Pomeroy-Stevens Amanda, D'Agostino Alexis, Adero Nancy, Merchant Hannah Foehringer, Muzoora Abel, Mupere Ezekiel, Agaba Edgar, Du Lidan
SPRING Project, Arlington, VA, USA
John Snow Inc (JSI), Arlington, VA, USA.
Food Nutr Bull. 2016 Dec;37(4 suppl):S124-S141. doi: 10.1177/0379572116674554.
In 2010, Uganda began developing its first multisectoral nutrition plan, the Uganda Nutrition Action Plan (UNAP), to reduce malnutrition. While the UNAP signals high-level commitment to addressing nutrition, knowledge gaps remain about how to successfully implement such a plan.
We tracked the UNAP's influence on the process of priority setting and funding for nutrition from 2013 to 2015.
This study used a longitudinal mixed methods design to track qualitative and budgetary changes related to UNAP processes nationally as well as in 2 study districts. Qualitative changes were assessed through interviews, news content, and meeting notes. Changes in allocations and expenditures were calculated based on budget documents, work plans, and validation interviews.
Important enabling factors named by stakeholders included identity, human resources, sustainable structures, coordination, advocacy, and adaptation of the UNAP to local needs. Evidence suggests that the UNAP facilitated improvements in the last 3 factors. We found no systematic increases in planned nutrition activities, nor did we find increases in allocations or expenditures for nutrition between fiscal years 2013-2014 and 2014-2015. Expenditure data were not always available for all funding mechanisms. In the 2 study districts, there was little flexibility within financing structures to allow for additional nutrition activities.
Results suggest the UNAP has played an important role in strengthening the enabling environment for nutrition action. The next UNAP will need to translate these improvements into a greater number of nutrition activities and higher levels of funding at the national and subnational levels.
2010年,乌干达开始制定首个多部门营养计划——《乌干达营养行动计划》(UNAP),以减少营养不良现象。尽管《乌干达营养行动计划》表明了在解决营养问题方面的高层承诺,但对于如何成功实施这样一项计划,仍存在知识空白。
我们追踪了2013年至2015年《乌干达营养行动计划》对营养优先事项设定和资金投入过程的影响。
本研究采用纵向混合方法设计,以追踪全国以及两个研究地区与《乌干达营养行动计划》相关的定性和预算变化。通过访谈、新闻内容和会议记录评估定性变化。根据预算文件、工作计划和验证访谈计算拨款和支出的变化。
利益相关者提到的重要促成因素包括身份认同、人力资源、可持续结构、协调、宣传以及使《乌干达营养行动计划》适应当地需求。有证据表明,《乌干达营养行动计划》促进了后三个因素的改善。我们发现计划中的营养活动没有系统性增加,在2013 - 2014财年和2014 - 2015财年之间,营养方面的拨款或支出也没有增加。并非所有资金机制都能获取支出数据。在两个研究地区,融资结构内几乎没有灵活性来开展更多的营养活动。
结果表明,《乌干达营养行动计划》在加强营养行动的有利环境方面发挥了重要作用。下一个《乌干达营养行动计划》需要将这些改善转化为更多的营养活动以及国家和地方层面更高水平的资金投入。