Posts: Food Security & Agri Business
ENHANCING NUTRITION SERVICES IN GOVERNMENT HEALTH SYSTEMS: INSIGHTS FROM KRC-UGANDA’S MCHN+TSFP PROJECT IN KYAKA II REFUGEE SETTLEMENTS
Ms.Sharon assessing the nutrition status of a baby at a Health Centre in Kyaka II refugee settlement KRC-Uganda’s robust Human Resource (HR) department, bolstered by multiple donations, continues to expand its efforts in addressing malnutrition comprehensively in humanitarian settings. Through partnerships with international organizations, KRC-Uganda has evolved from dependency to autonomy, securing substantial multi-year grants, from international organizations like World Food Program (WFP). KRC-Uganda is extending its support to nutrition rehabilitation centers at health facilities, emphasizing the enhancement of multi-sectoral dimensions. Human Resources (HR) ultimately plays a pivotal role in strengthening systems and mobilizing resources. However, there remains a notable gap in the integration of nutrition services across the health systems of hosting districts. The purpose of this study is to evaluate the quality and quantity of nutrition services provided at Bujubuli Health Centre IV in Kyegegwa District, which serves both refugees and nationals, during the month of January 2024. Specifically, the study aims to assess the technical staffing capacity available for nutrition services and supplies. A semi-structured questionnaire was used in a cross-sectional approach, administered to participants, including 12 patients (qualitative) and 2 in-charge and nutritionist of the health facility (also qualitative). Respondents were selected using a combination of simple random and purposive sampling methods. Happy mother and baby walking away with their nutritious foods from the health centre. The findings reveal an average nutritionist-to-patient ratio of 1:700 per day, which is higher than the recommended ratio of 1:400 by the World Health Organization (WHO) in 2013. This nutritionist supports various clinics, including the Young Child Clinic (YCC), ANC, Out-patient Department (OPD), nutrition, and community outreaches, and is required to work day and night shifts for In- patient Therapeutic Care (ITC) admitted cases. The high ratio is justified by the continuous capacity-building platform available for the healthcare team, considering the diminishing funds from donors. However, these high numbers also contribute to long waiting times. Over the last 4 months, there have been no stock-outs of therapeutic feeds. However, there is a growing need for buffer stocks due to the increasing number of clients, especially nationals attracted by the comprehensive services, which has further increased waiting times. KRC-Uganda, the lead nutrition partner, raised the need for more stock, and WFP responded positively. It is worth noting that the District Hospital does not have a nutritionist. With the increasing demand for integrated health and nutrition services, particularly in the face of food insecurities, the primary focus should be on recognizing the importance of the nutrition profession. Therefore, it is recommended that the district prioritizes planning and budgeting for a nutritionist to facilitate robust coordination and collaboration with other stakeholders. Achieving this during KRC-Uganda’s tenure with the district would be a significant success. By Nalunkuuma Sharon, Program Manager, Kyaka II field office KRC-Uganda
CREATING DEMONSTRATION GARDENS IN ECD CENTERS TO COMBAT MALNUTRITION
Mr. Aheebwa Mubarak- the KRC-Uganda Agricultural Extension Worker supporting the CMC members in establishment of nursery beds Meet Ms. Enid Kyarisima, a vibrant 32-year-old Ugandan woman who lives in Mukondo C with her loving family. She’s a dedicated caregiver (teacher) at Lucky Nursery School in Mukondo C Zone, nestled in the heart of the Kyaka II Refugee Settlement in Kyegegwa District. Lucky Nursery School is part of a special Kulea Watoto project, which is implemented by the International Rescue Committee (IRC) and Kabarole Research and Resource Centre-Uganda (KR-Uganda). This initiative aims to enhance early child development in the settlement. At Lucky Nursery School, Kyarisiima Enid nurtures 235 children aged 3-6 years, providing them with a nurturing environment to learn and grow. The day starts early at 8:00 AM and wraps up at 12:30 PM, packed with activities designed to stimulate young minds. But there’s more to the story. Kulea Watoto goes beyond the classroom, promoting the establishment of demonstration gardens in 53 selected ECD centers, including Lucky Nursery School. These gardens serve multiple purposes, from providing a space for children to engage in outdoor activities to offering practical lessons in nutrition and sustainable