Nutrition Improvement Projects in Tanzania: Appropriate Choice of Institutions Matters\ud

Nutrition Improvement Projects (NIPs) are sets of planned activities specifically undertaken as interventions to reduce malnutrition and its associated problems in the communities. The study focused on five NIPs of varying nature. The projects included the internationally known Iringa Nutrition Project, and the National Salt Iodation Project. Others include, a locally processed weaning food, and smallholder agricultural-based projects. The aligning of institutions for delivering primary health services attempted by some nutrition improvement projects in Tanzania seems to be in disharmony with the organizational capacities, and therefore causing high transaction costs. On the other hand, things look promising for the deliverance of non-public good services. The private sector - through the use of market mechanism, and more involvement of the civil society as a way of increasing the participation of beneficiaries, hold the key to success for that matter. Such arrangements are likely to be favoured by the continuing economic changes in the country.\u

Household Food Access Insecurity along the Urban-Rural Continuum in Morogoro and Iringa, Tanzania

The overall objective of this paper was to assess household food access insecurity along the urban-rural continuum of Morogoro and Iringa towns in Tanzania. The specific objectives were to: (1) measure the extent of household food access insecurity along the urban-rural continuum, and (2) identify the socio-economic characteristics associated with the household food access insecurity. The study was cross-sectional in design whereby a sample of 300 households was selected using a Geographic Information System (GIS)-based simple random sampling procedure. The primary data were collected through interview schedules using the Household Food Insecurity Access Scale (HFIAS) tool. The data were analysed descriptively and inferentially using the Statistical Package for Social Sciences (SPSS) software. Ordinal logistic regression was used to determine the influence of some household socio-economic characteristics on the household food access security. Generally, the results showed that the households that are located in the urban settings are more likely to be food access secure than the households situated in peri-urban and rural settings (p ≤ 0.001). Other factors that had statistical significant effect on the household food access security include age and education level attained by household head, and non-farming activities. It was concluded that household food access insecurity is a widespread phenomenon along the continuum although it is more prevalent in rural as compared to urban settings. Thus, it is recommended that more opportunities for non-farming income generating activities engagements be created throughout the continuum to support the households that rely entirely on farming. Keywords: household food access insecurity, urban-rural continuum, socio-economic characteristics, Morogoro and Iringa, Tanzania

Nutrition governance at the sub-national level in Tanzania: a case of Morogoro municipality and district councils.

Introduction: Nutrition governance has been proven to be a relevant approach to improving nutrition services in developing countries. Tanzania has adopted it since 2011, but limited studies have been done. This study examines nutrition governance through government commitment to nutrition budget and nutrition coordination. Methods: The study was cross-sectional, and conducted in two councils of Morogoro district. It involved the review of documents and interviews with 140 respondents, and a semi-structured questionnaire and checklist tools were used. Content analysis and the Excel database were used for the analysis. Results: From this study, it was revealed that nutrition budget planning and spending based on own sources are not matched and spending has been low in rural councils. For the nutrition coordination, at the council level, the meetings were held as required but still faced the problem of attendance of core members and follow-up of the standard agendas. At the sub-council level inclusion of nutrition as a standing agenda in the ward and village/street development committee meetings quarterly has been less than 50%. Conclusion: Therefore, nutrition budget provisions such as subsidies, especially to the rural council, committee member sensitization, capacity building, and investment in the ward/village/street development committees could accelerate nutrition governance thus improving nutrition intervention

Evaluating pictorial charts as a means of collecting participant-recorded data on household dietary diversity in low-literacy communities in Tanzania

