1.3 Develop linkages between programmes, training and research so that they reinforce each other for efficient, effective and sustainable scaling up of nutrition actions TFNC, HLSCN, Academia (Sokoine, MUHAS) On-going 2. Strengthening Institutional linkage between PMO-RALG and TFNC 2.1 Ensure reports from Councils going to the PMO-RALG are copied to TFNC Focal Points for the Regional/Districts. TFNC, December 2014 and 2.2 Share experience by attending each other’s relevant meetings TFNC, HLSCN, PMO-RALG MSCN On-going 3. Resource Mobilization 3.1 Identify and mobilize resources for nutrition by developing a resource mobilization strategy
3.2 Develop a concept on the establishment of a basket fund for nutrition, building on the experience of Zambia and other countries TFNC, Development Partners March 2015 3.2 Develop a Human Resources Strategy for nutrition through an assessment and analysis of current situation and the needs required for operationalizing the reviewed NNS TFNC March 2015 3.3 Provide for the necessary tools to implement nutrition activities as per NNS Nutrition Plans and Budgets at all levels HLSCN Ministries, MSCN (regional and district), TFNC On-going 4. Improved planning and budgeting for nutrition 4.1 Review and adjust the inclusion of nutrition in the Government’s Guidelines for the MOF & TFNC September 2014
preparation of annual plan and budget starting with the 2015/2016 budget year under preparation. 4.2 Train the Nutrition Officers/Nutrition Focal Points at all levels on planning and budgeting. MOF & TFNC On-going 4.3 Include planning and budgeting in the development of the Common Results, Resources and Accountability frameworks. TFNC, MoF, MoHSW March 2015 5. Research, M&E 5.1 Develop the capacity of TFNC to do operational research and for M&E and link with other relevant institutions to improve the quality and evidence-base for TFNC, Development Partners, academia (Sokoine, MUHAS, NIMR) On-going
Table 3: Consolidated key successes, issues/challenges and proposed actions based on review of the 8 Strategic Objectives of the National Nutrition Strategy by the First Tanzania Joint Multi-Sectoral Nutrition Review held at JNCC, Dar Es Salaam, 19-21 August 2014 NNS Strategic Objective Key successes Key challenges/issues Proposed way forward 1. Accessing Quality Nutrition Services Nutrition activities were planned by MDAs and LGAs and executed (85%) More was planned on agriculture-related activities than planned in the NNS All the councils are implementing nutrition interventions (such as VAS and deworming) Nutrition services not prioritized at MDA, regional and Council levels Inadequate funding for delivery of nutrition services Demand outstripping supply especially with measurement equipment and rehabilitation commodities (F75, F100, RUFT, Micronutrient Powder) Strengthen advocacy to MDAs, regions, councils (Action: TFNC, MoF, by Sept 2014 Write a circular instructing LGAs to set specific percentage of their budget for nutrition (Action: PMO-RALG by Sept 2014). Advocate for incorporating Anthropometric equipment and supplies and commodities in MSD catalogue (Action: TFNC, MOHSW- ongoing)
2. Behaviour Change Communication Social and Behavioural Change and Communication (SBCC) strategy was developed Insufficient technical assistance and financial support for implementation of the SBCC strategy Lack of a system to harmonize key nutrition messages by different SBCC relevant strategies. M&E system for tracking progress on implementation of SBCC strategy not fully operational There is need for SBCC sub committees at the regional and district level. Tracking of the impact of the SBCC strategy should be included in the Common Results Framework 3. Legislation for Supportive Environment for optimal nutrition Developed fortification regulation and enforcement. Launching of food fortification program in May 2013 (cooking Oil, Wheat flour and salt). Inadequate awareness on food fortification regulations food producers and consumers Inadequate capacity for quality Develop stronger linkage between the multi-sectoral policy and technical coordinating structures with the regulatory bodies (TFDA and TBS)
Reviewed Code on Marketing of Breast milk Substitutes (BMS) assurance and enforcement. The sugar fortification standard though already in place is not included in the food fortification regulations Control of food fortification is difficult for imported products due to illegal importation using unauthorized ports of entry. flour fortification is still in process because medium and small-scale producers, who produce more than 90% of maize flour, are not yet mapped and lack Addition of Maternity Protection Legislation, particularly Maternity legislation as stipulated under the current Employment and Labour Relations Act in Tanzania. This is one of important legislation for supporting maternal and child nutrition. Addition of Maternity Protection Legislation, particularly Maternity Leave legislation as stipulated under the current Employment and Labour Relations Act in Tanzania. This is one of important legislation for supporting