living. Mr. Aheebwa guiding the CMC members on how to prepare the main garden for vegetables Kyarisiima Enid is at the forefront of this initiative, working with the Center Management Committee (CMC) whose members were trained by Kulea Watoto to make the most of the available land at the ECD center. Inspired by the training she received, she reached out to the Mother Baby Area (MBA) in Mukondo C, supported by Save the Children, and secured seeds for onions and cabbages. With determination, hard work and training from KRC-Uganda’s extension worker Mr. Aheebwa Mubarak, they cultivated a thriving garden, even in the face of a prolonged drought. Their efforts paid off with a bountiful harvest of 60 heads of cabbage which they sold Shs.1,000 each. This not only benefited the school but also extended to support households in need of a nutritious diet. Their success didn’t stop there. In October 2023, they received more seeds and farming equipment, expanding their efforts to include a wider range of vegetables such as cabbages, Swiss Chards, carrots, green peppers and onions. They also reached out to 10 households with malnourished children to establish their own kitchen gardens. We harvested a combined total of 263 cabbages, which were sold for Shs.1,500 each, resulting in earnings of Shs.394,500. Additionally, we earned Shs.150,000 from the sale of carrots and onions. As of now, we still have 310 heads of cabbages and onions remaining, which are scheduled to be sold in February 2024. Mr. Aheebwa guiding the CMC members on pests and disease management Looking ahead, Kyarisiima Enid and her team have big plans. They aim to expand their garden, cultivate maize and beans, and initiate a school feeding program. Their goal is to ensure that every household in the ECD catchment area has a thriving vegetable garden, promoting self-sufficiency and healthy living. The lead caregiver inspecting the cabbages and carrots ready for harvesting Kyarisiima Enid is grateful for the support and training provided by Kulea Watoto, which has empowered her and the CMC with valuable skills in early child development and sustainable agriculture. With their continued dedication, they are making a tangible difference in the lives of children and families in the settlement. By Katya Rabson Monitoring and Evaluation Officer KRC-Uganda
ASSESSING PROGRESS: THE FUNCTIONALITY OF KYEGEGWA DISTRICT NUTRITION COORDINATION COMMITTEE (DNCC)
Kyegegwa DNCC at the district headquarters after the meeting In September 2020, Uganda approved the second Uganda Nutrition Action Plan (UNAP II) (2020/21 – 2024/25) as the country’s strategic framework for scaling up nutrition during that period. The UNAP II mandates the Ministry of Local Government to strengthen the enabling environment for scaling up nutrition-specific and sensitive actions at the local governments in Uganda. These actions are better facilitated when there is a fully functional District Nutrition Coordination Committee (DNCC). The Maturity Model Approach (MMA) uses five levels – Level 1 (Nascent), Level 2 (Emerging), Level 3 (Established), Level 4 (Institutionalized), and Level 5 (Optimized) to assess the functionality of Nutrition Coordination Committees (NCC). With funding from CARE International, Kyegegwa DNCC underwent an assessment by the Ministry of Local Government (MLG) in April 2023 and was found to be at the “Nascent” stage, where several indicators were falling below the threshold. Before the assessment, the district did not have a clear nutrition coordination structure. The MLG swiftly tasked the Chief Administrative Officer (CAO) to convene a meeting with the Heads of Departments and representatives of development partners (with KRC-Uganda fully represented), who would later comprise a District Nutrition Coordination Committee (DNCC). The DNCC is composed of heads of departments (Health, Education, Water & Environment, Works & Transport, Agriculture, Gender & Social Development, Trade & Industry, and Administration), and implementing partners in Health & Nutrition (KRC-Uganda, Medical Teams, Save the Children, and CARE International) as Ex-members. The CAO appointed the District Planner, Mr. Denis Busobozi, as the Coordinator of the committee. He identified gaps that needed to be addressed, such as incomplete membership in the NCCs at both district and sub-county levels, and partial integration of nutrition into the planning framework of the district. During the Budget conference held in October this year, this was one of the key priorities; the District Planner directed the committee to submit interventions that can be included in the district budget. KRC-Uganda, as the lead nutrition partner in the district, was very keen to actively participate in the Budget Conference and have its