Ngongo, Samuel2026-01-122026-01-122025-11-26Ngongo, S. (2025). Factors affecting the implementation of supplementary feeding programme in refugee settlements: a case of Rhino Camp Refugee Settlement in Terego and Madi-Okollo district (unpublished graduate dissertation). Muni University, Arua, Uganda.https://dir.muni.ac.ug/handle/20.500.12260/862A dissertation submitted to the Faculty of Health Sciences in partial fulfilment of the requirements for the award of a Master's Degree in Public Health of Muni University.Background: Despite the implementation of Supplementary Feeding Programmes (SFPs) in Rhino Camp Refugee Settlement, child malnutrition remains a critical public health emergency, characterized by high rates of stunting, wasting, and anemia. The persistent high burden of malnutrition suggests significant underlying factors are impeding the effectiveness of these interventions, necessitating a systematic investigation. Methodology: A cross-sectional research design that integrated both quantitative and qualitative methods was employed. The study sampled 400 respondents, who were caregivers/guardians/parents, and 25 respondents, these included programme staff, programme managers(WFP) and administrators for Key informant interviews. Data were collected through structured survey questionnaires, focus group discussions (3 Zones)these were selected because of easy proximity to nationals who happen to be beneficiaries of SFPs, and key informant interviews. Quantitative data were analyzed in Stata version 15 using Pearson correlation and regression analysis, while qualitative data was analyzed using thematic analysis. Findings: The study identified two primary categories of influencing factors: Child-Related Factors: A positive correlation was found between child-related factors (appetite, palatability of supplements, health condition, and discrimination of food types) and SFP implementation success (r = 0.434, p < 0.001). Regression analysis confirmed these factors as significant predictors, accounting for 18.8% of the variance (B = 0.775, p < 0.001). Qualitatively, children readily accepted ready-to-use therapeutic/supplementary foods (RUTF/RUSF) but widely rejected Corn-Soya Blend (CSB++) porridge due to its taste and preparation burden. Programme Delivery-Related Factors: A strong positive correlation existed between programme delivery factors (accessibility, community sensitization, timing, funding, and human resources) and implementation success (r = 0.426, p < 0.001). These factors were significant predictors, explaining 18.2% of the variance (B = 0.416, p < 0.001). Key implementation challenges included inadequate funding leading to ration cuts and stockouts, long distances to distribution points, high beneficiary-to-staff ratios, and politicization of aid. Critically, insufficient general food rations led to the diversion and sharing of SFP supplements at the household level. Conclusion: The implementation of SFPs in Rhino Camp is significantly constrained by a complex interplay of child acceptability issues and systemic programme delivery barriers. The inadequacy of general food assistance fundamentally undermines the supplementary nature of the programme. Recommendations: To enhance programme effectiveness, it is recommended to (1) diversify and improve the palatability of food supplements to meet children's preferences; (2) secure flexible, multi-year funding to prevent stock-outs; (3) decentralize distribution points to improve accessibility; (4) increase staffing levels and invest in capacity building; and (5) enhance community sensitization and engagement strategies. Addressing these factors is crucial for improving nutritional outcomes among refugee and host community children.enSupplementary feedingRefugee settlementsRhino CampTeregoMadi-OkolloUgandaThesis