United Republic of Tanzania
Tanzania is coastal country of Eastern Africa endowed with important land and water resources that has a high agricultural potential. Agriculture is a key sector of Tanzania’s economy, as it accounts for 45% of GDP and is the source of livelihood for more than three-quarters of the population. The majority of the population is still rural although urbanization increased in the last three decades to reach 38%. Currently the rate of urbanization is slowing down. The population is very young, as 43% of Tanzanians are below 15 years of age. Life expectancy, now 46 years on average, has decreased in the past 20 years, probably due to increasing HIV/AIDS prevalence, which affects around 7% of the adult population.
Although improvement was observed during the last decade, infant and underfive mortality rates remain high. Eighty percent of the population has physical access to health facilities, but user fees and poor quality of services, mainly due to lack of skilled health personnel, reduce the effectiveness of the health system. However, immunization coverage among infants is very high.
Poor sanitation conditions are common both in the rural and urban areas, while access to safe water is a problem mainly for rural inhabitants. In the rural population, poverty is widespread, as approximately 40% of the population are below the basic needs poverty line, while in the urban areas approximately a quarter of the population is poor.
The diet is based on cereals (maize and sorghum), starchy roots (cassava) and pulses (mainly beans). Consumption of micronutrient dense foods such as animal products and fruits and vegetables is low and subsequently micronutrient deficiencies are widespread. At national level, the dietary energy supply does not fulfil average energy requirements of the population. The Dietary diversification index is very low, as starchy foods provide almost three quarters of the total energy supply, despite the wide variety of food produced in the country. Rapid urbanization and lower prices of imported foods have made imports of cereals rise.
Undernutrition is still highly prevalent in Tanzania. More than a third of children underfive years are affected by chronic malnutrition (stunting). In the Southern zone prevalence surpasses 50%. Stunting is due to a combination of factors including maternal malnutrition, inadequate infant feeding practices, low quality of health care and poor hygiene. Breastfeeding is widely practiced but exclusive breastfeeding is not widespread and complementary feeding practices are inadequate.
At the same time, the country is undergoing a nutrition transition due to changes in dietary habits, especially among middle and high income groups living in urban areas who consume energy dense and processed foods. The prevalence of overweight and obesity is noticeable among women (almost one woman out of five).
Thanks to the National Iodine Deficiency Disorder Control Programme launched in 1986, total goitre prevalence has drastically decreased (currently it is 7%). Vitamin A deficiency among children must be assessed as there are no data available currently to document the importance of the deficiency. Supplementation with Vitamin A capsules reaches less than half of preschool children and only 20% of mothers. Anemia is a major public health problem as almost three quarters of preschool children and half of the women are affected. Iron deficiency due to the low level of consumption of foods of animal origin is the main cause, but incidence of malaria and other parasitic diseases are contributing causes. Various national programmes have been implemented in the country to combat malnutrition and micronutrient deficiencies, but more efforts are needed.