Levels, Barriers And Facilitators For Nutrition Governance At Regional And District Administrative Levels In Tanzania Mainland

ABSTRACT

Background: Good nutrition governance has great influence on the improvement of health and nutrition status of people. The government of Tanzania has taken significant measures to strengthen nutrition governance as part of national efforts to improve nutrition. However, little is known on the current status of nutrition governance in Tanzania.

Objective: This study determined the barriers and potential facilitators for effective Nutrition governance at Regional and administrative level in Tanzania Mainland.

Methods: The study adopted a cross sectional study design constituting 184 Nutrition Councils and 26 Regional Nutrition officers in Tanzania Mainland. The study used mixed method approach where convenient sampling was used to select study respondents while purposive sampling was employed in selecting 12 key informants. Semi structured web page administered questionnaires were administered to respondents using survey monkey software, while an interview guide was used to interview key informants. Descriptive statistics were performed using SPSS Version 20 while the R statistical package was used to determine the nutrition governance patterns in Tanzania. On the other hand, thematic texts were analyzed using Nvivo software version 11 to identify the themes in qualitative data.

Results: About 40% and 60% of the Councils in Tanzania Mainland had inadequate and adequate nutrition governance respectively. Ten nutrition governance patterns were identified namely: Nutrition training, Fund for nutrition, Nutrition information, supportive supervision, Nutrition plan, Nutrition messages, Prioritization of nutrition, Nutrition information feedback, Nutrition budget and access to nutrition data. About 90% and 73% of nutrition officers at Council and Regional levels, respectively, were faced with barriers in implementing nutrition activities. The most common barriers were inadequate funding for nutrition, inadequate nutritionists, lack of reliable transport system and lack of tools for assessing nutrition status. About 59% and 67% of nutrition officers at Council and Regional levels, respectively, had facilitators to implement nutrition activities. The most common facilitators were in service training, supportive supervision and availability of development partners supporting nutrition services.

Conclusion: In conclusion, Councils differ in the level of nutrition governance. Adequacy of funds for nutrition services had low scores for almost all councils in Tanzania mainland. Despite having in service training, nutrition supportive supervision and collaboration with development partners, it is important to have accountability in funds disbursement and execution for timely implementation of nutrition activities