Information sheet 4 N4G COMMITMENT TO INCREASE PROPORTION OF CHILDREN CONSUMING MINIMUM ACCEPTABLE DIET
1.0
Changes in infant nutritional requirement after 6 months
●
From the age of 6 months, an infant needs more energy and nutrients that breast milk alone may not provide.
●
Complementary feeding becomes necessary to fill the energy and nutrient gap.
●
Complementary feeding is the process of providing other foods and liquids to an infant, besides breast milk, when the child’s energy and nutrient needs can no longer be met through breast milk alone. However, complementary feeding ought to comprise adequate nutrients required for the child’s growth and development.
2.0
What is the minimum acceptable diet for children 6-23 months? Minimum acceptable diet comprises of: Minimum dietary diversity: children 6-24 months consuming from 4 or more of the 7 food groups within a 24-hour dietary recall (1. grains/tubers/roots; 2. legumes/nuts, 3. milk/dairy products, eggs, 4. vitamin A rich fresh foods and other foods and vegetables) Minimum meal frequency: children 6-8 months are fed a minimum of 3 meals a day, and children over 9 months fed 4 times per day (apart from breast milk). Low dietary diversity is among the major causes of stunting. The minimum acceptable diet for children 6-23 months should therefore be diverse in nutrients and provided by caregivers in real time, according to the recommended frequency.
3.0
Progress made on complementary feeding and minimum acceptable diet for children 6-23 months
●
In 2004, the Government developed and launched the Tanzania National Strategy on Infant and Young Child Nutrition.
●
Promotion of optimal complementary feeding after six months of exclusive breastfeeding in the country through the successive national programmes including the NNS, NMNAP II, and sectoral programmes through the health sector have had a significant impact.
●
Most infants (90%) aged 6-8 months are receiving timely complementary feeding
●
The proportion of children of 6-23 months who consume a minimum acceptable diet has increased from 20.0% in 2014 to 30.3% in 2018
●
Marasmus and Kwashiorkor have diminished, eliminating the need for special nutrition rehabilitation units in hospitals for their treatment that were widely operational in the 1970s and 80s.
4.0 ●
Challenges/ bottlenecks Although most infants are receiving complementary feeding, the quality of these complementary foods and frequency of feeding is often inadequate.
●
Early introduction of complementary foods, especially in poor WASH conditions, increases risk of malnutrition as the foods may be of inferior quality and infected with pathogens.
●
Inadequate childcare as women in rural areas and maids in urban areas (traditionally responsible for caring for children) are often overburdened with household chores and other livelihood tasks.
-
5.0
Way forward
The Government has set a target of increasing the proportion of children 6-23 months who consume a minimum acceptable diet from 30% to 50% by 2026. This objective is being pursued through the NMNAP II, and actions that have been outlined include: Protection, promotion, and support for appropriate complementary feeding with continued breastfeeding up to 2 years. Provision of micronutrient supplementation-Vitamin A for children 6-59 months. Zinc treatment for diarrhea and deworming. Growth monitoring and promotion. Prevention and treatment of infectious disease and quality care of sick children. HIV testing, treatment and nutrition assessment, counseling, and support- appropriate infant feeding practices for HIV exposed infants. Promotion of handwashing with soap and improved water and sanitation practices. Promotion of good parenting and nurturing care practices for early child development. Provision of cash transfers, food and nutrition related productive assets creation, and liveli hood support to promote dietary diversity in children. Strengthen food quality and safety standards.
Beyond the NMNAP II, more interventions to facilitate improved dietary intake are being implemented under the FYDPIII framework through the agriculture sector. Besides sustenance and scaling up of ongoing interventions to increase number of biofortified staple crops and mandatory fortification of commonly used commodities, more food system-based approaches to improve dietary intake are being leveraged through the NSAAP 2020/21-2021/25. They include actions that promote production of specific crops to address nutrient deficiency, increased production of diversified nutrient dense crops (indigenous and non-indigenous), collaboration with the private sector to reduce post-harvest food loss, improvement of storage and preservation to address seasonality, and processing that retains nutrient value and improves shelf life and safety.