Nutrition and realistic support to households are important public health services from Hope Clinic Lukuli

The UNICEF monitoring data for the Millennium Development Goals, published as Countdown 2015 Uganda reports 2006 figures of 38% of children with moderate to severe stunting and 16% of under 5s being under-weight for age. It also notes that 14% of children had a low birth weight compared to WHO standards for sub-Saharan Africa.

The UNICEF East and Southern Africa office in 2010 released a report emphasising the need to address nutrition with as much effort as measles, malaria or HIV. In a January 2010 release they noted,

"Stunting (low height for age) indicates nutritional deprivation early in life – from conception up to two years of age. Unlike underweight, which is a composite of both stunting and wasting (low weight for height), stunting past the age of two is irreversible, and has long-term debilitating effects: Children who are stunted are at greater risk of illness and death. It is estimated that countries lose over three per cent of their GDP through the effects of under-nutrition. According to the latest data from UNICEF, the prevalence of stunting in the developing world has declined from 40 per cent to 29 per cent between 1990 and 2008, but the progress has been stagnant in Africa. Over the same period, stunting in Africa has only been reduced from 38 per cent to 34 per cent. Of the 24 countries that account for 80 per cent of the world’s stunting burden, seven are in the Eastern and Southern Africa region"

The Art Club set up the Nutrition Board	Fun and learning - nutrition in a sack	Home grown fresh veg may not be enough

In the MDG report 2010 for Uganda, the 2006 Demographic and Household Survey (DHS) remains the most often cited source. The MDG report notes, that of the 16% of under-5s, whilst 36% was the greatest concern in
Karamoja (northern Uganda, poor farming climate, largely pastoralists) and 22% in the north (post-conflict area) of the country in 2005/2006, comparatively developed Kampala still had cases amounting to 10%. Hope Clinic Lukuli is serving this population - they are living in Makindye, in the wetlands - as well as similar areas across the city in Bwaise and Kisenyi.

As Hope Clinic Lukuli is an integrated health facility, we provide a range of services (ANC, laboratory, HIV care, immunisation) but also ensure that a patient attending for one reason can be approached by staff on other topics or receive information through posters, leaflets, newspapers or watching the CD-Rom in the waiting area. Through child immunisation we weigh, check height and development milestones. We can advise on feeding, offer de-worming tablets and vitamins to improve the uptake of nutrients and if necessary, counsel for Early Infant Diagnosis of HIV. If we could be supported to bring more of the deliveries into Hope Clinic from the community, a greater proportion of mothers would have PMTCT services. We therefore miss the chance to protect babies and at the immunisation the failure to take on weight can be due to a variety of conditions but HIV may be one. Through Plumpy 'Nut we could provide a very high protein paste that has given low-weight babies the boost to gain strength and so to process the ART that they will need.