Evaluation of Local Government Policy Frameworks for Stunting Reduction in Uganda: A Case Study of Ntumgamo, Sheema and Kabale Districts

Abstract

Background: Stunting continues to be the most prevalent form of under nutrition affecting over 149 million children under five year globally. The largest burden is faced by low and middle income countries (LMIC) where more than half of these children live.1,2 In Uganda, every 3 in 10 children is stunted with over 2 million children affected.3 The effects of stunting bare consequences beyond an individual to community and national level.4 The government of Uganda has now recognized nutrition as a cross-cutting issue that must be addressed through all government planning and implementation policy frameworks at both national and local government level. 5,6 The aim of this thesis to evaluate the level to which nutrition has been integrated within local government policy frameworks so as to identify the nutrition policy environment that would influence efforts toward reducing stunting. Methods: This was a qualitative policy content evaluation policy documents from three (3) case study districts in south western Uganda. A “5C” framework adapted from the stories of change “meta-protocol” developed by Gillespie and van den Bold in 2015 was used to evaluate the sample policy documents. “3C’s” of commitment, coherence and community were used to develop a coding framework. Data were analyzed using Atlas ti. software and interpreted using an evaluation scale. Results: Findings from the study showed an overall high political commitment for nutrition programs across all districts. There was a low commitment of financial and human resources for nutrition and weak coordination structures for implementation of nutrition programs across all the districts. Conclusions: For local government to achieve sustainable positive outcomes in stunting reduction, there is need to translate political efforts to actions through commitment of resources, coordinate, and regulate stakeholder efforts for planning and implementation of programs.