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Nutrition Public Expenditure Review

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Nutrition Public Expenditure Review PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA UNITED REPUBLIC OF TANZANIA MINISTRY OF FINANCE PUBLIC EXPENDITURE REVIEW OF THE NUTRITION SECTOR MAIN REPORT MARCH 2014 INN VEX PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA CURRENCY EQUIVALENT 2010/11 (A VERAGE ) USD 1 = TZS 1,420 EUR 1 = TZS 1,883 GBP 1 = TZS 2,195 2011/12 (A VERAGE ) USD 1 = TZS 1,563 EUR 1 = TZS 2,176 GBP 1 = TZS 2,507 2012/13 (A VERAGE ) USD 1 = TZS 1,562 EUR 1 = TZS 2,009 GBP 1 = TZS 2,476 MEASURES METRIC SYSTEM FISCAL YEAR 1 JULY – 30 JUNE Acknowledgement : In addition to consultants from INNNOVEX Development Consulting Ltd, the study was under the Assistant Commissioner of Budget, Ministry of Finance Mr John Mwilima and coordinated by Mr Charles Mwamwaja. The field work to the 15 selected local councils included the Government staff as follow: Mrs Rachel Ntiga (MoF); Mr Emmanuel Matiku (MoF); Mr Martin Tupilike (MoF); Mrs Aneth Nombo (TFNC); and Mr Fred Lwoga (TFNC). The national team also highly appreciated direct and indirect support from many stakeholders and notably the support team documented on Annex B of this report. INNOVEX©2014 Page | ii PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA TABLE OF CONTENTS Abbreviations and Acronyms ...................................................................................................................................................... v Executive Summary .................................................................................................................................................................. vii 1 Background and Context .................................................................................................................................................. 1 1.1 Introduction ............................................................................................................................................................. 1 1.2 Background ............................................................................................................................................................ 1 1.3 Study Objective ...................................................................................................................................................... 3 1.4 Study methodology ................................................................................................................................................. 3 1.5 Main report structure .............................................................................................................................................. 6 2 Nutrition Policy and Framework ....................................................................................................................................... 7 2.1 National Level ......................................................................................................................................................... 7 2.2 National Nutrition Strategy .................................................................................................................................... 11 2.3 Sub-national Level ................................................................................................................................................ 13 2.4 Scale up nutrition actions ..................................................................................................................................... 14 2.5 Institutional Framework ........................................................................................................................................ 15 2.6 Institutional Issues ................................................................................................................................................ 18 3 Allocations and Alignment of Budget.............................................................................................................................. 19 3.1 Budget Allocations ................................................................................................................................................ 19 3.2 Budget Composition ............................................................................................................................................. 22 3.3 Budget Alignment ................................................................................................................................................. 26 3.4 Sources of Finance ............................................................................................................................................... 29 3.5 Budget Target Areas ............................................................................................................................................ 32 4 Planning and Execution of Nutrition Interventions.......................................................................................................... 34 4.1 Planning Process .................................................................................................................................................. 34 4.2 Budgeting process ................................................................................................................................................ 38 4.3 Budget Execution ................................................................................................................................................. 40 4.4 Situational Analysis .............................................................................................................................................. 44 5 Conclusion and Recommendations................................................................................................................................ 50 5.1 Key Findings ......................................................................................................................................................... 50 5.2 Conclusion ............................................................................................................................................................ 52 5.3 Main Recommendations ....................................................................................................................................... 53 6 Annexes ......................................................................................................................................................................... 54 6.1 Annex A: List of References ................................................................................................................................. 55 6.2 Annex B: Support Team ....................................................................................................................................... 57 6.1 Annex C: Selected Cross-Tab Results ................................................................................................................. 58 6.2 Annex D: National Level Interventions ................................................................................................................. 61 6.3 Annex E: Sub-national Level Interventions ........................................................................................................... 74 INNOVEX©2014 Page | iii PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA 6.4 Annex G: Nutrition Milestones in Tanzania .......................................................................................................... 82 INNOVEX©2014 Page | iv PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA Abbreviations and Acronyms ASDP Agriculture Sector Development Programme ASP Agriculture Strategic Plan CAADP Comprehensive Africa Agriculture Development Programme DC District Council ECAGR Exponential Cumulative Average Growth Rate FAO Food and Agriculture Organization GDP Gross Domestic Product GoT Government of Tanzania IDD Iodine Deficiency PMO Prime Minister’s Office LGA Local Government Authority MAFC Ministry of Agriculture, Food Security and Cooperatives MC Municipal Council MCDGC Ministry of Community Development, Gender and Children MCH Maternal and Children Health MDA Ministries Departments and Agencies MDGs Millennium Development Goals MKUKUTA Mkakati wa Kuondoa Umasikini na Kukuza Uchumi Tanzania MoF Ministry of Finance MoHSW Ministry of Health and Social Welfare MTEF Medium Term Expenditure Framework NCD Non-Communicable Diseases NFFA National Food Fortification Alliance NNS National Nutrition Strategy NPFS National Programme for Food Security NTD Neural-Tube Defect OC Other Charge PE Personal Emolument PER Public Expenditure Review PMO-RALG Prime Minister’s Office, Regional Administration and Local Government PO-PC President’s Office, Planning Commission RS Regional Secretariat SPFS Special Programme for Food Security TAFSIP Tanzania Agriculture and Food Security Implementation Plan TDHS Tanzania Demographic and Health Survey TFDA Tanzania Food and Drugs Authority INNOVEX©2014 Page | v PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA TFNC Tanzania Food and Nutrition Centre TGEB Total Government Expenditure Budget TWG Technical Working Group TZS Tanzania shilling UNICEF United Nations Children’s Fund USD United States dollar VAD Vitamin A Deficiency VAS Vitamin A Supplementation INNOVEX©2014 Page | vi PUBLIC EXPENDITURE REVIEW ON NUTRITION SECTOR FOR MAINLAND TANZANIA Executive Summary Background Malnutrition in
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