planned activities incorporated into the district plan. Additionally, 2% (amounting to 4.5 million Uganda shillings) from the Discretionary Development Equalization Grant (DDEG) is allocated for Nutrition in the district. This amount is considered insufficient compared to the needs, as it is mainly used for convening DNCC meetings and monitoring exercises (provision of meals and transport refund to participating members). Kyegegwa district officials drafting their Workplan To further strengthen the functionality of the NCCs, UNICEF facilitated a 5-day training for the Kyegegwa DNCC in Hoima district. The training aimed to equip the committee with knowledge on their roles and the documentation of the progress of activities conducted by the NCC. The DNCC has met once in its fullness, and more orientation on the roles of each member has been done, focusing on planning, implementing, and monitoring district multi-sectoral nutrition activities. The Sub-County Nutrition Coordination Committees (SNCCs) have been formed in the 19 sub-counties and 06 town councils of the district. With the progress made so far, the DNCC’s functionality has moved from Nascent level in early 2023 to Established stage (Level three) by December 2023. Kyegegwa district still needs more technical and financial support to ensure it reaches the Optimized stage (the highest level). This can be achieved with adequate funding for nutrition program activities, sufficient technical capacity/human resources to oversee nutrition program activities, full integration of nutrition capacity development and interventions into the annual work plan budgets, robust monitoring and evaluation frameworks for nutrition outputs, outcomes, and impact, and increased research capacity to generate data and knowledge. By Oteba Eric, Nutrition Officer Kyaka II Refugee Settlement.
The Looming Debt Trap Dilemma Facing the Contemporary Smallholder Farmer and the Small and Medium Entrepreneur (SMEs) in Uganda
In many regions of Uganda and across Africa, a significant majority of the population, comprising over 70%, is engaged in farming and small-scale businesses as their primary means of livelihood. Unfortunately, smallholder farmers and entrepreneurs in this demographic face a considerable challenge in accessing affordable capital to initiate, expand, or enhance their existing ventures. Subsequently, these individuals, often referred to as the ‘unbankable‘ by mainstream banking institutions, resort to obtaining high-interest loans from predatory money lenders. As reported by the Ankole Times, during the National Resistance Movement Caucus held at the Entebbe State House on September 28, 2023, President Yoweri Kaguta Museveni Tibuhaburwa directed the Minister for Finance to issue a statutory instrument addressing the interest rates charged by money lenders, aiming to curb the observed misconduct. Credit is due to the source that provided this information, and appreciation is extended for the president’s directive. Without a doubt, notwithstanding other factors contributing to poverty among smallholder farmers and small-scale entrepreneurs, the combination of exorbitant interest rates from money lender sharks and the existing unfavorable tax regime has further exacerbated the poverty situation. The mere fact that the president acknowledged the issue of high interest rates suggests its prevalence nationwide. Mpanga Market in Fort Portal Tourism City, where I am a regular client, instances of over-indebtedness among the struggling men and women who operate small restaurants and bars in what is colloquially referred to as ‘the Struggle Market’ are regrettably common. To put it more succinctly, numerous small-scale businesses find themselves ensnared in a web of debt. Technically, a debt trap occurs when a creditor extends loans to a borrower with excessively challenging terms, leading the clients to struggle to repay the loan. Consequently, the borrower is compelled to remain a perpetual debtor. In this scenario, the borrower effectively becomes an involuntary worker for the lender or the lending institution, without receiving compensation for their efforts. Over time, the lender starts eroding the borrower’s equity until the client’s capital is depleted. For lack of a more fitting term, let’s refer to this phenomenon as ‘Capital-Colonialism.’ Eventually, the lender extends its ownership influence over the client’s assets, ultimately seizing the collateral. Undoubtedly, this exacerbates the impoverishment of the already economically disadvantaged. Notably, the cumulative impact of this will lead to a state of debt crunch. This is a situation in which the lender’s capacity to extend loans to the public diminishes due to a rise in loan defaults, with negative effects on overall economic performance. The president’s intervention, through a directive to the minister aimed at addressing the prevalent practice of borrowing high-interest loans by small-scale farmers and small to medium-scale entrepreneurs, is timely. This action is crucial in preventing the country from succumbing to a credit crunch. By Mugisa Jared, Microfinance and Agribusiness Manager
