There is significant movement globally and in Uganda on addressing issues of nutrition and health in vulnerable populations including women and children. This is especially important since approximately 0.5 million women die each year of pregnancy related complications linked under nutrition, while more than 5 million pre-school children die of preventable causes due to the combined effects of disease and under nutrition. There is some progress being made globally, with 63 countries as of 2010 on track to achieve the First Millennium Development Goal (MDG) of reduction by 50% in underweight prevalence among preschoolers by 2015. However, 54 countries continue to make insufficient progress or no progress at all.
A key gap in achieving targets has been the lack of understanding on what needs to be done and how to actually implement it. While there is agreement that scaling up a select set of interventions will have huge payoffs but how this can be achieved remains unclear. As noted by Darmstadt et al. (2008), a major obstacle to program success is the nearly complete lack of information on the cost, effectiveness and process of scaling up interventions in a health systems context. This stands true for all program interventions whether they are uni-sectoral or multi-sectoral and integrated in nature.