Introduction

Severe Acute Malnutrition (SAM) is rampant in Tanzania and without proper plans and strategies the problem will continue to hit most Tanzanians. The country has adopted Community Based Nutrition Rehabilitation (CBNR) as a strategy to manage malnourished children at community level. This is an important component of nutrition services delivered by Tanzania Food and Nutrition Centre (TFNC) to the population and is routine service as long as prevalence of severe malnutrition is high.

Prevalence of severe wasting in Tanzania according to 2004/5 is 5 percent which means we need rehabilitate those already malnourished parallel with effort to prevent malnutrition. Tanzania Food and Nutrition Centre played a leading role in this endeavor

since its inception.

Activities Implemented

In the past, facility based facility based nutrition rehabilitation was the approach used. Severely malnourished children were hospitalized with their mothers and rehabilitated there in the health facility. Upon restoration of normal nutrition status the children were allowed to go home. This approach was not sustainable as it was expensive, alien and giving temporary relief. When children were sent back to the real/home environment that precipitated malnutrition, recurring of the same problem often occurs. Therefore that approach was changed to community based approach whereby severely malnourished child is rehabilitated at home in the same environment that precipitated it by addressing not only subject’s critical conditions or complications but also the environment (food and nutrition insecurity, hygiene and diseases).

Once the mother or household is able to manage a malnourished case successfully, then that household is not only able to sustain them but also total prevention of malnutrition for siblings is afforded. Therefore this is a better approach and uses locally available food and other resources at village or household level. TFNC has advocated this since 1994 and several ways have been employed as follows:
 

• Dissemination of guideline on Community Based Nutrition Rehabilitation to all relevant stakeholders including district councils and NGOs.

• Technical expertise services to various programs implementing nutrition rehabilitation.

• Nutrition Education materials production and distribution to stakeholders.

• A five years (2006/07 to 2010/11) Community Based Nutrition Rehabilitation strategic plan has been developed to address weaknesses and give guidance to districts in implementing CBNR activities.

• District level launching of CBNR activities in Mtwara and Lindi in 2005.

Future Plans

• Support districts in launching comprehensive CBNR activities similar to Mtwara initiative.

• Twelve districts namely Kibondo, Kasulu, Nzega, Igunga, Iramba, Singida Rural, Ruangwa, Nachingwea, Liwale, Kilwa and Mtwara rural districts are to be offered technical support to implement CBNR activities. It is expected that later more districts will be included.

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