After Trump aid cuts, Kiryandongo turns to communities to fight malnutrition

2026-03-18 - 10:25

For a district that hosts more than 82 tribes from across Uganda and neighbouring countries, Kiryandongo’s challenges are as complex as its diversity. Alongside its 365,000 Ugandan nationals, the district is home to about 165,000 refugees, a population that continues to grow as new arrivals cross the border each week. Carved out of Masindi district in 2010, Kiryandongo is now one of Uganda’s 13 refugee-hosting districts and home to the country’s fourth-largest refugee settlement. Authorities estimate that between 400 and 500 refugees arrive every week, adding pressure to already stretched services. Locally, the district is often described as the “United States of Africa.” Its refugee settlement hosts people from Eritrea, Sudan, South Sudan, the Democratic Republic of Congo, Burundi, Tanzania, and other countries. Uganda’s open-door refugee policy continues to attract asylum seekers. By the end of February, at least 13,122 asylum applicants had arrived in the country, including Eritreans (45%), South Sudanese (24%), Congolese (20%), Sudanese (6%), and others. REFUGEE PRESSURE WORSENS FOOD SHORTAGES The growing refugee population has intensified food insecurity in the district, worsening already fragile nutrition levels. District officials say the Shs 10,000 monthly assistance per household is far from enough to sustain families. Locals often sell part of their food rations to meet other needs, while refugees spend what little money they have buying food, driving demand that local supplies struggle to meet. Staple foods such as maize, cassava, matooke, and beans remain available, but they often fall short of meeting the nutritional needs of households, especially children. Kiryandongo Chief Administrative Officer Anselm Kyaligonza says the district has had to balance humanitarian obligations with mounting social pressures. “For us, we say with or without [other services], we’re happy because we have given someone another life. The major objective is to give someone another life [resettlement] and then look for other things later,” Kyaligonza said. Limited economic activity has also contributed to rising teenage pregnancies and expanding household sizes in the settlement. “Majority of the households in the settlement have very many children — 13, 9, 15 — as if they produce every year,” he said. “One time I asked why so many children, and the issue was predominantly because they have nothing to do. They spend a lot of time procreating, but the quality of children is wanting.” AID CUTS DEEPEN THE CRISIS Like many refugee-hosting districts, Kiryandongo has historically depended heavily on international donor funding. But recent cuts to foreign aid – partly triggered by policy shifts in the United States under President Donald Trump, have worsened the situation. Health services are now severely over- stretched. The district’s overall health staffing stands at just 38 per cent, while nutrition staffing is at 30 per cent. At Panyadoli health centre IV, the district’s only government nutrition nurse has reportedly been working seven days a week since December to keep services running. Health experts have long argued that Uganda, a country rich in fresh agricultural produce, should not be struggling with widespread malnutrition. Yet the Uganda Demographic and Health Survey (2022) shows that 26 per cent of children under five, more than two million children, suffer from chronic malnutrition or stunting. In Kiryandongo alone, Global Acute Malnutrition (GAM) stands at 15.6 per cent, while Severe Acute Malnutrition (SAM) is 4.7 per cent. COMMUNITIES STEP IN With international aid shrinking, authorities and development partners are increasingly turning to local communities as the frontline defense against malnutrition. With support from UNICEF and funding from the United Kingdom, Japan, and the European Union’s humanitarian arm (ECHO), about 400 Village Health Teams (VHTs) from eight of the district’s 13 sub-counties have been trained to manage uncomplicated cases of severe acute malnutrition within communities. Community care-groups demonstrate how prepare healthy meals These community care groups now lead peer-to-peer education on nutrition, teaching families how to prepare balanced meals using locally available foods, monitor children’s growth using MUAC tapes, and improve infant and young child feeding practices. CHANGING ATTITUDES TOWARD NUTRITION Despite these efforts, misconceptions about nutrition remain widespread. Some parents still attribute conditions such as stunting or kwashiorkor to witchcraft, rather than poor feeding practices. Communal eating habits can also leave children nutritionally vulnerable, since meals are rarely tailored to their specific needs. But community groups such as the MI- YCAN Mother Care Groups in Panyadoli Settlement are slowly shifting attitudes. One group in Cluster G has 15 members — 10 women and five men — serving as lead mothers and fathers. Each member mentors between 10 and 15 other mothers in their community. Irene Abalo, a member of the group, says they receive monthly training on breastfeeding, the use of MUAC tapes, and preparing nutritious meals from local foods. They teach mothers how to prepare enriched porridge using millet flour mixed with oil, sugar or honey, and sim-sim paste, as well as how to introduce mashed foods to children after seven months. The groups are also reviving kitchen gardens, a once-common practice that ensured families had a steady supply of vegetables. Households are encouraged to plant fruit trees such as jackfruit, mangoes, and oranges, providing children with essential vitamins and fibre. FATHERS JOIN THE FIGHT Men are also increasingly participating in child nutrition efforts. Davis Owiny, a lead father in Cluster G, says the programme has helped men understand their role in supporting children’s nutrition. “The men were totally off on nutrition but now they know how to handle nutrition and children feeding,” he said. He added that many fathers now prioritise keeping nutritious food for their children instead of selling it to buy alcohol. PREVENTION IS CHEAPER THAN TREATMENT Yves Willemot, UNICEF Uganda’s chief of communication, advocacy and partnerships, says empowering families and communities is one of the most cost-effective ways to fight malnutrition, particularly as global funding becomes uncertain. A mother plays with her child in Kiryadongo According to Willemot, every $1 invested in nutrition generates a return of $6 to $7 in economic benefits. “People need to understand that nutrition is not only about responding to a challenge, it is also about preventing the challenge from happening in the first place,” he said. “Local communities have a key role to play because they can make the changes needed to ensure children have access to nutritious diets that prevent malnutrition.” SIGNS OF PROGRESS UNICEF’s support also includes training health workers, strengthening nutrition supply chains, providing therapeutic foods such as RUTF, F75 and F100, and expanding community screening programmes. Dr Irene Nabitaka, the acting district health officer, says mass screening programmes have already produced encouraging results. Global Acute Malnutrition has fallen from 10 per cent in 2024 to 7 per cent by October 2025, thanks largely to early detection and treatment. The district hopes to reduce the rate below the 5 per cent acceptable threshold. Through 25 outreach programmes across five high-burden sub-counties, 860 children were screened, leading to 72 referrals for treatment of moderate and severe malnutrition. Community care groups have also expanded to 68 groups across seven sub-counties, with 793 caregivers reaching more than 1,000 children under five and 637 adolescents through household engagement. In seven sub-counties alone, 5,896 children were screened, identifying: 236 cases of moderate acute malnutrition (4%), 83 cases of severe acute malnutrition (1.4%), 319 cases of global acute malnutrition (5.4%) But Nabitaka warns that recent donor funding cuts, which have led to the layoff of more than 156 staff, risk reversing these gains. Even so, health officials remain hopeful that community-driven solutions may offer a more sustainable path in the long fight against malnutrition in one of Uganda’s most complex districts.