NUTRITION CHALLENGES IN TANZANIA Dr Julius Ntwenya PhD-Human Nutrition School of Nursing and Public health UNIVERSITY OF DODOMA 1

Stunting prevalence was reduced by 18% since 2010 and by 30% since

Status of Stunting in Tanzania according to SMART Survey 2014 Kagera 52 Njombe 52 Iringa 51 Ruvuma 49 Kigoma 49 Rukwa 48 Geita 46 Dodoma 45 Katavi 43 Morogoro 37 Lindi 37 Mbeya 36 Manyara 36 Singida 34 Mtwara 34 Tabora 33 Mwanza 32 Mara 32 Unguja North 31 Pwani 31 Shinyanga 30 Pemba South 28 Arusha 27 Simiyu 26 Unguja South 25 Pemba North 25 Tanga 24 Town West 21 Kilimanjaro 18 Dar es Salaam 16 3

Trends in nutritional status of children under 5 Tanzania Sources: WHO Global database and TNNS survey 2014 There are improvements of all forms of malnutrition among children under five years in Tanzania 4

Risk factors for stunting In Tanzania Parents had no schooling and were illiterate Children from poorest households, those who resided in urban areas and in the Northern zone of Tanzania Delivered at home by TBAs Whose mothers did not attend any antenatal clinics. Children who were 5-born or higher Children who were perceived by their mothers to be small at birth and those from poorest households With no potable drinking water Chirande et al. BMC Pediatrics (2015) 15:165 DOI /s

Coverage of Vitamin A Supplementation increased in Mainland but not in Zanzibar 6

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Quality of Complementary Food for Children 6-23 months has not improved in Tanzania 8

Coverage of Iron and Folic Acid Supplementation during pregnancy has improved, but the level is still very low 9

Use of Iodized Salt at Household level Use of Iodized Salt at Household level has decreased in Mainland despite provision of potassium iodate to TASPA 10

Overview of the 2010-TDHS-Re analysis 11

Percentage of women with obesity by age in Mainland Tanzania and Zanzibar, TDHS

Spatial distribution of obesity in Tanzania 13

Regions of Tanzania by adjusted HDI categories: Source T-PHDR

Nutritional status of school children 15

Double burden of malnutrition among School children 16 Underweight Overweight -Obesity

Disparities in the double burden of malnutrition by sex among school age children 17

Prevalence of food insecurity by seasons among 307 subjects studied, adult rural household members from the Kilosa District, Tanzania. Ntwenya JE, Kinabo J, Msuya J, Mamiro P, Majili ZS (2015) Dietary Patterns and Household Food Insecurity in Rural Populations of Kilosa District, Tanzania. PLoS ONE 10(5): e doi: /journal.pone

Diabetes nts/Tanzania_Scorecard.pdf 19

Non communicable diseases Of the 2223 subjects in Rural Hai district, 1553 (69.9%, 95% CI 68.0–71.8) had hypertension (BP 140/90) Journal of Human Hypertension 27, (June 2013) | doi: /jhh

Challenges in scaling up nutrition Limited knowledge – Foods – Cooking skills – Interaction with other components-climate, environment – Social and economic development Traditional Beliefs Training and institutional setups Integrating nutrition with other sectors 21

Asanteni sana kwa kunisikiliza Karibuni Dodoma Asanteni sana kwa kunisikiliza Karibuni Dodoma 22