Nutrition Unit is a Section in the Community Health department whose goal is to contribute to the improvement of the nutritional status of the general population through intensified services to a level that is consistent with good health.
The unit supports implementation through strategy, policy and guideline development, setting standards, capacity building & development, monitoring & evaluation, quality assurance, resource mobilization and technical support in nutrition.
The nutrition unit has the following major areas of focus, which include;
1. Maternal Infant and Young Child Feeding; Government of Uganda recognizes the critical role of nutrition in the health and well-being of women, mothers and children, who are indispensable segments of the population, for socio-economic transformation and development. The Government has therefore created an enabling environment to support Maternal, Infant and Young Child Nutrition programmes through provision of policies, guidelines, regulations, and protocols, as well as service delivery avenues which allow access to nutrition services for such a population. However, the Ministry of Health has evolved from common Infant and Young Child feeding to Maternal Infant and Young Child and Adolescent Nutrition (MIYCAN) due to the focus on the first 1000 days ( that is , from conception until the baby is 2 years old) and the need to include Adolescents. The goal of MIYCAN Road map is to accelerate implementation of key interventions to improve, protect and promote optimal maternal, infant, young child and adolescent nutrition practices in order to achieve improved health, well-being and survival of women, children and adolescents in Uganda. This overall goal will be achieved through the application of various strategic interventions and actions.
2. Micronutrients: this thematic area focuses on supplementation and fortification. Food fortification is one of the strategies being pursued by the Government of Uganda to reduce micronutrient deficiencies.
Food fortification in Uganda is achieved in three main ways which include; Bio fortification, Industrial Fortification and Home Fortification (Point of Use Fortification) .
- Bio fortification; the Ministry of Health in partnership with key stakeholders is promoting the production and consumption of bio-fortified foods like iron rich beans, orange fleshed sweet potatoes and high protein maize.
- Industrial fortification; this is where vitamin and mineral premix is added to a food product. Industrial food fortification started in 1994 with mandatory iodization of all imported salt, and later expanded to other staples with the creation of fortification standards for oil, sugar, wheat and maize flour in 2004. These standards include fortifying edible cooking oils and fats with vitamin A, and wheat and maize flour with vitamin A, iron, zinc, folic acid, and other B-complex vitamins including thiamin, riboflavin, niacin, B6, and B12. It is mandatory for all industries producing 10Metric Tonnes(MT) of edible oil and /or fat, 20 MT of wheat flour and 10 MT of maize flour per 24hr hour period to fortify their products with vitamin A and iron. The mandatory food fortification regulations came into effect from July 1, 2013.
- Home fortification ; this is where micronutrients powders (Vitamins and mineral powders) are added to complementary foods of children 6 - 23 months of age to increase their vitamin and mineral intake. The mixture is provided in a single-serving sachet, the contents of which are simply sprinkled over the food before consumption. With this intervention, foods can be fortified either in the home or in any other place where meals are to be consumed. The Home Fortification programme was officially launched on 3rd December 2015.
Supplementation; the main interventions are Vitamin A and Iron Folic Acid (IFA). Vitamin A is administered to children under 5 years of age every 6 months from 1 year as per the Integrated Child Health Days guidelines. Postpartum Vitamin A supplementation was discontinued among in Uganda according to the guild lines released by World Health Organisation (WHO) in 2011. IFA is given to pregnant women to prevent Anaemia.
3. Nutrition and Disease: this includes Integrated Management of Acute Malnutrition and Nutrition in HIV/AIDS. Integrated Management of Acute Malnutrition (IMAM) is an approach which addresses acute malnutrition and focuses on the integration of the management of acute malnutrition into the on-going routine health services at all levels.
In Uganda IMAM has four components; Community, Supplementary Feeding Programmes (SFP), Outpatient Therapeutic Care (OTC) and Inpatient Therapeutic Care (ITC) programmes.
The Community services involve early identification, referral, and follow-up of the acutely malnourished at community level. SFP manages and treats MAM in children of 6-59 months and other vulnerable groups that include pregnant women, lactating women with infants less than 6 months, those with special needs such as the elderly. OTC provides home-based management and rehabilitation of SAM patients as well as MAM patients with HIV/TB who have an appetite and no medical complications. ITC is for the management of SAM with medical complications.
Nutrition in HIV/AIDS: Deals with patients of chronic diseases, including HIV and tuberculosis (TB). Ministry of Health and development partners have provided targeted nutrition interventions to districts and health facilities using the Nutrition Assessment, Counseling and Support (NACS) approach in services for people living with such people.
4. Monitoring , Evaluation and Surveillance: this focuses on;
- Updating of registers, tally sheets, report forms to capture nutrition indicators through the Health management Information System (HMIS)
- Training of biostatisticians on the up-dated HMIS nutrition component
- Development of nutrition health facility assessment tools (2014- 2015)
5. Operational and formative Research: this focuses on participating in food security and nutrition related surveys, namely;
- Baseline, mid-line and end-line surveys for the introduction of home fortification with micronutrient powders
- Formative research for the development of micronutrient powders
- Worm load Survey 2014
- Dietary survey and knowledge Attitude and Practice survey on IYCF to inform the development of food based complementary feeding recommendations in the East and Western regions
- A national fortification assessment aimed at assessing program coverage of fortified staple foods, as well as the contributions towards daily Reference Nutrient Intakes (RNIs), in partnership with the United States Centers for Disease Control and Prevention (CDC) and Makerere University (June 2015).
6. Food Safety: working in partnership with the African Union and East African Community (EAC) and in conjunction with other key stakeholders, the EAC project on Aflatoxin Prevention and Control was conceptualized and launched in March,2014. The overall focus of this project was to mitigate the adverse impacts of Aflatoxin along the food and value chains in the region, which birthed the EAC Regional Strategy and Action Plan on prevention and Control of Aflatoxin for the period.