Sando David, Sachin Shinde, Moshi Grace, Sando Mary-Mwanyika, Yussuf Mashavu, Mwakitalima Anyitike, Fawzi Wafaie
Managament and Development for Health (MDH), Dar es Salaam, Tanzania.
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.
Matern Child Nutr. 2025 Jul;21 Suppl 1:e13544. doi: 10.1111/mcn.13544. Epub 2024 Aug 2.
School health and nutrition programmes are effective strategies to address the health problems among school-going children and adolescents. We examined the policy environments, successes and bottlenecks associated with school health and nutrition programmes in Tanzania. We used the 'policy triangle framework' to examine 22 national and regional school health and nutrition policies and programmes in Tanzania. We also interviewed 16 key informants to gain further insights into school health and nutrition programmes. Several school health and nutrition policies in Tanzania outline the basic elements of school-based health and nutrition services. Yet, these documents neither recognise vulnerable groups, recommend age-appropriate strategies to address children's and adolescents' varied and transient needs, nor provide a framework for implementing and tracking recommended activities. In these documents, underweight and infectious diseases, including human immunodeficiency virus/acquired immunodeficiency syndrome, are frequently identified as major concerns of young people, with little or no consideration of social determinants. Diverse strategies including school feeding, water and sanitation services, health and nutrition education and promotion of healthy behaviours are identified. In doing so, these documents adequately define the roles and responsibilities of all government actors, but young people and their guardians are not actively engaged in design and implementation. Additionally, there are several challenges to implementing these policies including budgetary constraints, limited resources, a lack of inter-sectoral coordination and insufficient capacity within targeted schools. To improve the health and nutritional status of school-going children and adolescents in Tanzania, adequate budgets, strengthened coordination and implementation efforts, the development of school-based stakeholders' capacity, as well as the involvement of all other stakeholders, including adolescents, are imperative.
学校健康与营养计划是解决在校儿童和青少年健康问题的有效策略。我们研究了坦桑尼亚与学校健康和营养计划相关的政策环境、成功经验和瓶颈。我们使用“政策三角框架”来研究坦桑尼亚的22项国家和地区学校健康与营养政策及计划。我们还采访了16名关键信息提供者，以进一步深入了解学校健康与营养计划。坦桑尼亚的几项学校健康与营养政策概述了校内健康与营养服务的基本要素。然而，这些文件既未承认弱势群体，也未推荐适合不同年龄段的策略来满足儿童和青少年多样且多变的需求，也未提供实施和跟踪推荐活动的框架。在这些文件中，体重不足和包括人类免疫缺陷病毒/获得性免疫缺陷综合征在内的传染病经常被确定为年轻人的主要担忧，而很少或根本没有考虑社会决定因素。确定了包括学校供餐、水和卫生服务、健康与营养教育以及促进健康行为在内的多种策略。在这样做的过程中，这些文件充分界定了所有政府行为体的角色和责任，但年轻人及其监护人并未积极参与设计和实施。此外，实施这些政策存在若干挑战，包括预算限制、资源有限、缺乏部门间协调以及目标学校内部能力不足。为改善坦桑尼亚在校儿童和青少年的健康与营养状况，必须有充足的预算、加强协调和实施力度、培养校内利益攸关方的能力，以及让包括青少年在内的所有其他利益攸关方参与进来。
