Information sheet 1 TANZANIA NATIONAL NUTRITION GOVERNANCE
Good and effective nutrition governance is critical for nutrition improvement as it provides the requisite enabling environment for planning, implementation, monitoring and evaluation of nutrition interventions including service delivery. It enables interventions that work to be delivered through effective and efficient systems that are accountable and adhere to the basic laws of the land and human rights. Tanzania has relatively adequate nutrition governance built on a long-established political will supportive of nutrition improvement in the country, an enabling policy and institutional framework, and a track record of commitment of public resources and mobilization of substantial resources from development partners to improve nutrition. Tanzania nutrition governance is characterized by the following key features:
1.0
A policy framework covering key sectors that contribute to nutrition
This comprises of several primary government policies and strategies that guide nutrition specific and sensitive interventions across the key line sectors, including health, food security, education, community development, WASH, industries and the private sector. Key policies include: ●
The National Health Policy of 2017
●
The Food and Nutrition Policy of 1992
●
The National Agricultural policy 2013
●
The National Livestock Policy,2006
●
The National Water Policy 2002
●
The National Fisheries Policy,2015
●
The National Women and Gender Development Policy,2005
●
The National Education and Training Policy 2014
●
The National Disaster Management Policy 2004
KEY GOVERNMENT STRATEGIES THAT FACILITATE NUTRITION IMPROVEMENT INCLUDE: ●
Third Five Year National Development Plan III (FYDP III 2021/2022 -2025/2026).
●
Health Sector Strategic Plan V.
●
Agricultural Sector Development Programme 2 (ASDP-II 2017/2018- 2027/2028).
●
The Nutrition Sensitive Agriculture Action Plan (2020).
●
Livestock Sector Development Strategy (2010)
To support operationalization of these policies and strategies the Government has also developed and disseminated relevant technical guidelines covering specific key areas including: ●
infant and young child nutrition.
●
management of acute malnutrition.
●
food based diets.
●
Biofortification guidelines.
●
Micronutrient supplementation.
●
nutrition assessment, counseling, and support (NACS),
●
environmental health, sanitation and hygiene,
●
nutritional care for people living with HIV and Aids,
●
prevention and control of Non-Communicable Diseases,
●
School feeding and nutrition guidelines
The government has also instituted different laws and regulations
to protect and
advance nutrition for national health and well-being. They include: ●
National Regulation for Marketing of Breast Milk Substitutes and Designated Products (1994)
●
Code of Hygienic Practice for Foods for Infants and Children
●
Maternity Leave Legislation
●
Food safety legislations
●
Food fortification regulations
2.0
An institutional framework for nutrition that goes down to the LGA level
The institutional framework for nutrition comprises of structures for leadership and policing, planning and coordination, implementation of nutrition interventions, and training, academia, research, and development.
THEY FALL INTO 2 MAJOR CATEGORIES: ●
Key line ministries, departments, and agencies (MDAs) that have been assigned
with specific mandates for nutrition. They include: the Prime Minister’s Office, the Ministries responsible for health, local government( Nutrition Unit-PORALG, regional secretariats and local government authorities), education, community development, agriculture, livestock, fisheries, water and sanitation, and industry and trade. ●
Specialized government departments and agencies include the Tanzania Food and
Nutrition Centre, National Bureau of Standards, National Bureau of Statistics, higher educational institutions involved in training of nutrition professionals and research. The institutional framework also comprises of multisectoral coordination mechanisms established at national, regional and LGA levels to facilitate coordination of nutrition actions at the respective levels.
3.0
Multisectoral mechanisms for coordination of nutrition at national and subnational levels
NATIONAL LEVEL The High-Level Steering Committee for Nutrition under the leadership of the Prime Minister’s office is the highest multsectoral, multpartnership national nutrition coordination platform. It is supported by the ministry responsible for health for policy guidance; the Nutrition Unit -PORALG for monitoring of nutrition interventions in regional secretariats and local government authorities; and the Tanzania Food and Nutrition Center for overall technical coordination of nutrition in the country.
REGIONAL LEVEL At regional level there is a Regional Multsectoral Nutrition Committee (RMSNC) that draw members from the technical departments at the regional secretariat, private sector, CSOs and influential people in the region. Generally, the regional level supports, and coordinates initiatives implemented at LGAs level.
