The Highflyer Report spoke to Daisy Yossa, CASCADE Project Manager at CARE International, on how partnerships, community engagement and practical solutions are shaping Uganda’s fight against malnutrition.
Q: CARE is part of the Nutrition for All campaign. What role are you playing on the ground?
A: Cascade is one of the projects being implemented here in the country called, in full, Catalyzing Strengthened Policy Actions for Healthy Diets and Resilience. We are privileged to have been part of the launch of this national advocacy campaign dubbed Nutrition for All by Ministry of Health, with kind support from UKAID and UNICEF.
We believe that if we are going to address malnutrition in this country, it requires concerted efforts. And our take from today’s message, clearly directing interventions to community level, is spot on because of the fact that malnutrition happens at a certain point in our community, in our environment, and this happens at community level. We also appreciate the recognition of our regions which continue to persistently have poor nutrition indicators, that is Karamoja and the Tooro sub region.
This really underscores the importance of behavior and social norms. As a project from the onset, we conducted a general analysis, well knowing that there are multiple drivers of malnutrition.
Q: You mentioned working with “reference groups” in communities. Who are these and why do they matter?
A: In this country in Karamoja, we are implementing the Cascade project, and what we are doing, we work with what we call the reference groups. And reference groups were born out of the gender analysis, where communities told us, if you would like to change our norms and practices, these are critical players, work with them.
Among the groups of people they recommended were religious leaders, cultural leaders, clan leaders, they talked about teachers, they identified and shared with us people they thought were very critical.
We are, through Ministry of Health, implementing the MIYCN (Maternal, Infant and Young Child Nutrition) guidelines , which is a full, complete tool that actually has different messages for which groups should eat and should consume. So this tool has been popularized among these reference groups, so they use the MIYCN guidelines as an instrument to create awareness and share information.
Q: Beyond awareness, how are you helping communities actually change their diets?
A: We’re also conducting food demonstrations, so that we’ll get to know that if we are talking about a diverse diet, what does it constitute?
They’re able to see and touch and cook, and they know that, you know, this is what we mean by a complete diet. Nutrients usually are lost during the process of cooking, and we are saying, cook for this period of time.
These are the food groups.This is what this food will do to your body. So it’s a complete package where people know what to cook, why they’re cooking it, why they need to consume it, and what it means and what it will do for their bodies.
Q: What is being done at policy and financing level to support these efforts?
A: At policy level, because, you know, in this campaign they’ve talked about financing, we need investments. So we work with the local governments through the district nutrition coordination committees, which are comprised by heads of departments.
We are saying, look here, let’s optimize the planning processes. Can we plan for nutrition? After we have planned for nutrition across sectors, in education, in health, in community development, in production, do we have activities? They could be nutrition-specific, they could be nutrition-sensitive. Are budgets then attached to those activities?
So we are working with the district nutrition coordination committees, first building their capacity to know how to plan, but after they plan, ensuring that budgets are allocated and after budgets have been allocated, they are disbursed. Because budgets being allocated is one thing, but getting the money in your pocket for the department to execute what has been planned is something else.
Q: What impact are you seeing so far, especially in Karamoja?
A: So, looking at Impact One, from the recent Key Project Indicator Assessment that we conducted in 2025—and the report of which we will share with the Nutrition Division—we are delighted to note a progressive change and shift in some of the norms, notably food taboos that we identified during our gender analysis.
In Karamoja, certain animal-sourced foods, in particular, were traditionally prohibited for women. Women were not allowed to eat liver, chicken, or eggs because of the belief that if they consumed them, they would have large babies. It was further believed that if they had large babies, they would not be able to deliver naturally, and in such cases, they would require surgical intervention. In addition, undergoing a caesarean section was often associated with being considered a weak woman. These kinds of sanctions around what women should and should not eat, based on perceived consequences, are now showing a progressive shift. Women are increasingly being allowed to consume these foods as communities begin to appreciate the nutritional benefits of animal-sourced foods. Just as they are important for men, they are also recognized as important for women, particularly because women conceive, carry pregnancies, and support child development.
Secondly, one of the successes we have noted is the adoption of climate-smart agriculture practices. These practices are important because they are closely linked to higher productivity. When farmers adopt improved methods such as planting in lines, mulching, and cultivating high-yield crops, production increases even on small pieces of land, leading to surplus yields. Over 50% of our project participants who were interviewed reported that they have adopted these practices and are already seeing returns on their investment, which we are proud of.
We are also observing increased household resilience to price and climate-related shocks through the promotion of quality declared seeds, which we are advancing in partnership with the National Agricultural Research Organisation (NARO) and as a result, most farmers are now adopting these high-yielding and climate-resilient seed varieties, as opposed to traditional seeds that often require the same labour input but yield lower returns. Overall, we are encouraged to see that this progress is steadily increasing.
Q: What are the key gaps that still need attention?
A: Social protection systems still need strengthening, especially for vulnerable households. And while progress is being made, behaviour change takes time. We must keep reinforcing the right messages and supporting communities consistently.
Q: Finally, what should the Nutrition for All campaign focus on to succeed?
A: First, take the conversation back to the community. That’s where malnutrition begins—and where it must be solved.
Second, tackle social norms head-on. What we would like to add in terms of the strategies is what we call the role model engagement,because what people eat is heavily influenced by beliefs and traditions. We need to work with men, cultural institutions and religious leaders because they shape these norms.
And third, we must address diets themselves. In many areas, people rely on one staple food especially in the Tooro Subregion as we heard, people eat matoke—morning, noon and night. That’s not enough. We need to promote diverse diets that include all food groups so that women and children get the nutrients they need.
If we get those three things right—community focus, behaviour change and better diets—then we will start to see lasting progress.