ArticleBMJ public health2026
Collaborative dynamics in multisectoral nutrition governance of Uganda's second nutrition action plan: a qualitative case study.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Malnutrition has various causal pathways that necessitate participatory design, implementation, monitoring and evaluation of interventions, culminating in the current multisectoral collaborations for nutrition. In addition to the growing interest and investment in multisectoral collaboration, there is demand for knowledge on the processes of delivering collaborative nutrition plans and endeavours. These processes remain less studied and undocumented. Objective: The study examined dynamics during national level implementation of Uganda's second Nutrition Action Plan (UNAP) II, inspired by the reduction in stunting in Uganda alongside multisectoral nutrition governance under the Scaling Up Nutrition (SUN) Movement. Methods: 20 key informant interviews and 28 documents provided information for this case study. The interviews were conducted among representatives of key ministries, departments and agencies implementing UNAP II and representatives of the SUN Networks. The Integrative Framework for Collaborative Governance structured a primarily deductive thematic analysis of principled engagement, shared motivation and capacity for joint action. NVivo 12 was used to manage coding and analysis. Results: Multisectoral coordination meetings supported accountability and joint planning. A recurrent cross-cutting pattern was mandate competition, described by participants as mandates being 'hijacked' when resources were attached to particular activities. Accounts linked these disputes to political pressure and role encroachment resulting in exclusion of some actors regarded as controversial. Trust, transparency and commitment varied across sectors and were closely tied to financial resources and individual actors. Capacity for joint action was constrained by weak knowledge management as well as limited financial, technical and human resources, much of which relied on donors. Formal allocation of roles did not by itself prevent mandate disputes or power imbalances. Conclusion: Improving UNAP implementation requires stronger procedures for coordination, resolving disputes, knowledge management, continuity beyond individual focal persons and deliberate trust-building across participating organisations.
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