LOCAL GOVERNMENT AUTHORITY LEVEL Most LGAs have functional Council Multisectoral Nutrition Steering Committees for nutrition actions down to community level. The majority of LGAs have also employed
professional
district nutrition officers to provide technical support in planning, coordination, implementation and monitoring of nutrition interventions.
4.0
Nutrition funding
Since joining the Scaling Up Nutrition (SUN)Movement in 2011 and assumption of a central role in the global network, Tanzania adopted a multisectoral approach to nutrition and made significant progress in public funding for nutrition: ●
In the financial year 2011/2012, Government introduced a budget line for nutrition.
●
A minimum budget allocation for nutrition was established for LGAs at TZS 1,000 per child under 5 to be increased gradually.
●
The national annual budget for nutrition increased from TZS 17.8 billion ($ 12.5 million) in 2011 to TZS 27.5 billion ($ 17.6 million) in 2012 and to TZS 33.2 billion ($ 21.3 million) in 2013, a growth of 31% over a period of three years (PER, 2014).
●
The PER 2018 which Included public expenditure on nutrition sensitive interventions, unlike the PER 2014, indicated an increase by 19%, from TZS 905 billion in 2014/15 to TZS.1,082 billion in 2015/16.
●
The total NMNAP I budget for the 5 years (2016 - 2021) was USD 268 million.
●
The total NMNAP II budget for the 5 years (2021 - 2026) is TZS 642,366,870,493 (USD 275,693,935.83).
-
4.1
Major sources of funding for nutrition
THE GOVERNMENT OF TANZANIA-OWN SOURCES: ●
These include domestically mobilized resources through taxes and non-taxes as well as LGA own sources
●
Nutrition funding has been prioritized in the national budget and the central government issues annual budget guidelines for nutrition
- ●
Government transfers resources to LGA where over 70% of spending is done and conducts regular supervision through PORALG and TFNC.
DEVELOPMENT PARTNERS ●
Development partners have been the major source of funding for nutrition for many years providing over 50% of all overall nutrition expenditure and over 70% funding of all nutrition specific interventions.
●
The major development partners funding nutrition include USAID, Irish Aid, DFID, UNICEF, WFP, Nutrition International (NI) and Global Alliance for Improved Nutrition (GAIN).
Development partners engage with the government through their established platform known as Development Partners Group (DPG Nutrition). Given the high levels of malnutrition that are difficult to reverse in the short term and changes or uncertainties in the global aid architecture, there is need for mobilization of more domestic resources for nutrition and ensuring efficient utilization for optimal impact.
5.0
The multisectoral nutrition information system
A key function in nutrition governance is ensuring availability and accessibility of adequate quality information and data on nutrition including key nutrition problems/risk factors, trends, interventions and their outcomes, and resources for nutrition (human, financial, food, commodities). Another major function is frequent collection of intervention outcome data to generate evidence for interventions. The government in collaboration with partners has taken various measure to improve availability and accessibility of nutrition information and data to meet the diverse needs by stakeholders and key implementing partners. These initiatives include: ●
Integration of nutrition indicators in relevant national surveys including Tanzania Demog raphic health Surveys.
●
Conducting the Tanzania National Nutrition Survey since 2016.
●
The Public Expenditure Review for Nutrition.
●
Establishment and strengthening of the multisectoral Nutrition Information System.
●
Operational research on nutrition conducted by higher educational institutions and other research institutions.
●
Implementation of NMNAPI Monitoring, Evaluation, Accountability, and Learning (MEAL) framework (MEAL): June 2016-June 2021.
As a result of these initiatives, nutrition data generation and collection have improved, along with data quality, availability, and accessibility.
6.0
Overall outstanding challenges in nutrition governance
THE CHALLENGES INCLUDE: ●
Over dependence on external funding for nutrition especially for nutrition specific interventions exposes national nutrition plans and key interventions to delay or low implementation due inconsistency in quantity and timing of support.
●
Budget execution for nutrition at national and sub national levels is low-this affects implementation of planned interventions and undermines impact on malnutrition.
●
Inadequate multisectoral nutrition coordination, particularly in some LGAs with coordination committees that are not well constituted or do not hold the requisite quarterly meetings.
●
Nutrition human resource gaps- in LGAs that have not yet employed fulltime professional nutrition officers and others that experience shortage of adequately trained health service providers to deliver nutrition interventions at facility and community levels.
