Why food-rich regions struggle with severe child malnutrition

Findings from the Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2022 reveal serious regional disparities in child nutrition, with stunting remaining a major public health challenge nationwide.

The survey shows that 15 out of 26 regions have stunting levels above 30 percent, described as very high by the World Health Organization (WHO).

The findings show that Iringa has the highest prevalence at 56.9 percent, followed by Njombe at 50.4 percent and Rukwa at 49.8 percent.

Experts say the problem goes beyond food production, noting that poverty, poor maternal nutrition, limited dietary diversity and inadequate health services mean that even in high-producing areas, children do not get enough nutritious food, keeping stunting levels high.

Tanzania Food and Nutrition Centre managing director Germana Leyna told The Citizen that all six food groups are essential for human health.

“Within 24 hours, a person should eat foods from all six groups, fruits, vegetables, grains, proteins, dairy and fats. Are these regions producing all the foods needed to keep children healthy?” she asked.

Dr Leyna added that poverty also contributes to stunting, as parents sometimes sell large quantities of food, leaving too little for family consumption.

She said many women work long hours in income-generating activities, limiting time to care for children.

“We are working with health care providers and other stakeholders to educate communities on household solutions to improve nutrition.”

Iringa Region nutrition officer Anna Nombo said her region is among the worst affected, noting that while staple foods are produced, most families cannot afford protein or vegetables.

“We established a village programme to hold Nutrition Day every three months. This spreads good practices on child care to prevent stunting. All villages have been participating for three years,” she said.

Ms Nombo added that nutrition clubs in schools promote poultry and rabbit farming, hinting that, despite the local milk industry, many families cannot access enough milk.

Mbeya Region nutrition officer Itika Mlagalila said poverty and entrenched habits are key drivers of malnutrition.

She said women’s participation in income-generating activities often keeps them away from home, reducing the time they can devote to caring for their children.

“Doing things out of habit is also a challenge. Many people eat without understanding the health risks for themselves and their families,” Ms Mlagalila said.

She added that Mbeya follows national guidelines to combat malnutrition and has introduced various programmes at school and community levels to raise awareness.

“We hold food and nutrition events four times a year. Health specialists engage with citizens in different areas, educating them on the best ways to fight malnutrition using resources available in their communities.”

Schools are also part of the campaign, she said, specialists visit institutions to train students on malnutrition, who then pass the knowledge to their parents, reminding them what constitutes a healthy meal and how to prepare it.

Ms Mlagalila said fighting poverty requires the participation of all community members.

She said if men took their duties seriously, women would have more time to care for their families and rest, “One hand cannot do it alone.”

The nutrition expert from Njombe added that men’s lack of responsibility in family care, combined with poverty, is a major factor contributing to malnutrition.

“Globally, men are often the breadwinners, but many have become disengaged, leaving women to provide food and care for the household alone,” said the region’s chief on anonymity.

“How can a woman feed the entire family and still ensure children are healthy and educated? While educating communities is important, we must also remind men of their responsibilities,” added the source.

In Singida, the Kiomboi Therapeutic Feeding Unit (TFU) in Iramba district has treated over 400 children with severe acute malnutrition since 2021, combining lifesaving care with family education.

Many children now receive treatment earlier, thanks to community awareness led by Action against Hunger and the TFU.

A lead doctor at the TFU, Dr Salma Mahayu, said the facility provides local families with accessible treatment while teaching them the importance of exclusive breastfeeding and balanced diets.

“We are changing community perceptions and empowering parents to prevent malnutrition before it becomes severe,” she said.

Community engagement has been key, she said, adding that Action against Hunger trained health workers, village leaders and hospital staff to monitor children and provide education. This improved early detection, follow-ups after discharge and spread knowledge beyond the hospital.

Mothers like 28-year-old Kundi Kija from Nkonkilangi village illustrate the impact.

After her one-month-old baby was admitted to the TFU, she learned about exclusive breastfeeding, preparing nutritious foods from local ingredients and maintaining a balanced diet as a breastfeeding mother.

She now plans to share her knowledge with other mothers, creating a ripple effect across the community.

Other regions can learn from Singida by integrating treatment with community education, training local health workers and emphasising practical nutrition advice using locally available foods.

Strengthening therapeutic units, ensuring access to essential nutrition supplies and empowering families can help reduce malnutrition nationwide, replicating the success of Kiomboi TFU.