Combatting Monocropping with integrated farm Management
In the lush landscapes of Uganda, smallholder farms have long relied on traditional farming practices, particularly the method of monocropping. However, this approach has been branded as a “disastrous agriculture system” by Ocean Robbins (2022), and its detrimental effects on land productivity and food security are becoming increasingly evident. Monocropping, the practice of cultivating a single crop repeatedly, offers neither the dietary diversity we need nor the ecological balance our ecosystems crave. As a result, farming families are grappling with pronounced nutritional and food insecurities, exacerbating the economic and social challenges they face. In the early 1990s, the Ugandan government initiated a shift towards early maturing crops, diverting attention from diverse staple crops like tubers, legumes, and cereals. Moreover, there has been a growing trend towards purely commercial farming ventures, such as tea and sugarcane production, which fail to ensure sufficient and nutritionally balanced diets for the nation. To combat this looming crisis, KRC Uganda has taken proactive measures. Through their agriculture extension programs, they are employing the Integrated Farm Plan Approach (PIP) to train family farmers in adopting agroecological practices for food production. These practices not only promote crop and dietary diversity but also work to regenerate the natural ecosystems essential for healthy food systems. In conclusion, monocropping continues to be a “disastrous agriculture system” in Uganda. To convey this message effectively to smallholder farmers still practicing it, education is key. Farmers need to understand that monocropping is detrimental both to the land and to food security. The solution lies in supporting local, organic, diverse farms that produce the variety of foods we need without leaving the environment in a deteriorating state. It’s time to embrace sustainable farming practices for a brighter, more food-secure future in Uganda. By Moses Akugizibwe Extension Worker, KRC-Uganda
The Supremacy of Nutrition Education and Counselling
Nutrition is a central element of our daily lives, influencing our overall health and well-being. Proper Nutrition plays a critical role in preventing chronic diseases, promoting growth and development, and enhancing our quality of life. However, several individuals struggle to make informed dietary choices due to a lack of knowledge or misinformation. This is where Nutrition education and counselling step in as powerful tools to empower individuals with the knowledge and skills they need to make healthier food choices. Understanding Nutrition Education and Counselling Nutrition education refers to the process of providing individuals or communities with information, knowledge, and skills related to nutrition and dietary choices (Academy of Nutrition and Dietetics, 2013) Nutrition Counselling, on the other hand, is a more personalized approach that involves one-on-one or group sessions with a registered dietitian or nutritionist. It focuses on assessing an individual’s dietary habits, addressing specific nutritional needs, and providing tailored guidance and support to help individuals make healthier choices. Basing on this approach, the Impacts on Individuals that have been observed include; Improved Dietary Choices where individuals have become more aware of the nutritional value of foods and the importance of a balanced diet. This knowledge has empowered them to make healthier food choices, leading to improved overall nutrition. Education about the impact of nutrition on chronic diseases such as heart disease, diabetes, and obesity has motivated individuals to adopt healthier eating habits, reducing their risk of developing these conditions. Through personalized guidance, individuals have set realistic goals and learn strategies for achieving and maintaining a healthy weight by helping individuals decipher food labels, understand portion sizes, and make informed decisions when grocery shopping or dining out. Counselling sessions have identified nutrient deficiencies and modify dietary plans to address them, ensuring that individuals meet their nutritional needs. It has also proved lower healthcare costs as a result of decreased rates of diet-related diseases and conditions. Therefore, by continuously equipping people with the knowledge and skills to make healthier food choices, we can lessen the burden of chronic diseases, improve overall well-being, and generate healthier, more vibrant communities. As we continue to prioritize nutrition education and counselling, we move one step closer to a world where everyone has the opportunity to nourish healthier lives. Tumuhereze Joshua Nutrition Officer
