The Highflyer Report spoke to Daisy Yossa Immaculate, 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: CARE and the Catalysing Strengthened Policy Actions for Healthy Diets and Resilience (CASCADE) is privileged to have been part of the launch of this national advocacy campaign dubbed Nutrition for All by Ministry of Health and UNICEF.
We believe that addressing malnutrition in this country requires concerted efforts. And our take from today’s message directing interventions to community level is spot on as various forms of malnutrition are evident in our communities. Delighted that regions which continue to persistently have poor nutrition indicators, that is Karamoja and the Tooro sub region are targeted for this campaign.
As an organisation, we are implementing activities geared towards increasing the production and consumption of nutrient dense foods across six sub regions of the country. These include iron rich beans, orange fleshed sweet potatoes, orange maize and dark leafy vegetables. Other interventions are Nutrition education at community level through community structures notably schools (over 100 schools) and village heath teams as well as food systems level advocacy particularly planning, budgeting, programming and financing for nutrition at subnational and national levels by both public and private sector.
Critical in our programming is evidence and noteworthy is the gender analysis the project conducted in 2023 that underscored the extent to which social and gender norms impact nutrition at household and community levels.
Q: You mentioned working with “reference groups” in communities. Who are these and why do they matter?
A: Reference groups are individuals within the communities that they (community) consider influential and in high regard to change people’s perspectives, beliefs and behaviours. They include teachers, community development officers, community health workers, parish chiefs, religious and cultural leaders. They matter because they are critical pathway to the community in the villages and households where people live. Through tailored training on gender norms change, facilitation skills enhancement and tooling particularly with Maternal, Infant and Young Child Nutrition MIYCAN cards, they are the foot soldiers at the fore of social and behavioural change crucial to change nutrition statistics from the bottom up.
Collaborating with the Ministry of health, the MIYCAN card has been popularized as a tool for Nutrition education to bring about shifts in behaviours and practices that impact the nutrition of women, children and households.
Q: Beyond awareness, how are you helping communities change their diets?
A: We are conducting food and cooking demonstrations to exemplify what constitutes a diverse and nutrient rich diet. Participating communities can see, touch and cook. In the process of the cooking, the food compositions such as vitamins, iron, carbohydrates, protein and others are explained including the benefits to the body. Nutrients usually are lost during the process of cooking and isn’t known by many. The cooking period/length of time for specific foods is also shared during the demonstration.
The farmers groups that we work with across the six subregions of Lango, Tooro, Karamoja, West Nile, Acholi, Busoga) have also been provided with foundation seed for nutrient dense crops for multiplication. Gardens with orange fleshed sweet potatoes vines, yellow maize and dark leafy vegetable seeds have thus been established, from which farmers share seed amongst themselves and ensure all year-round access and availability for replanting. Our key message to the farmers and communities has been to prioritise consumption of the harvest and surplus for the market to purchase what they can’t produce; but must be nutritious.
Q: What is being done at policy and financing level to support these efforts?
A: At policy level, we are cognisant of needed investments in the food and agricultural sector. We thus engage with the local and central government through district and sectoral nutrition coordination committees on nutrition prioritisation within the planning and budgeting frameworks. This covers sectors notably of education, health, trade, agriculture and production, water, gender and community development.
Through the CASCADE project, the capacity of the district nutrition coordination committees in 15 districts and 3 cities has been enhanced to plan, budget, program and report on nutrition related interventions.
Q: What impact are you seeing so far, especially in Karamoja?
A: The project in 2025 assessed several of its indicators to gage performance and established; acute malnutrition had reduced but noted persistent chronic undernutrition among children under five. There is widespread adoption of climate-smart agriculture (97.4%), food preservation (95.0%), seasonal food storage, and early planting has strengthened year-round food availability. These practices reduce reliance on food aid and enhance households’ ability to maintain diets during lean seasons.
We note a progressive change and shift in some of the norms, notably food taboos that were identified during the project gender analysis.
In Karamoja, animal-sourced foods such as liver, chicken and eggs were prohibited for women. There is a belief that if they consumed them, they would have big babies and would not be able to deliver naturally, and in such cases, they would require surgical intervention. Undergoing a caesarean section is 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 recognizing the importance for women, particularly because women conceive, carry pregnancies, and support child development.
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 tackled.
Second, tackle social norms head on through among other strategies male engagement. What people eat is heavily influenced by culture, beliefs and traditions with men at power centres. There is need to work with/engage men, cultural and religious institutions because they gate-keep these norms.
And third, we must address diets. In some regions, communities rely on one staple food for example in the Tooro Subregion. There is need to amplify the message on dietary diversity-include all food groups so that women, children and households get the recommended nutrients for complete health.