Towards concerted government efforts? Assessing nutrition policy integration in Uganda

Abstract

To tackle malnutrition more effectively, Sub-Saharan African governments have developed overarching, integrative policy strategies over the past decade. Despite their popularity, little is known about their follow-up and ultimately their success (or failure). Consequently, tracking the progress of such political commitment has gained global importance. Various studies provide insights into changes in nutrition-related policies. Nevertheless, it is generally acknowledged that we have limited understanding of how nutrition concerns are explicitly addressed in policies of different ministries. This study uses a novel policy integration perspective to investigate the extent to which eight ministries in Uganda integrated nutrition concerns across their policy outputs between 2001 and 2017. The approach used assumes nutrition policy integration is a dynamic process occurring in different policy dimensions. We performed a qualitative content analysis to assess 103 policy outputs for changes in subsystems involved, policy goals, and instruments used. Overall, we found a shift towards increased integrated government action on nutrition over time. The 2011-2015 analysis period was a critical juncture where increased integration of nutrition was observed in all policy integration dimensions across all ministries. However, considerable variations in actor networks, goals, and instruments exist across sectors and over time. The sustainability of nutrition integration efforts remains contentious, because of which continuous monitoring will be essential.

Beyond paper realities : Fostering integrated nutrition governance in Uganda

“…(re)organisation of the language used in discussions to identify the varied coherent interpretations (Schwartz-Shea and Yanow 2013). In our case, we aim to identify the different causal narratives GOU 2011GOU , 2003; a rise in nutrition-related resources and an increase in nutrition integration across ministries (Namugumya et al 2020b). Despite Uganda's centralised system, in which the president holds much power and the ruling party's domination in parliament, there is considerable variation in political representation across parliamentary terms.…”

“…In a previous study, we assessed the extent of nutrition policy integration across policy outputs of different sectors in Uganda between 2001 and 2017 (Namugumya et al 2020b). In that study, we distinguished between four time periods corresponding with Uganda's election cycles (2001-2005; 2006-2010; 2011-2015; 2016-2017).…”

“…The ministries and local governments comprising the cases in this dissertation were strategically selected for appropriate reflection of the influence of contextual variations on the policy mechanism and practices determining (dis)integrated nutrition governance in Uganda. The sectors studied in chapter 4 were selected based on the study showing differences in the nutrition policy integration patterns across the cases over time (Namugumya et al 2020b). The choice of the local governments was based on variation in nutrition investments by donor projects and childhood stunting indicators (UBOS and ICF 2018;KRSU 2016).…”

“…A common example is that governments often adopt integrated goals, but lag behind in terms of instruments (Candel and Biesbroek 2016). In our previous study, we assessed three of these integration dimensions for nutrition governance in Uganda: subsystem involvement, policy goals, and policy instruments (Namugumya et al 2020b). Subsystem involvement refers to the range of ministries engaged in nutrition governance.…”

“…as shown by the adoption of the Uganda Nutrition Action Plan 2011-2016. Recent studies show that the Ugandan government has made remarkable progress in integrating nutrition concerns across ministerial and subnational policies (Namugumya et al 2020b;Turcan and Bene 2017).…”