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ASTUTE Operations Research for Scaling up Growth

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ASTUTE Operations Research for Scaling up Growth Operations Research for Scaling Up Growth: ASTUTE Addressing Stunting in Tanzania Early (in the under 5s) In partnership with IMA World Health, Tanzania Food and Nutrition Centre (TFNC), and Cornell University REGIONAL NUTRITION PROFILE Mwanza, Tanzania REGIONAL DEMOGRAPHIC PROFILE Source: National Bureau of Statistics Tanzania (web) Total Population: 2,772,509 49.1% 50.9% MALE FEMALE 33.3% 66.7% URBAN RURAL 46.7% 50.3% 3% 0-14 YRS 15-64 YRS 65+ THE STATE OF NUTRITION IN MWANZA Data from the Demographic and Health Survey (DHS) 2015-16 63% 39% 58% CHILDREN STUNTED 4% 39% CHILDREN WASTED 34% 14% CHILDREN 14% 14% UNDERWEIGHT 5% 4% 63% CHILDREN STUNTED CHILDREN WASTED CHILDREN UNDERWEIGHT CHILDREN WITH ANY CHILDREN WITH ANY ANEMIA ANEMIA MWANZA TANZANIA THE PREVALENCE CHANGES OVER TIME OF STUNTING, 1991-92 1996 2004-05 2010 2015-16 WASTING, AND DHS DHS DHS DHS DHS STUNTING UNDERWEIGHT HAS 44% 41% 35% 39% 39% WASTING 7% 6% 3% 4% 4% DECREASED FROM UNDERWEIGHT 17% 21% 10% 11% 14% 1991 TO 2016 Source: Demographic Health Survey [Datasets]. Calverton, Maryland: ICF International, 1991-2016 ASTUTE is funded with UK aid from the UK government through the Department of International Development (DFID) Children under 5, women of reproduction age especially pregnant/lactating Who are those with women and adolescent girls are most affected by undernutrition due to suboptimal physiological needs for growth and reproduction. The 1,000 day period, from conception to 2 years officers a critical window for actions that result in high nutrition status? impact. Poor nutrition begins in the womb and extends into adult life. Tanzania National Multi-sectoral Nutrition Action Plan (NMNAP), October 2016 Multi-sectoral Nutrition Action Achieving high coverage of effective high-impact interventions requires multi-sectoral harmonization and collaboration with key stakeholders and sectors. A multi-sectoral nutrition system is composed of Agriculture and Food Security; Health and HIV; Water, Sanitation and Hygiene; Education and Early Child Development; Social Protection; and Environment and Climate Change. Progress can be made if these sectors work together on nutrition actions together. How can Different Sectors Improve Nutrition? Train farmers; improve cultivation Expand school gardens; use school feeding practices; provide youth programs as a platform for nutrition education; EDUCATION AGRICULTURE empowerment programs improve Literacy and Numeracy Strategy Increase community fish ponds and Create father’s support groups to promote improved poultry pens; promote meat men’s participation in infant feeding; include LIVESTOCK & and egg consumption among children 6 COMMUNITY nutrition components in community FISHERIES to 24 months DEVELOPMENT development trainings Scale up water supply in rural areas, Deliver nutritional services and counselling educate on hygiene practices and safe through antenatal care, routine immunisation, WATER, SANITATION & disposal of child faeces HEALTH and family planning HYGIENCE Select examples from the Tanzania National Multi-sectoral Nutrition Action Plan (NMNAP), October 2016 Data and Evidence are Key to Success Having data is important for decision making. Data can help us know the scope of undernutrition by informing us of the proportion of the population that is affected by various health and environmental issues. Data can also tell us about ongoing activities in districts and regions, and help us learn who stakeholders are, what they do, and who they reach. Household Handwashing in Mwanza Women’s Education in Mwanza 2015-16 DHS *Children <5 years with diarrhea (2015-16 DHS) = 16.7% 77.1 68.1 67.0 86.2 59.0 23.4 39.9 5.5 14.1 2004-05 DHS 2010 DHS 2015-16 DHS Women with secondary or higher education Households with Households with soap Households with water only and water handwashing station Women who are literate What other data are available or could be collected in Mwanza Region for decision- making among stakeholders and departments? What actions are improving nutrition? Operations Research for Scaling Up Growth: ASTUTE Addressing Stunting in Tanzania Early (in the under 5s) In partnership with IMA World Health, Tanzania Food and Nutrition Centre (TFNC), and Cornell University REGIONAL NUTRITION PROFILE Geita, Tanzania REGIONAL DEMOGRAPHIC PROFILE Source: National Bureau of Statistics Tanzania (web) Total Population: 1,739,530 49.5% 50.5% MALE FEMALE 16% 84% URBAN RURAL 50.5% 47% 2.5% 0-14 YRS 15-64 YRS 65+ THE STATE OF NUTRITION IN GEITA Data from the Demographic and Health Survey (DHS) 2015-16 41% 68% CHILDREN STUNTED 58% 6% 41% CHILDREN WASTED 34% 16% CHILDREN 16% 14% UNDERWEIGHT 6% 5% 68% CHILDREN STUNTED CHILDREN WASTED CHILDREN UNDERWEIGHT CHILDREN WITH ANY CHILDREN WITH ANY ANEMIA ANEMIA GEITA TANZANIA THE PREVALENCE CHANGES OVER TIME OF STUNTING, 1991-92 1996 2004-05 2010 2015-16 WASTING, AND DHS DHS DHS DHS DHS STUNTING UNDERWEIGHT HAS 44% 41% 35% 39% 41% WASTING 7% 6% 3% 4% 6% DECREASED FROM UNDERWEIGHT 17% 21% 10% 11% 16% 1991 TO 2016 Source: Demographic Health Survey [Datasets]. Calverton, Maryland: ICF International, 1991-2016. Geita was a council within Mwanza Region until 2012. All data prior to 2015-16 share the same results as Mwanza. ASTUTE is funded with UK aid from the UK government through the Department of International Development (DFID) Children under 5, women of reproduction age especially pregnant/lactating Who are those with women and adolescent girls are most affected by undernutrition due to suboptimal physiological needs for growth and reproduction. The 1,000 day period, from conception to 2 years officers a critical window for actions that result in high nutrition status? impact. Poor nutrition begins in the womb and extends into adult life. Tanzania National Multi-sectoral Nutrition Action Plan (NMNAP), October 2016 Multi-sectoral Nutrition Action Achieving high coverage of effective high-impact interventions requires multi-sectoral harmonization and collaboration with key stakeholders and sectors. A multi-sectoral nutrition system is composed of Agriculture and Food Security; Health and HIV; Water, Sanitation and Hygiene; Education and Early Child Development; Social Protection; and Environment and Climate Change. Progress can be made if these sectors work together on nutrition actions together. How can Different Sectors Improve Nutrition? Train farmers; improve cultivation Expand school gardens; use school feeding practices; provide youth programs as a platform for nutrition education; EDUCATION AGRICULTURE empowerment programs improve Literacy and Numeracy Strategy Increase community fish ponds and Create father’s support groups to promote improved poultry pens; promote meat men’s participation in infant feeding; include LIVESTOCK & and egg consumption among children 6 COMMUNITY nutrition components in community FISHERIES to 24 months DEVELOPMENT development trainings Scale up water supply in rural areas, Deliver nutritional services and counselling educate on hygiene practices and safe through antenatal care, routine immunisation, WATER, SANITATION & disposal of child faeces HEALTH and family planning HYGIENCE Select examples from the Tanzania National Multi-sectoral Nutrition Action Plan (NMNAP), October 2016 Data and Evidence are Key to Success Having data is important for decision making. Data can help us know the scope of undernutrition by informing us of the proportion of the population that is affected by various health and environmental issues. Data can also tell us about ongoing activities in districts and regions, and help us learn who stakeholders are, what they do, and who they reach. Household Handwashing in Geita Women’s Education in Geita 2015-16 DHS *Children <5 years with diarrhea (2015-16 DHS) = 11.4% 68.1 67.0 67.1 92.0 65.3 14.1 34.2 5.5 10.8 2004-05 DHS 2010 DHS 2015-16 DHS Women with secondary or higher education Households with Households with soap Households with water only and water handwashing station Women who are literate What other data are available or could be collected in Geita Region for decision- making among stakeholders and departments? What actions are improving nutrition? Operations Research for Scaling Up Growth: ASTUTE Addressing Stunting in Tanzania Early (in the under 5s) In partnership with IMA World Health, Tanzania Food and Nutrition Centre (TFNC), and Cornell University REGIONAL NUTRITION PROFILE Kagera, Tanzania REGIONAL DEMOGRAPHIC PROFILE Source: National Bureau of Statistics Tanzania (web) Total Population: 2,458,023 49.1% 50.9% MALE FEMALE 9.2% 90.8% URBAN RURAL 47.7% 48.8% 3.5% 0-14 YRS 15-64 YRS 65+ THE STATE OF NUTRITION IN KAGERA Data from the Demographic and Health Survey (DHS) 2015-16 42% 58% 58% CHILDREN STUNTED 2% 42% CHILDREN WASTED 34% 17% 17% CHILDREN 14% UNDERWEIGHT 5% 2% 58% CHILDREN STUNTED CHILDREN WASTED CHILDREN UNDERWEIGHT CHILDREN WITH ANY CHILDREN WITH ANY ANEMIA ANEMIA KAGERA TANZANIA THE PREVALENCE CHANGES OVER TIME OF STUNTING, 1991-92 1996 2004-05 2010 2015-16 WASTING, AND DHS DHS DHS DHS DHS STUNTING UNDERWEIGHT HAS 48% 49% 44% 44% 42% WASTING 5% 12% 5% 5% 2% DECREASED FROM UNDERWEIGHT 23% 29% 18% 17% 17% 1991 TO 2016 Source: Demographic Health Survey [Datasets]. Calverton, Maryland: ICF International, 1991-2016 ASTUTE is funded with UK aid from the UK government through the Department of International Development (DFID) Children under 5, women of reproduction age especially pregnant/lactating Who are those with women and adolescent girls are most affected by undernutrition due to suboptimal physiological needs for growth and reproduction. The 1,000 day period, from conception to 2 years officers a critical window for actions that result in high nutrition status? impact. Poor nutrition begins in the womb and extends into adult life. Tanzania National Multi-sectoral Nutrition Action Plan (NMNAP), October 2016 Multi-sectoral Nutrition Action Achieving high coverage of effective high-impact interventions requires multi-sectoral harmonization and collaboration with key stakeholders and sectors. A multi-sectoral nutrition system is composed of Agriculture and Food Security; Health and HIV; Water, Sanitation and Hygiene; Education and Early Child Development; Social Protection; and Environment and Climate Change.
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