Zidikheri Mziraya, Gasto Frumence
School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
East Afr Health Res J. 2023;7(2):211-218. doi: 10.24248/eahrj.v7i2.733. Epub 2023 Nov 30.
In recent years, Tanzania has made good progress in addressing the problem of chronic malnutrition in children, but the levels are still unsatisfactory, at almost three in ten of its children are stunted. The government of Tanzania has taken significant measures to establish and strengthen multi-sectoral governance as part of national efforts to reduce the unacceptably high level of malnutrition. However, few studies have qualitatively documented stakeholder's perspectives at sub-national and community level with regards to performance of multi-sectoral governance in improving nutrition status of children in Tanzania.
This study aimed to explore the achievements, facilitating factors and challenges of multi-sectoral governance in improving child nutrition in Buhigwe District Council.
This was cross-sectional study, which employed qualitative method of data collection whereby semi-structured interviews were used to conduct in-depth interviews with members of the multisectoral steering committee for nutrition in Buhigwe Council and parents/caregivers of under-five children.
There is significant improvement in allocating funds for multisectoral governance interventions targeting under five children across sectors, improved inter-sectoral coordination and increased knowledge on feeding practices among parents/caregivers. Strong leadership and political commitment, inter-sectoral linkage and Presence of Non-Governmental Organizations (NGOs) supporting nutrition were identified as factors for improving child nutrition in the context of multisectoral governance. The issue of insufficient funding, inadequate spending of allocated funds, inadequate capacity, lack of cross-sectional financial mechanism and tools to collect nutrition information were raised by stakeholders as factors hindering the implementation of multi-sectoral governance in improving child nutrition.
Smooth implementation of multi-sectoral interventions targeting under-five children requires strong multi-sectoral governance, which is supported by adequate spending of the allocated funds, strong leadership and political commitment, presence of NGOs supporting nutrition and inter-sectoral linkage among line sectors. However, key stakeholders including central and local government authorities should address the challenge of insufficient funds, inadequate capacity, lack of cross-sectoral co-financing mechanism and tools to collect nutrition information, which were reported as barriers to the implementation of multi-sectoral governance in improving child nutrition.
近年来，坦桑尼亚在解决儿童慢性营养不良问题方面取得了良好进展，但其水平仍不尽人意，近十分之三的儿童发育迟缓。坦桑尼亚政府已采取重大措施建立和加强多部门治理，作为国家努力降低高得令人无法接受的营养不良水平的一部分。然而，很少有研究定性记录在国家以下和社区层面利益相关者对坦桑尼亚多部门治理在改善儿童营养状况方面表现的看法。
本研究旨在探讨布希格韦区议会多部门治理在改善儿童营养方面的成就、促进因素和挑战。
这是一项横断面研究，采用定性数据收集方法，通过半结构化访谈对布希格韦议会营养多部门指导委员会成员以及五岁以下儿童的父母/照顾者进行深入访谈。
各部门为针对五岁以下儿童的多部门治理干预措施分配资金方面有显著改善，部门间协调得到加强，父母/照顾者在喂养实践方面的知识有所增加。强有力的领导和政治承诺、部门间联系以及支持营养的非政府组织的存在被确定为在多部门治理背景下改善儿童营养的因素。利益相关者提出资金不足、分配资金支出不足、能力不足、缺乏跨部门财务机制以及收集营养信息的工具等问题，这些都是阻碍多部门治理在改善儿童营养方面实施的因素。
针对五岁以下儿童的多部门干预措施的顺利实施需要强有力的多部门治理，这得到分配资金的充足支出、强有力的领导和政治承诺、支持营养的非政府组织的存在以及各职能部门之间的部门间联系的支持。然而，包括中央和地方政府当局在内的关键利益相关者应应对资金不足、能力不足、缺乏跨部门共同融资机制以及收集营养信息的工具等挑战，这些被报告为多部门治理在改善儿童营养方面实施的障碍。