Review of National Food and Nutrition Policy and Strategy on-going Revision of TFNC Act planned (awaiting finalization of the Food and Nutrition Policy) Nutrition officer and focal person positions at national, regional and district levels occupied (153 out of 159- District nutrition officer, 25 out of 25 regions, national 9 out of 10 Ministries and MDA) In service training program for nutrition officers in place. (Note: most refer to TFNC) working tools and budgeting Lack of a systematic and effective supervision, coaching and mentoring. by Link reporting of Regional and District Nutrition Officers with TFNC in addition to PMO-RALG with TFNC Regional/District Focal points to provide coaching and mentoring (Action: and TFNC – on-going) 6. Advocacy and Resource Mobilization Guidelines for planning and budgeting were disseminated in RS and LGAs The advocacy tool PROFILES has been developed for 2014 Inadequate awareness among key government leaders/officials on the importance of nutrition in development plans 1. Complete development of the national Advocacy strategy and support regions/districts to adapt it (Action: TFNC with partners by March 2015) 2. Implement the action plan arising
Nutrition Public Expenditure Review (PER) done Nutrition is not a priority in the Comprehensive Council Health Plans Parallel programming and resource planning Inadequate advocacy skills Lack of advocacy action plans in the districts Lack of and Nutrition Advocacy Strategy LGAs allocate little or no funds from own sources for nutrition and advocacy in particular from the PER for Nutrition (Action: MoF, TFNC) 3. Develop a concept not for establishment of a nutrition basket fund, separate from the health one. 7. Research, Monitoring and Evaluation Research, studies, assessments and evaluations have generated a lot of information on the nutrition situation, its Inadequate translation of results of research, studies and evaluations into Collate key recommendations from the different assessments and evaluations and submit to HLSCN
causes and recommendations on what should be done to address identified gaps. Nutrition is integrated into the Health Management Information System (HMIS), the Food and Nutrition Security Information Assessments (FNSIA) and other data bases operational practice. Lack of Common Results, Resources and Accountability Frameworks make it difficult to monitor and evaluate on basis of results. Lack of a nutrition surveillance system Lack of linkage between different nutrition relevant data bases Lack of use of IT and especially mobile technology in M&E and in evidence advocacy and communication for discussion and action on those where agreement is reached (Action: TFNC, by March 2015) As part of the Plan for operationalizing the reviewed NNS, develop consensus Common Results, Resources and Accountability Frameworks (Action: TFNC by May 2015) Re-establish sentinel site nutrition surveillance (Action: TFNC, Bureau of Statistics, R/DNuO by July 2015)) Establish a Virtual Nutrition Information Centre which can link up with different data
bases (Action: TFNC) Liaise with mobile phone and companies to develop an IT strategy for nutrition. 8. Coordination and Partnerships Government has established and Operational Steering/Coordination Committees at the National level (High Level Steering Committee on Nutrition-HLSCN) and Multi-Sectoral Steering Committees on Nutrition (MSCN) at Regional and District Levels. Technical and coordinating committees (Thematic Working Weak link between national and regional/district coordination & reporting structures Weak functioning of Steering Coordinating Committees due to low functional capacity; infrequent meetings of TWGs and Regional and District Steering Committees on nutrition (MSCN); low Develop functional capacity of Committees, allocate human and financial resources and Secretariats of Steering Committees at all levels to develop calendars of meetings, identify strategic agendas and communicate effectively with members on planned meetings and their outcome Use the “3 ONES” principle for Coordination in
Groups –TWGs at national level have also been established. The Scaling Up Nutrition (SUN) Movement processes with its annual reviews have improved participation in nutrition including formation of Public Private-Partnerships. Platforms formed include Government, Development Partners, UN Agencies, NGOs & CSO, Private Business Network resources for convening meeting and lack of meeting schedules Lack of consolidated plan for all nutrition activities at District, Regional or National level; Parallel planning processes for development partners and NGOs and difficulty to monitor progress of nutrition activities at District, Regional and national levels constrain coordination The of different stakeholders in the MSCN are not well the reviewed NNS: One plan for nutrition at district, Regional and National level One body at district, Regional and National One and (M&E) system at district, Regional and National level PMO-RALG with TFNC to disseminate the TOR of the MSCN and TWGs and