UNITED REPUBLIC OF TANZANIA Implementation of National Multi-sectoral Nutrition Action Plan (NMNAP) From October to date DPG MEETING 5th April 2017

Presentation Outline NMNAP’s Desired Change Conditions for Change Towards the Desired Change/KRA Contribution to Health Sector to the NMNAP NMNAP Monitoring and Evaluation System Progress of the Implementation of NMNAP Better nourished is the desired change which will have Contribution to economic growth, reduced poverty and inequalities

NMNAP’s Desired Change “Children, adolescents, women and men in Tanzania are better nourished leading to healthier and more productive lives that contribute to economic growth and sustainable development”. The NMNAP desired change will be measured through impact level indicators which were selected to reflect nutrition priorities and targets in the national development agenda; regional and international commitments. Better nourished is the desired change which will have Contribution to economic growth, reduced poverty and inequalities

Conditions for Change Towards the Desired Change/KRA Adolescents, pregnant women and mothers/care givers of children under five years are supported to practice optimal nutrition behaviours; Children, adolescents and women of child bearing age consume adequate micronutrients; Affected Children and communities demand, access and use quality services for acute malnutrition; Communities in Tanzania are physically active and eat healthy; Line ministries, private sector and CSO scale up nutrition sensitive interventions to reach all communities; Govt and partners at all levels actively practice good nutrition governance; Quality nutrition information is used by communities, government and partners for evidence-based decision and action. For each of the seven conditions for change the theoretical assumptions were made explicit and specific contribution to conditions were formulated.

Contribution of Health sector to the NMNAP (within Outcome 5) For each of the seven conditions for change the theoretical assumptions were made explicit and specific contribution to conditions were formulated.

Contribution of Health sector to the NMNAP (key interventions) For each of the seven conditions for change the theoretical assumptions were made explicit and specific contribution to conditions were formulated.

Investment Plan – Budget Requirements Areas Components Annual Budget in TZS Billion Total in TZS Billion Total in USD Million 2016/17 2017/18 2018/19 2019/20 2020/21 Nutrition Specific Interventions Maternal Infant, Young Child and Adolescents Nutrition 34.9 49.9 60.9 36.1 14.0 195.8 89.01 Micronutrients 21.9 23.4 24.3 25.3 24.9 119.8 54.46 Integrated Management Acute Malnutrition 4.0 12.6 24.6 30.7 96.7 43.94 Diet related Non communicable Disease 1.8 18.9 22.1 18.4 10.6 71.8 32.65 Nutrition Sensitive Interventions Agriculture sector 728.1 737.0 723.5 720.5 713.1 3,622.3 1,646.48 Health and HIV sector 1,461.0 1,556.0 1,704.0 1,801.0 - 6,522.1 2,964.59 WASH sector 1,149.0 1,148.8 1,148.0 5,743.9 2,610.86 Education sector 351.8 351.4 353.1 351.3 1,759.4 799.73 Social Protection sector 436.9 491.5 1,021.3 1,033.2 4,016.2 1,825.56 Environment sector 1.6 7.8 3.55 Enabling Environment Multisectoral Nutrition Governance 6.3 8.8 7.4 8.0 37.8 17.18 Multisectoral Nutrition Information System 8.5 16.3 20.4 6.6 68.0 30.91 Total Budget without Nutrition Sensitive Interventions 77.4 129.9 159.6 134.7 88.3 589.9 268.16 Total Budget with Nutrition Sensitive Interventions 4,205.8 4,416.9 5,110.5 5,193.0 3,335.5 22,261.7 10,118.93 *: Data were extracted from Five Year Development Plan (FYDP 2016-21) and sectoral plans (eg. HSSP IV, TASAF) plus additional nutrition sensitive activities identified by NMNAP task team as they were not included in sectoral plans **: Exchange rate 1 USD = 2200 TZS

Investment Plan Distribution of Nutrition Sensitive Interventions per sector

NMNAP Monitoring and Evaluation System 2013/14 2014/15 2015/16 2016/17 2017/18 2018/19 2019/20 2020/21 2021/22 Quarterly Multisectoral Nutrition scorecard BNA BNA BNA BNA BNA BNA BNA BNA JMNR JMNR JMNR JMNR JMNR JMNR JMNR JMNR PER-N PER-N PER-N MTR Progressive scaling - up Nutrition services Children, Adolescents and Adult women and men Children, Adolescents and Adult women and men The integrated CRRAF will be used ass the overall framework to monitor NMNAP, specific monitoring and evaluation milestones will be done through JMNRs, MTR, PER, NNS and of NMNAP evaluation Routine monitoring will be through multi level steering committeesat different levels. Institulization of these committee is therefore crucial step in facilitating routine monitoring TNNS TDHS TNNS TNNS BNA: Bottleneck Analysis JMNR: Joint Multisectoral Nutrition Review PER-N: Public Expenditure Review on Nutrition MTR: Mid-Term Review TNNS: Tanzania National Nutrition Survey TDHS: Tanzania Demographic and Health Survey TDHS Learning: Operational Research and Documentation

Progress of the Implementation of NMNAP (Governance) Endorsement of the NMNAP by HLSCN in October 2016 Signing of the NMNAP document by different key line Ministries; Continued recruitment of nutrition officers by the Government; LGAs in all the Councils of Tanzania used the NMNAP to guide Planning and Budgeting for FY 2017/18 for nutrition specific and nutrition sensitive interventions; Preparation of TOR for different thematic Key Thematic Working Groups, Main Technical Working Group and the HLSCN;

Progress of the Implementation of NMNAP (Nutrition Specific Interventions) (MIYCAN): Half of the regions of Tanzania are currently covered by large scale stunting reduction programme aiming at a coverage of 75% of mothers and caregivers of children under 5; (Micronutrients): Child Health and Nutrition Months (CHNMs) implemented twice yearly providing VASD, MUAC screening and nutrition education; (IMAM): Revision and update of IMAM guidelines (ongoing); (NCDs): Launching of “Afya Yako Mtaji Wako” Campaign for Prevention of Non Communicable Diseases by the Vice President and the Minister for Health;

Progress of the Implementation of NMNAP (Nutrition Sensitive Interventions) Launch of the synergy between large scale nutrition programmes and TASAF III / PSSN to reach the most vulnerable households with nutrition education; Integration of nutrition interventions in the ASDP II; Integration of nutrition in HSSP IV; Integration of nutrition in the FYDP.

Progress of the Implementation of NMNAP Evaluation of the implementation of selected nutrition interventions using Bottleneck Analysis (BNA) for the first semester has been done; Finalisation of indicators for the Multisectoral Nutrition Scorecards. Training of National facilitators and regional capacity building meetings planned in April 2017 to produce the Multi-sectoral Nutrition Scorecard. JMNR approach adapted to the new NMNAP. JMNR currently being conducted for the period July-December 2016;

Challenges and ideas for discussion How to coordinate with sectors to ensure that key interventions are being scaled-up in all regions, or at least in the same regions? How to coordinate with sectors to track progress towards the desired results? How to coordinate with sectors to track spending in nutrition sensitive interventions?

ASANTENI SANA