Innovative methods to collect dietary data at multiple times across the year are needed to better understand seasonal or temporal changes in household diets and measure the impact of nutrition-sensitive agricultural programmes in low-income countries. The present study aims to validate a picture-based research tool for participants to self-record their household’s dietary diversity each month in villages of Manyoni District, Tanzania. Pictorial record charts were developed to reflect local food resources. In 113 randomly selected households, the person responsible for food preparation was trained to mark all items consumed by any household member within the home, or prepared for consumption outside the home, for a single recording day. The next day, an interview-based household 24-h food recall (H24HR) was collected for the same period. Separate analyses tested agreement (a) between picture charts and H24HR and (b) between H24HR following chart completion and on an alternative day. Concordance between methods differed between food groups and items but was high to very high for all cereals, vegetables, pulses, legumes and nuts and almost all fruits. Recording of ten items (including non-cultivated fruits and ingredients of mixed dishes) differed significantly between H24HR assessments, all of which were reported by more households in interviews following chart completion. Results suggest potential for visual prompts and the contemporaneous nature of data collection to improve the accuracy of interview-based recall. With adequate investment in developing and implementing context-adapted tools, pictorial charts may also offer an effective standalone method for use at multiple time-points in agricultural programme

Prevalence and risk factors for diabetes mellitus among tuberculosis patients in Moshi Municipal Council, Kilimanjaro Tanzania

Background: Diabetes Mellitus (DM) is a worldwide public health problem and its prevalence has been rising rapidly in low and middle income countries (LMICs) including Tanzania. According to WHO report 2015, DM is ranked number six as a leading cause of death  worldwide. Strong evidence suggests that DM may be associated with Tuberculosis (TB) and could affect TB treatment outcomes. Tanzania is among the 22 countries that have a high burden of TB and currently facing increased epidemic of DM. The increasing diabetes  prevalence may be a threat to TB control and counteract strategies to end TB by 2030 as proposed by WHO.Objective: To determine proportion of TB patients who are co-infected with DM in Moshi municipal council, Kilimanjaro Tanzania.Methodology: This study was a hospital based cross-sectional study conducted in April to July 2018 at 4 health facilities; Mawenzi Regional Referral hospital, St. Joseph District Designated hospital, Pasua Health center and Majengo Health centre in Moshi municipal. The study included adults aged 18 years and above attending either of the 4 health facilities for TB care. The study included newly diagnosed and those who were on TB treatment. Interviews were conducted followed by blood glucose testing. Data was entered and analysed using SPSSResults: A total of 153 TB patients were enrolled, their mean age was 42.5 (±14.75) years and 46 (30.1%) were females. The prevalence of DM among TB patients in this study was 9.2%. Factors associated with TB-DM comorbidity were: age (OR 4.43, 95% CI: 1.18-16.55), HIV status (OR 3.88, 95% CI: 1.06-14.11), and family history of DM (OR 6.50, 95% CI 0.67-25.56).Conclusion: One in ten patients with TB had confirmed DM. There is a need for future studies to assess if DM influences TB treatment and outcomes in this setting

Indigenous vegetables: a sustainable approach to improve micronutrient adequacy in Tanzanian women of childbearing age

This research article was published by Springer Nature in 2021Background/objectives Increasing dietary diversity is a viable strategy for addressing micronutrient malnutrition in women of childbearing age (WCA) from low-income countries. Recently, it has been demonstrated that some indigenous vegetables (IV) with high nutrient density may help to ameliorate micronutrient’s intake. The Minimum Dietary Diversity index for Women (MDD-W) could be considered as a proxy to describe one important dimension of women’s diet quality. This cross-sectional study aimed at exploring aspects contributing to micronutrients adequacy in Tanzanian WCA, with a focus on IV consumption and other socio-demographic factors. Subjects/methods Data collection was conducted among urban and peri-urban women in Arusha city, Tanzania. Socio-demographic factors were collected using a structured interview. Information on IV consumption and MDD-W calculation were obtained using a 24-h recall. Results One-hundred and forty-one women aged 14–49 years were interviewed. Sixteen per cent of the sample consumed at least one portion of IV/day. The total median MDD-W was 4.0 (IQR. 3.0–5.0) and it was adequate in the 44% of the sample. Women who consumed IV had MDD-W 0.66 points (95% CI: 0.02–1.30, p = 0.046) higher than those who did not; consuming IV had an odds ratio of more than three times concerning women not consuming IV (OR: 3.30, 95% CI: 1.24–8.81, p = 0.017). Conclusions The IV consumption is positively associated with micronutrient adequacy and its absence from the diet can be an indicator of micronutrient deficiencies in vulnerable people such as WCA. For that reason, this study suggests that IV consumption may improve micronutrient deficiency in WCA