Diet and Nutrition
“We are guilty of many errors and many faults, but our worst crime is abandoning the children, neglecting the foundation of life. Many of the things we need can wait. The child cannot. Right now is the time his bones are being formed, his blood is being made and his senses are being developed. To him we cannot answer ‘Tomorrow’. His name is ‘Today’“ Gabriela Mistral, Nobel Prize Winner 1945
Despite these wise words nutrition barely featured in the Millennium Development Goals. Hunger was the first goal but this focused filling bellies with no specific concern of the nutritional value of the food used to achieve that goal.
In the first 10 years of this millennium over 600,000 children aged below 5 years are estimated to have died as a result of malnutrition in Tanzania alone. This year another 47,000 children will die prematurely because they are malnourished. Tanzania the third worst affected country in Africa and has approximately 2.4 million malnourished children.
Food inflation and a change of focus has placed nutrition on the agenda. In September 2010 the ‘Scaling Up Nutrition’ (SUN) movement was launched, and within 3 years it is working with 35 countries who have committed to the scaling up of nutrition intervention and advance of nutrition-sensitive development. As SUN approaches the end of its first 1000days they have stated that: -
- Improved nutrition levels can be achieved with deliberate action
- There are 3 factors that can help enable a good environment for deliberate action to be achieved: knowledge and evidence, politics and governance, and capacity and resources
- Nutrition is a political tool and so commitment must not be squandered
- Leadership is needed to create and sustain momentum
- For nutrition programmes to succeed they will require long term strengthening of organisational capacities which will require external support
- More operational research on delivery implementation and scale up interventions need to be undertaken.
SUN went on to recommend at each country needs to clarify their needs and capabilities and establish goals relating to the following areas:-
- Access to affordable nutritious food, clean water sanitation, health care and social protection;
- Increased adoption of practices that contribute to good nutrition (such as exclusive breastfeeding for at least the 1st 6 months of life);
- Optimal growth of children, demonstrated as reduced levels of stunting (low height for age) and wasting (low weight for height); and
- Improved micro-nutrient status, especially in women and children, demonstrated as reduced levels of micro-nutrient deficiency
The Tanzania Government undertook at Demographic and Health Survey in 2010, this survey revealed:-
- 42% of children under five are stunted, 16% are underweight, while 5% are wasted
- 59% of children aged between 5 and 59 months have iron deficiency,
- 33% of children below six years have Vitamin A deficiency.
- 11% of women of reproductive age (15-49 years) have low weight, 41% have iron deficiency while 58% of expectant mothers have iron deficiency
- 40% of breastfeeding women and 45% of expectant mothers have Vitamin A deficiency.
The Government, under SUN’s guidance have agreed to focusing on:-
- Infant and young child nutrition programmes
- Vitamin A deficiency control programmes
- Iodine Deficiency control programme
- Management of acute Malnutrition
- Nutrition in emergency
- Nutrition Assessment counselling and Support; and
- Nutrition and HIV
The President established a number of nutrition groups and partnerships within the government and with civil society to develop ways of raising nutritional awareness and the importance of it. A nutritional strategy has been developed and the costs associated with it being calculated. President Kikwete is eager that this programme be decentralized to ensure that nutrition is on the agenda with those working closest to affected communities. . In addition, nutrition officers are being recruited and nutrition budget training is being provided at the district level. The government has introduced a budget line for nutrition expenditure and has developed budget guidelines to help ministries and local government authorities improve budgeting for nutrition.
On 16 May 2013 President Kikwete launched a nationwide nutrition sensitization campaign – the Presidential Call for Action on Nutrition, stressing the importance of nutrition advocacy at all levels of government. He announced a nationwide aimed at ensure all Tanzanians get nutritious food with the ultimate aim of building healthier people. “We have embarked on the fortification of industrial products such as salt, cooking oil and flour. To that end he announced that the government will work with flour millers in rural areas to add nutrients to their produce in an effort to improve villagers’ health. The president further noted that nutritious foodstuffs are not necessarily expensive although many people were not well informed on the types of food that constitute a balanced diet. He said “we should eat vegetables, fruits, eggs and meat alongside other foodstuffs. We should understand that eating too much fat and being obese does not mean that one is healthier. What matters is eating a balanced meal.” He went on challenge traditional beliefs that have mostly denied children and women their right to eat nutritious food.
The Government’s approach is to look at food fortification, food security and agricultural support which they plan to manage though their health and agricultural network, ignoring in the process the development and poverty reduction plans, the education, social protection and women’s empowerment programmes which might have been useful forums to work with. Programs aimed at strengthening agricultural development and increasing food security are essential components to scaling up nutrition. These programs ensure that nutritious food is affordable and accessible to everyone and empower small farmers to lift families and communities out of poverty.
Adequate health is a cornerstone for ensuring good nutrition. Programs that protect women and children from disease, and provide timely and appropriate treatment, are essential for improving nutrition. Good health allows women and children to have an appetite for nutritious food and to be able to absorb the nutrients they need.
Programs aimed at strengthening agricultural development and increasing food security are essential components to scaling up nutrition. These programs ensure that nutritious food is affordable and accessible to everyone and empower small farmers to lift families and communities out of poverty
LTTs grassroots research identifies community members, who have mostly completed primary level to grade 4 or 7 depending on their age, have limited conceptual understanding of the relationship between diet and good health and little understanding of nutrition.
Our pilot programme, built in to our farmer programme, has selected 10 suitable participants. Through a series of 6 workshops we will transfer knowledge, change perceptions and through peer learning expand the resulting impact. Combined with lessons of farming different types of crops and managing the land we will empower the participants to diversify their farming activities, improve their food security and diet resulting in improved their household health
Should this programme prove to the successful as we believe it will, it can be scaled up in different ways and through different stakeholders and can form part of the Regional Commissions push again under-nutrition that the President is so eager to achieve.