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 Full Title Proposal to develop a routine monitoring system for children’s 
nutritional status for integration into existing surveillance systems and to produce a regular Bulletin on Child Nutrition.
 Short Title Nutrition Monitoring
 Project Leader Deborah Wason
 Description Malnutrition is one of the most serious public health problems affecting children in Tanzania. Large groups of children are affected by one or more forms of malnutrition, including stunting, underweight and wasting. Thirty five percent (35%) of children under-five have chronic malnutrition (stunting), which means they have low height for their age; twenty one percent (21%) are underweight which means they have low weight for their age; and 2% have immediate malnutrition (wasted), which means they have low weight for their height. Malnutrition in developing countries, including in Tanzania, is estimated to be responsible for 35% of infant deaths and 55% of the burden of disease. Malnutrition leads to poor cognitive development and consequently reduced education outcomes and reduced efficiency.

The Demographic and Health Survey (DHS) provides valuable cross-sectional nutrition data to track trends over time in nutritional status at the regional and national level in Tanzania. However, the data are collected every 5 years and this is too infrequent to detect emerging nutrition crises in time to effect remedial action. In fact, there is no system of regular nutritional surveillance in Tanzania. The Panel Surveys of the National Bureau of Statistics, which are designed to provide supplementary data in the years between each DHS, include nutrition indicators but only on an annual basis and in a nationally representative sample. The Rapid Vulnerability Assessment Surveys (RVAs) of the Government of Tanzania include a nutrition indicator (mid-upper arm circumference) to flag possible nutrition problems twice a year, in February and September. However, the data are collected from only 3-6 purposively selected villages in food insecure districts, and the RVAs are therefore neither nationally representative, nor designed to track nutritional status over time.

The IHI has been conducting the Demographic Health Surveillance (DSS) in two sentinel sites in Tanzania for the past ten years: in Rufiji, in Coast Region and Ifakara Urban and Rural in Morogoro Region. In 2009 IHI added a further site in Kigoma. Data collected at periodic intervals (at least three times a year) in these DSS districts would enable the monitoring of nutritional status of under-fives over the year. It will also provide an insight into how households cope with shocks such as rising food prices, threats to livelihoods, and changes in food availability, with a special focus on coping strategies that may impact negatively on nutritional status. Early evidence of nutritional crises is needed to galvanize action and mobilize resources to mitigate the impact of shocks on the nutrition, health and survival of children.

The project's objectives are as follows;

1.  To track the nutritional status of children in the DSS areas

2.  To link trends in the nutritional status of children to outside events such as rises in food prices and natural disasters.

3.  To explore possible associations between the nutritional status of children and other events within the household such as sickness/death, and socio-economic status.

4.  To learn from the routine monitoring of children in the DSS areas so that nationally representative monitoring can be undertaken when the Sentinel Panel of Districts comes on-line.

5. To produce information on nutrition in a relevant and easily readable form for policy makers/health managers/other interested parties on a regular basis highlighting the most pertinent nutrition issues facing Tanzania.

6.  To explore trends in the nutritional status of children nationally from existing datasets and how they link with other factors.
 Collaborators Esther Elisaria                    Ifakara Health Institute (IHI)                 

 Source of funding UNICEF
 Start Date March 2010                        End Date     June 2011
     

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