4.5 Key strategies
4.5.1 Community-centred multisectoral approach as overarching strategy
82. Acknowledging that nutrition is a crosscutting issue that requires the effective contribution of multiple actors, sectors and administrative levels, the NMNAP is based on a national multisectoral strategic nutrition framework for planning, implementation and coordination. Thus, the overarching strategy for the NMNAP is a community-centred multisectoral nutrition approach that explicitly embraces simultaneous actions for nutrition specific interventions at the level of immediate causes and nutrition sensitive interventions at the levels of underlying and basic causes of malnutrition. A multisectoral nutrition system is composed of multiple sectors (e.g. agriculture, health, WASH (water, sanitation and hygiene), education, social protection, environment); multiple levels (national, regional, Local Government Authorities and importantly the community); and multiple partners (Government, development partners – UN/multi-laterals, bilaterals, NGOs, CSOs, academia and private sector). The multisectoral community-centred strategy is based on the overwhelming scientific evidence that achieving high coverage of the evidence-based high impact nutrition interventions (Lancet Nutrition Series 2008 and 2013) requires multisectoral harmonization and collaboration with key nutrition stakeholders.
4.5.2 Supportive cross-cutting strategies
83. The overarching multisectoral approach is complemented by several supportive strategies which are relevant and applicable to each of the seven key result areas. These include: -
1) Social and Behaviour Change Communication (SBCC) for nutrition through interpersonal communication and mass media to promote adoption of appropriated behaviours and practices and commitment to achieving common results for everyone and everywhere in the country for improved nutrition. The NMNAP will use the SBCC Strategy for 2013-2018.
2) Advocacy and Social mobilization to sustain political will and Government commitment for nutrition and to mobilise adequate resources for nutrition. Social mobilisation activities are important to create awareness of the problems of malnutrition among decision makers and community members to improve nutrition. For example, a 2013 landscape analysis by TFNC found that policy makers and communities do not perceive stunting and micronutrient deficiencies as problems to be addressed. Since many of the actions in advocacy and social mobilization require behavioural, attitude and practice changes by policy makers and communities for overall societal change all types of media need to be involved. Social mobilization will also increase the participation of communities in the implementation of the NMNAP. Since the key actors for improved nutrition are households and communities ensuring their active participation of communities is a critical success factor for the NMNAP.
3) Community-Centred Capacity Development (CCCD): The development of human, institutional and organizational capacity is critical in the implementation of the NMNAP especially at the community level. Community participation in doing their own triple A processes of assessment, analysis and action can be greatly enhanced by developing the capacity of the community and that of community-based organisations to support social accountability mechanisms (see section 6.1 for definition of social accountability). Recognizing that communities constitute the greater whole of society and that they exist in relationship with society as a whole, development of capacity of communities should go hand in hand with developing capacity at the higher levels – council, district, region, national.
4) Developing functional human resource capacity: Although human resource technical capacity in nutrition is fairly adequate, functional capacity in communication skills, coordination and strategic leadership and management requires further development. System-wide development of nutrition relevant institutions, especially for TFNC as the institutional leader in the implementation of this NMNAP will be given priority. Institutionalization of the nutrition steering committees at all levels and developing their functional capacity will be further explored.
5) Aligning all stakeholders with the NMNAP through Community-Public-Private Partnerships (C-PPP) using the “three ONES principle” of ONE plan, ONE coordinating mechanism and ONE monitoring and evaluation framework, so that every stakeholder come together to tackle malnutrition and build an enabling environment for improved nutrition with equity. Capacities will be developed to conduct and manage C-PPPs as part of a collaborative leadership strategy. Forming strategic partnerships at all levels of the nutrition system will enhance coordination and accountability. Strategic collaboration, including the engagement of the private sector through implementation of appropriate principles of social and corporate responsibility, is likely to result in cost-efficiency and effectiveness and promote ownership and sustainability.
6) Delivery of quality and timely nutrition services: This NMNAP will promote the delivery of nutrition and nutrition-relevant services that are timely and of high quality. Tools will be put in place to assess the effective implementation and delivery of services, and where bottlenecks are identified, remedial and corrective measures will be adopted including legal enforcement as appropriate.
7) Mainstream equality in all the seven Key Result Areas of the NMNAP without discrimination, focusing on women, children and adolescent girls. Although generally Tanzania has made good progress in empowering women, traditional patriarchal practices remain, that favour men, including in nutrition relevant practices, and are often reflected in both formal and informal systems and institutions especially in the rural areas.
8) A resource mobilization strategy will be developed to advocate for resource allocation to the NMNAP by both Government and partners.
9) Tracking progress and operational research and development will be promoted to ensure key lessons and insights gained from the implementation of the NMNAP are learnt and used in adjusting and improving the proposed interventions at regular intervals and linking research with programmes and training. Research will also provide quality assurance, robust data on program performance and support learning. Linking research to the programmes and to training will assure evidence-based sharing of experience and intergenerational transfer of knowledge. Efforts will be made to link the implementation of the NMNAP with nutrition-relevant centres of excellence both nationally and internationally.
10) Overall planning and coordination is a key strategy to align implementation of the NMNAP to achieve far greater results than what single sectors could achieve alone.