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

2. 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

3. 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

4. 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.

5. 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.

6. 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.

7. 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 ) 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

8. Investment Plan Distribution of Nutrition Sensitive Interventions per sector

9. 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

10. 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;

11. 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;

12. 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.

13. 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;

14. 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?

15. ASANTENI SANA