Agnes' Story: Leading Nutrition Change in Tanzania's Health System

Associated Press

22-05-2025

Published by Action Against Hunger.
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For over two decades, Agnes Jairo has worked as a nurse at Mgandu Dispensary in rural Tanzania. She trained many of her colleagues when they first arrived at the dispensary as new health workers, and they still admire her expertise. Agnes' passion for nursing was ignited when she observed the care provided by a nurse during a hospital visit with her mother at a young age. She knew then that she wanted to dedicate her life to healing others and improving the wellbeing of her community.
The Nutrition Crisis in Tanzania
Only about 19% of children in Tanzania have the World Health Organization's outlined Minimum Diet Diversity for children ages 6-23 months, which recommends a minimum of five food groups a day to achieve nutritional health. 'The majority of the illnesses we receive here are caused by poor nutrition, especially among children under five years,' Agnes notes. According to Tanzania's 2022 Demographic and Health Survey, 30% of children in Tanzania suffer from stunting, which is when a child has a low height for their age due to having suboptimal nutrition, and 12% are underweight. This is a significant improvement from 2010, when 42% of children were stunted and 15% were underweight, but it still means that thousands of children are being subjected to the long-term, harmful effects of malnutrition like:
A child's nutritional health is closely related to that of its mother's, but women in Tanzania are highly vulnerable to malnutrition themselves. Only 18% of women in rural areas achieve the minimum dietary diversity due to factors such as limited access to resources, poverty, and harmful social norms. This is not just the case in Tanzania; roughly one in four women globally suffer from undernutrition according to the Gender Nutrition Gap Report. Improving women's nutrition is essential for them to thrive and reach their full potential.
When a woman is malnourished, pregnancy can aggravate existing nutritional challenges. Pregnancy increases the demand for critical micronutrients, which can be especially difficult to meet in conditions of food insecurity. UNICEF warns that deficiencies in certain nutrients like zinc, iodine, or calcium while pregnant lead to higher risks of complications such as pre-eclampsia or death during childbirth, and babies have a higher chance of being stillborn, having a low birthweight, or facing a developmental delay. Anemia, for example, is most commonly caused by an iron deficiency and is responsible for about 14.5% of maternal deaths in Tanzania each year. A 2021 study, High Burden of Anemia Among Pregnant Women in Tanzania: a Call to Address Its Determinants, evaluated approximately 23,200 women in Tanzania found that over 57% of pregnant women were afflicted with anemia, putting both mother and baby at risk.
In addition to the nutritional challenges of pregnancy, women are particularly vulnerable to malnutrition for a wide variety of socioeconomic factors. Some of the main contributors to poor nutrition outcomes in Tanzania include discriminatory attitudes of health providers, inadequate crop management, poor agricultural and hygiene practices, and household food insecurity. These realities point to the need for a gender-sensitive transformation of nutrition services in Tanzania—a need that the Gender Equitable Nutrition (GENTU) project is addressing head-on.
GENTU: A Gender-Responsive Approach to Nutrition
In 2023, Action Against Hunger, supported by Global Affairs Canada, launched the Gender Equitable Nutrition (GENTU) project to reduce gender gaps and contribute to gender equality in Tanzania and Uganda, primarily in rural communities. In doing so, the GENTU project is also able to directly address the issue of malnutrition among women and children in Uganda and Tanzania, tackling the two innately intertwined issues simultaneously.
The project began with a needs assessment for Maternal, Infant, Young Child, and Adolescent Nutrition (MIYCAN) in two target districts: Bahi and Itigi. The assessment suggested that an effective strategy to improve and sustain nutrition outcomes for the women, adolescent girls, and children in these districts would be to equip healthcare providers with the knowledge and skills needed to deliver gender-sensitive nutrition services. Thus, Action Against Hunger developed a plan to provide training and support that would transform the way nutritional interventions are approached.
With this project, women become health changemakers in their communities. Health workers are upskilled to provide effective nutritional interventions, and mothers are armed with the education and skills to make dietary decisions for themselves and their children. Set to run for five years, the GENTU project will directly support 214,764 people (58% female), and indirectly support 92,105 people (37% female) in highly at-risk, rural communities, taking a multi-sectoral approach to holistically address malnutrition and its root causes.
Building Capacity Through MIYCAN Training
After years of seeing the harmful effects of malnutrition on the women and children in her community, Agnes was eager to join GENTU's Maternal, Infant, Young Child, and Adolescent Nutrition (MIYCAN) training program. Agnes underwent on-the-job mentorship and training on providing support to women and children dealing with nutritional challenges. She also learned about counseling caregivers of underweight children, pregnant women, and breastfeeding mothers.
The training covered:
'Women and children in rural areas like Mgandu face significant vulnerabilities. Our clinic receives many patients, and we sometimes lack the resources to meet all their needs. These training sessions by GENTU have been invaluable, and I am grateful to be part of them,' said Agnes Jairo. Since completing the GENTU training, Agnes has applied her new skills in day-to-day clinical work. She provides support for pregnant women and mothers of underweight children, advises on breastfeeding practices, and monitors child growth using the knowledge and tools offered in the training. The Mgandu Dispensary where Agnes works provides antenatal services to approximately 1,160 children under five and 120 pregnant women monthly.
Strengthening Systems for Long-Term Sustainability
One of the key goals of the GENTU project is system-wide integration of nutrition services. By embedding training, supervision, and data tracking into existing healthcare systems, the project supports long-term sustainability beyond the life of the program. Health care providers like Agnes can train new health workers with the information and techniques learned in GENTU training, ensuring that best practices ripple across the system and improve nutrition interventions for years to come.
Additionally, the longevity of GENTU's work is preserved through knowledge-sharing within the community. Action Against Hunger holds Community Awareness sessions in which people can learn nutritional information and practices to take home. For example, communities are taught about the importance of diet diversity in combatting malnutrition, so when faced with a decision between buying a larger quantity of one type of food or a smaller quantity of greater variety, they know that a greater variety is typically the better option for nutritional outcomes. Community members can integrate healthy nutritional practices into their homes, lead their own learning sessions, and disseminate information for generations to come.
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Action Against Hunger leads the global movement to end hunger. We innovate solutions, advocate for change, and reach 21 million people every year with proven hunger prevention and treatment programs. As a nonprofit that works across over 55 countries, our 8,900 dedicated staff members partner with communities to address the root causes of hunger, including climate change, conflict, inequity, and emergencies. We strive to create a world free from hunger, for everyone, for good.
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