes to narrowing this gap in nutrition policy research. By doing so, the paper identifies gaps that policymakers ought to address to realize more effective nutrition governance. We end by proposing areas for additional research, including mechanismic-based approaches that could explain the patterns we observed in our study.