HANDLING NUTRITIOUS FOOD COMMODITIES: EXPERIENCE SHARED FROM KRC-UGANDA: BUJUBULI HCIV, KYAKA II REFUGEE SETTLEMENT
Bujubuli store with Minimum inventory. In today’s fast-paced business world, excess inventory can be a major obstacle to growth and profitability. Whether it’s unsold products taking up valuable storage space or excess and obsolete items tying up capital, having too much inventory can lead to increased costs and decreased cash flow. There are various causes of excess inventory that businesses should be mindful of. Forecasting errors, such as inaccurate predictions of product demand, can result in over-ordering or under-ordering, leading to surplus stock. Poor inventory management practices, like inadequate tracking systems or communication gaps between departments, can also contribute to excess inventory. Supplier issues, changes in demand, product life cycle mismanagement, quality problems, lack of communication, and bulk ordering are other factors that can lead to excess inventory. The consequences of excess inventory can be significant. Storing excess inventory requires warehouse space, leading to increased operational expenses. Money tied up in excess inventory, along with insurance and taxes, can impact profitability. Excess inventory may consist of products that become obsolete or outdated, leading to potential losses. Managing excess inventory can divert resources from other areas of the business, impacting overall efficiency. To prevent excess inventory, businesses can implement proactive strategies. Accurately predicting customer demand using data analytics tools can help prevent overstocking. Adopting a Just-in-Time (JIT) inventory management approach can help businesses order goods precisely when needed, reducing excess stock. Implementing regular audits and real-time monitoring can help maintain optimal stock levels and identify issues promptly. By effectively managing inventory and addressing the root causes of excess, businesses can streamline operations and improve their bottom line. By Anguyo Amos Stores Assistant KRC-Uganda, Kyaka II refugee settlement
Putting the future of Uganda’s agriculture and agricultural cooperatives into perspective
Growing up as a child in a farming household in the late 60s through the 70s, it was rare to hear dad or mum decrying lack or scarcity of money as it is nowadays for many families. For some reason for sure, many farm families derived their income from a certain cash crop, but I also recall that most of the social services were provided freely or subsidized by the government as a public good. As a young boy, I witnessed how farming was a profitable venture. Without due regard to the current gender jargon, allow me to mention that my late Father was a chairman of a primary Coffee Cooperative Society. Yes. He, and his many other farmers in the area earned their livelihoods mostly from the production and sell of clean Arabic coffee (aka, Kibooko), a cash crop which they collectively sold through the then vibrant Kagazi Tusigike Coffee Farmers’ Cooperative Society Limited to which my father was a chairperson. This was found in Kiceece Sub County, currently Kitagwenda District. It is no surprise that more than 90% of my contemporaries’ and my own school fees and clothing among other needs throughout the primary schooling came from coffee money. In addition to the coffee crop however, I knew many other well-to-do families which reared cattle, but mainly as a source of prestige. Predominantly, these two key pre-occupations (coffee and cattle) in my early days, were the mainstay of the many people, from peasant farmers, local government chiefs, professionals among other sub-occupations. From that early age, I was convinced that if you wanted money and prestige, you would have to venture into coffee and cattle farming and one did both, the better. Of course, one was required to possess enough land where to do farming and land was very much available in most cases by then. Thus, one’s wealth was measured by how much coffee or how many heads of cattle or a mixture of both. During my school days in the early 70’s however, I also came to learn and understand that much as our local cash crop in Kitagwenda was mainly coffee, I learned that there were other cash crops grown elsewhere in accordance with the then nationwide agricultural zoning according to the different