Dec 2015 – Aug 2019

Tackling stunting & severe wasting together in Tanzania



Tanzania – Africa

To demonstrate that both severe acute malnutrition and stunting can be tackled simultaneously through the health system in Tanzania.

$4,587,950 Grant Value

$784,684 evaluation budget

2.7 million children in Tanzania are stunted and 106,000 suffer from severe acute malnutrition, also known as severe wasting. 

This programme will test the hypothesis that lower costs and better impact can be achieved when you tackle severe acute malnutrition and stunting simultaneously through the health system– something which has not been done before in Tanzania. 

The programme will support community health workers and health facility staff to deliver a targeted bundle of interventions to mothers and children under five to prevent stunting. At the same time it will identify, refer, treat, and follow-up with cases of severe acute malnutrition in the community and in facilities. 

Social and behaviour change communication will be used at the community level to generate demand for services and influence harmful social norms by improving knowledge, attitudes and practice on maternal nutrition, and infant and young child feeding practices.

It is hoped that new evidence generated by the programme will influence the revision of national protocols for the treatment of severe acute malnutrition and countries that have a high double burden of stunting and wasting will also benefit from this experience.

The project aims to:

  • Reduce stunting through delivery of a targeted bundle of proven interventions spanning the 1,000 day period
  • Demonstrate for the first time that both severe acute malnutrition and stunting can be tackled simultaneously through the existing health system
  • Test the hypothesis that lower costs and better impact can be achieved through this integrated approach


Between December 2015 and November 2019, the programme intends to reach up to 784,000 pregnant and lactating women, 577,000 children under two years and 7,600 wasted children under the age of five. 

During the first year (December 2015 - November 2016), the following progress was seen: 

  • Programme offices have been established in the two regions: Ruvuma and Simiyu. Relationships with the local governments have been formalised through MOUs. Programme staff are now in place.
  • Ifakara Health Institute (IHI) completed a baseline survey, which included an assessment of Knowledge Attitude and Practices around infant and young child feeding.  
  • CUAMM completed a 'needs & bottlenecks' assessment in 81 health facilities and 72 villages in the two regions. The assessment identified a number of service delivery challenges which informed the programme design. 
  • Health care and community health workers have been trained on prevention, early detection, referral and follow up of undernourished children. Over 600 master trainers and field supervisors were involved. 
  • Materials for behaviour change communication on infant and young child feeding practices have been adopted from the Tanzania Food and Nutrition Centre (TFNC)
  • Treatment units for rehabilitation of children affected by severe acute malnutrition (SAM) have been established in seven district level health facilities. The units are also equipped with nutrition assessment equipment and therapeutic supplies. 
  • The first 475 children with SAM have received or are undergoing treatment in the established facilities
  • A mapping exercise for complementary programs was completed in the two regions. Based on the results, there is ongoing dialogue to create synergies, complementarity and coordination across programmes
  • An advocacy strategy on prioritisation of nutrition at local government level was agreed. An implementation plan was established. Consequently CUAMM has joined the Partnership for Nutrition in Tanzania (PANITA), a recognised Scaling Up Nutrition (SUN) CSO network with over 300 organisations with vision to advocate for reduction of child undernutrition.