●
Inadequate enforcement of existing regulations, for example fortification regulations, to create a more supportive environment for nutrition.
●
Inadequate generation and collection of relevant data from key line sectors including the private sector -MNIS not effectively linked with sectoral data systems and other decentralized systems
7.0
Way forward
With increasing recognition of the power of nutrition at global level as a key building block to health, human development, and economic productivity, nearly all the overarching national development strategies in Tanzania have prioritized and directly addressed nutrition. They are: ●
THE NATIONAL FIVE-YEAR DEVELOPMENT PLAN I (FYDP I) 2011/2012- 2015/2016
●
THE NATIONAL FIVE-YEAR DEVELOPMENT PLAN II (FYDP II) 2016/2017- 2020/2021
●
THE NATIONAL FIVE-YEAR DEVELOPMENT PLAN III (FYDP III) 2021/- 2022/2025/2026
The country has also implemented 2 comprehensive strategic nutrition action plans-the National Nutrition Strategy 2011/12-2015/16, and the National Nutrition Multisectoral Action Plan2015/16-2020/21. This indicates that nutrition is strategically positioned and prioritized in the national development agenda and many opportunities exist for planning and implementing multisectoral interventions that can result in a fundamental reduction in malnutrition. Over the next five years, building on the achievements and lessons learned from previous strategies, key nutrition specific and sensitive interventions, will be implemented, monitored, and evaluated under the NMNAP II 2020/21-2025/26.
7.1THE THENATIONAL NATIONALNUTRITION NUTRITIONMULTISECTORAL MULTISECTORALACTION ACTIONPLAN PLANIIII(NMNAP (NMNAP2020/21-2025/26) 2020/21-2025/26) 7.1 INAANUTSHELL: NUTSHELL: IN EXPECTED RESULT: Based on the Theory of Change, the desired change from NMNAP II is all Tanzanians are better nourished leading to healthier and more productive lives that contribute to economic growth and sustainable development. FOCUS: all age groups (across the life cycle) and those with special needs including the first 1000 days of life, early childhood, adolescents, those with chronic illnesses, the elderly, and vulnerable poor households during emergency situations.
KEY RESULT AREAS: ●
Reducing undernutrition
●
Reducing micronutrient deficiencies
●
Reducing overweight and obesity
●
Strengthening the enabling environment
ESTIMATED BUDGET: TZS 642,366,870,493 (USD 275,693,935.83) OVER FIVE YEARS. UNIQUE FEATURES: ●
It addresses nutrition across the lifecycle and has, beyond children and women, added focus on adolescents, elderly, and men.
●
It puts emphasis on food-based approaches for prevention and management of malnutrition
●
NMNAP-II has an accompanying resource mobilization strategy from the outset
7.2 THE NATIONAL AND GLOBAL ENVIRONMENT The potential strengths, opportunities , weaknesses and threats in the national environment to the NMNAP II are illustrated in Fig 1 below.
SOURCE: THE NATIONAL MULTISECTORAL NUTRITION ACTION PLAN(NMNAP II) DOCUMENT
7.3 THE GLOBAL ENVIRONMENT FOR THE NMNAP II Implementation of NMNAP II, international development partners support and the overall aid architecture can be considerably facilitated by a conducive global environment. On the other hand, developments in the global environment could adversely affect the NMNAP II. A rapid SWOT analysis leads to the following assumptions:
STRENGTHS AND OPPORTUNITIES ●
Phase 6 government diplomatic approach and re-establishment of strong international presence in international fora will attract more external support.
●
High priority of nutrition on the international development agenda
●
Strong global networks and platforms for nutrition-SUN, N4G etc
THREATS AND WEAKNESSES ●
Possible shocks in key donor countries may disrupt flow of funds.
●
Emergencies like COVID 19 may shrink economies and result in realignment of funding to domestic priorities.
●
Wars and civil strife in globally strategic areas may draw attention away from development aid abroad.
●
Conditionalities tied to donor support- including donor perspectives on human rights, democracy and constitutionalism.
It is important to exploit the identified strengths and opportunities in both the national and global environment for effective implementation of the NMNAP II. There is also a need to devise appropriate domestic initiatives to mitigate the potential impact of risks expressed through the identified weaknesses and threats.