ATONU BASELINE SURVEY REPORT TANZANIA ANH – Kathmandu 10th July 2017

Introduction Agricultural investment in sub-Saharan Africa has increased but have continued to focus on increasing food availability than promoting consumption and improving nutrition status Prevalence of malnutrition still high stunting rates above 40% and 33% of childhood deaths linked to under-nutrition Barriers to good nutrition: Lack of knowledge about food Insufficient harvesting, Poor storage Inaccessibility to markets, Inadequate empowerment of women on decision making

Introduction….. ATONU uses behavior change communication (BCC) to integrate the following in a livestock project: Promote consumption of chicken products (meat and eggs); Use of safe water, Promote good sanitation, and hygiene (WASH) practices Build capacity of households on budgeting to improve nutrition; Empower women in decision-making Home gardening to produce diverse vegetables to improve dietary diversity and quality.

Aim and objectives of baseline study Aim: To generate baseline data for monitoring progress and assess effectiveness of Nutrition Sensitive-Interventions being implemented in selected ATONU/ACGG villages to improve among other things dietary diversity Objectives: Assess nutritional knowledge among women from the study areas Identify factors influencing nutrition knowledge Assess current dietary practices and nutritional status of infants and young children aged below 5 years and women of child-bearing age Examine knowledge, attitude and decision-making practices around budgeting and expenditure as influenced by gender norms and beliefs

Approach and Methodology STUDY AREAS: Selected three out of five agro- ecological zones: Eastern Ecological Zone: Morogoro, (Mvomero and Kilombero) Central Ecological Zone: Singida (Iramba and Manyoni) & Dodoma (Bahi and Chamwino) Southern Highlands Ecological Zone: Mbeya (Ileje and Mbeya Rural) and Njombe (Wanging’ombe and Njombe Rural)

Cluster Randomized Design ACGG ONLY ACGG + 3 ATONU NSIs CONTROL 20 VILLAGES @ 2 VILLAGES/DISTRICT 20 VILLAGES @ 2 VILLAGES/DISTRICT 20 VILLAGES @ 2 VILLAGES /DISTRICT 600 HOUSEHOLDS 600 HOUSEHOLDS 600 HOUSEHOLDS 6

Determination of Sample size   n= Number of individuals and (1.63 and 1.61) are the variations of individual food diversity scores in the treatment and control group, respectively. and (1.96 and 0.842) are the z values at 5% and 80% (level of significance and the power of the test, respectively) is the detectable difference 2.99 and 2.56

Determination of cluster size K= is the number of clusters = is the inter cluster correlation coefficient (ICC) equal to 0.1 m = is the average cluster size (number of households in a village) which is 40 villages and K was 28

ACGG + ATONU Interventions Sample Description Agro- ecological Zone Region District ACGG ACGG + ATONU Interventions Control Total Villages HH Central 2 4 8 240 24 720 Southern Highlands Eastern 1 120 12 360 5 10 20 600 60 1800

Household Selection Criteria A. ACCG/ATONU cluster Participating in the ACGG program Have at least one woman of reproductive age (18- 49 years at enrolment) Provide informed consent B. Control cluster In addition to criteria ii and iii in A, a household should have produced chickens for at least two years and currently keeping not more than 50 chickens; have interest to expand production in the future

Data Collection Sampling of Villages Sampling of households ACGG villages as selected by ACGG project Control villages were also selected by the ACGG project from a list of potential villages for ACGG but could not be selected for the intervention Sampling of households Each ACGG village has 40 participating households ATONU sampled – 30 households per village based on our calculation Selection of 30 households was based on random numbers allocated to each household using Emergency Nutrition Assessment (ENA) software

Data Collection - Field work A structured questionnaire was administered at the household through face to face interviews with an adult woman responsible for food preparation and/or spouse where applicable Anthropometric measurements were carried out at a central agreed location

Data analysis A total of 1762 households were reached (98%) Data analysis was done on 1762 households Statistical Product and Service Solutions (SPSS) software version 18

RESULTS Household assets and income Housing and energy sources Crop, vegetable and fruit production Food availability, and accessibility Livestock production Food security Vegetable processing Household demographic characteristics Knowledge and practices on nutrition Maternal and child feeding knowledge Food consumption and utilization Water, sanitation and hygiene Gender and women empowerment Nutritional status

Characteristics of Respondents Education attainment - all Education attainment by treatment areas

KNOWLEDGE AND PRACTICE ON NUTRITION

Knowledge on Functions of Foods 98.6% 1.4% Do not know Know 97.6% 2.4% Do not know Know 43% 57% Do not know Know Sugar Oil Cereals

Know Know Know 26% 38% Meat Fruits Vegetables 74% 62% 50% Do not know

Knowledge on nutrition Causes of malnutrition

Type of messages on diets for women & Children

Food consumption and utilisation

Household Dietary Diversity

Food groups at different HDDS levels HDDS = 4 to 5 HDDS = 6 to 8 HDDS ≥ 8 Cereal Legumes Vegetables Oil and fats   Sugar and honey Roots & tubers Milk and milk product Fish Meat and meat product Fruits Eggs Spices and condiments

Water, sanitation and hygiene practices

Water Treatment & Associated Reasons

Hygiene practices

Household decision making

Mechanism of decision making

Decisions on food and income expenditure

Food Purchase Participation of women in decision making on what foods to purchase

Nutritional Status

Nutritional status of children below five years

Nutritional status of children below five years…

Nutrition Status of Children 6-10 Years

Nutrition Status of Children 6-10 Years…

Nutritional Status of Adults

Conclusion Low dietary diversity Limited knowledge on functions of food in the body and preparation Limited knowledge on nutrition/malnutrition causes and ways to reduce malnutrition Nutritional status of children below five years of age is sub-optimal. Prevalence of stunting is high and in some areas exceeding regional and national averages. Prevalence of wasting in some areas is unacceptably high (>5%) Nutritional status of children (6-19 years) is also suboptimal The nutritional status of adults, both males and females, has shown significant shift from a tendency for underweight to that of overweight and obesity

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