climatic conditions and soil characteristics. I also recall that the government gave incredible support to the agriculture sector mainly through government extension services. Again, due to the Agricultural Cooperatives arrangement, farmers were able to access free or subsidized in-puts and were assured of a stable price for their produce, thus a stable market. Unlike today, this was a great factor and motivation for successful farming. Notably, owing to the prevalence of the deliberately designated cash crops, the country was able to undertake organized export trade backed by the cash crops mainly namely; Coffee, Cotton, Tobacco and Tea among others which supported nascent of agro-based industrialization. Thus, in addition to agriculture which was a leading employer, the industries like the once vibrant Jinja Textiles among other agricultural value chains were able to provide another source of descent employment to the population. Because of this, there was negligible difference in incomes (less income disparities) among the population. Meanwhile, it is worth noting that during that time, the land tenure and land use systems made the production of the cash crop enterprises possible both on a small and large scale. Remarkably, the main cash crops export economy enabled the country to raise the revenues that supported the effective provision of the social services and development of infrastructure. It is no wonder that there were well equipped and staffed schools and hospitals. I am a real beneficiary of the free or subsidized school uniforms and scholastic materials and free health services during the time of my primary schooling. Until today, I look into the better past with nostalgia. Alas, Agriculture and the benefits associated with the sector seems to be taking a different trend. Since the liberalization of the economy (add private divestiture and restructuring of the public enterprises) at the advice of the World Bank and other external forces in the 80’s, farmers to a great extent seem to have lost direction and control over their major source of livelihood. Only until recently, Agriculture and Marketing Cooperatives have been neglected and almost condemned entities. Worst of all, the historical economic importance of the traditional cash crops was thrown into oblivion and the forces of demand and supply left to determine prices for the newly evolving cash crops like Maize, beans, bananas and fish among others. Remember, this is happening at a time when pressure on land has increased largely due to the rapidly increasing population. The population of Uganda which had been projected to reach 45.7 million by the year 2020 by the United Nations is now approaching over 49.6 million in 2023. This population explosion is against the static land and aquatic mass and reducing arable land. Unlike in the past where Agriculture was a genuinely biggest employer of the population, according to the National labor force survey (2016/17), the informal economy alone now employs 84.9% of the population, 90% of whom are youth (10-30 years). Analytically and by implication therefore, 90% of the 84% are not engaged in Agriculture since it is common knowledge that youth are rarely into agriculture. Currently though, the Cooperative Movement is being revived. The biggest question however still remains on whether good will from government and whether the current mechanisms in place will be able to make the farmer a happy person again as the case for the 60’s and early 70’s. Secondly, there is need to contemplate upon whether the current strategies can be able to ensure that the sector will be able to put enough and quality food on the table for millions of the population. Otherwise, the fate of the farmers’ dismay may be at hand sooner than later. By Mugisa Jared, Microfinance and Agribusiness Manager
The Annual African CITY FOOD month campaign
By Bernard Bwambale, Nutritionist and Program Manager, KRC On 29th July, Kabarole Research and Resource Centre joined Health Food Africa and Hivos to participate in the African City Food Month campaign webinar, that focused on the Multiplicities of entry points into urban food governance through the lenses of “Food Sensitive Urban Planning” and the “City Food Systems”. The annual event is organized by ICLEI (Local Governments for Sustainability), a global network working with numerous local and regional governments committed to sustainable urban development. The African City Food Month campaign highlights diverse, innovative and evolving African urban food systems. During the event, KRC presented operations of the Fort Portal Food System Lab to the global audience. Find the details of presentation here as delivered presented by Bernard Bwambale, KRC’s Nutrition Program Manager.