This special paper provides a summary of the situation of nutrition in Tanzania, and an institutional analysis of the principal actors in nutrition nationally and locally. The paper argues the need to focus on prevention of malnutrition by protecting, promoting and sustaining improved nutrition in children under two years of age. This strategy implies the need to strengthen care and services, especially health services, for pregnant women and young children, and to increase attention on advocacy and communication for improved nutrition, with special support for improvements in child care and feeding. There needs to be a deeper understanding by all key actors in nutrition – parents, communities and service providers – of the underlying and basic causes for inadequate care and feeding of young children. Research, improved information systems, and training will be needed. The following priority interventions are highlighted by this report: - Improvement of health and care of pregnant and lactating women, especially young women and girls; - Promotion and support of exclusive breastfeeding of babies for six months, and extended breastfeeding with complementary foods for children up to two years; - Helminth control through the regular deworming of children; - Rehydration for diarrhoea – carers of children must know to increase, or at least maintain, regular fluid and food intake;
- Malaria alleviation – provision of impregnated mosquito nets for pregnant women and young children, and early treatment of malaria with artesimin-based combination therapy; - Immunisation – sustained high vaccination rates, especially against measles; and - Micronutrient supplementation, particularly vitamin A supplementation. Each council’s integrated development plan should specifically incorporate nutrition with implementation coordinated by a designated focal point for nutrition. In areas of the country with high rates of child malnutrition, it is likely that additional staffing and financing for local authorities will be needed. The national institution for nutrition, the Tanzanian Food and Nutrition Centre, needs to drive this focused strategy forward, in conjunction with emphasis upon the Centre’s own strategic plan, including strengthened analytic work, increased technical support for sound information systems, and improved communication networks with national and community-based nutrition interventions. Above all, strong advocacy for nutrition and effective coordination of interventions under national leadership are urgently required to
raise the profile of nutrition and improve nutrition outcomes in Tanzania. The “silent” emergency of chronic malnutrition which so negatively affects the growth and development of nearly half the child population of Tanzania – and, in turn, the development of the country – should command much greater attention, at the very least the same levels of attention and resources which are accorded emergency response to alleviate temporary food shortages caused by drought or flooding. Lastly, the paper recommends the establishment of a National Committee for Nutrition to ensure that child nutrition is prioritised in national planning and monitoring systems, with strong emphasis on promoting the importance of nutrition for the achievement of MKUKUTA’s goals and on ensuring regular monitoring within the MKUKUTA monitoring system. The committee could also provide for effective national oversight of external support for nutrition.