Planning and Budgeting for Nutrition Programs in Tanzania: Lessons Learned From the National Vitamin A Supplementation Program

Background Micronutrient deficiency in Tanzania is a significant public health problem, with vitamin A deficiency (VAD) affecting ۳۴% of children aged ۶ to ۵۹ months. Since ۲۰۰۷, development partners have worked closely to advocate for the inclusion of twice-yearly vitamin A supplementation and deworming (VASD) activities with budgets at the subnational level, where funding and implementation occur. As part of the advocacy work, a VASD planning and budgeting tool (PBT) was developed and is used by district officials to justify allocation of funds. Helen Keller International (HKI) and the Tanzania Food and Nutrition Centre (TFNC) conduct reviews of VASD funds and health budgets annually in all districts to monitor the impact of advocacy efforts. This paper presents the findings of the fiscal year (FY) ۲۰۱۰ district budget annual review. The review was intended to answer the following questions regarding district-level funding: (۱) how many funds were allocated to nutrition-specific activities in FY ۲۰۱۰? (۲) how many funds were allocated specifically to twice-yearly VASD activities in FY ۲۰۱۰? and (۳) how have VASD funding allocations changed over time?   Methods Budgets from all ۱۳۳ districts in Tanzania were accessed, reviewed and documented to identify line item funds allocated for VASD and other nutrition activities in FY ۲۰۱۰. Retrospective data from prior annual reviews for VASD were used to track trends in funding. The data were collected using specific data forms and then transcribed into an excel spreadsheet for analysis.   Results The total funds allocated in Tanzania’s districts in FY ۲۰۱۰ amounted to US۱.۴ million of which ۹۲% were for VASD. Allocations for VASD increased from US۰.۳۸۷ million to US۱.۳ million between FY ۲۰۰۵ and FY ۲۰۱۰. Twelve different nutrition activities were identified in budgets across the ۱۳۳ districts. Despite the increased trend, the percentage of districts allocating sufficient funds to implement VAS (as defined by cost per child) was just ۲۱%.   Discussion District-driven VAS funding in Tanzania continues to be allocated by districts consistently, although adequacy of funding is a concern. However, regular administrative data point to fairly high and consistent coverage rates for VAS across the country (over ۸۰% over the last ۱۰ years). Although this analysis may have omitted some nutrition-specific funding not identified in district budget data, it represents a reliable reflection of the nutrition funding landscape in FY ۲۰۱۰. For this year, total district nutrition allocations add up to only ۲% of the amount needed to implement nutrition services at scale according to Tanzania’s National Nutrition Strategy Implementation Plan.   Conclusion VASD advocacy and planning support at the district level has succeeded in ensuring district allocations for the program. To promote sustainable implementation of other nutrition interventions in Tanzania, more funds must be allocated and guidance must be accompanied by tools that enable planning and budgeting at the district level.

کلیدواژه ها:

Budget ، Planning ، Nutrition ، Tanzania ، Vitamin A Supplementation and Deworming (VASD)