Anemia is a global health problem affecting most developing countries. We examined the prevalence of anemia and its predictors among children under 5 years of age in Arusha District, Tanzania. Random sampling technique was used to identify 436 children aged 6–59 months. Anemia status was assessed by measuring hemoglobin concentration from blood sample obtained from a finger prick and HemoCue® Hb 201+ photometer. Demographic information and dietary intake data were collected using a standardized questionnaire. Anemia cut-off points were defined according to World Health Organization standards for children aged 6–59 months. Logistic regression using backward procedure was used to estimate odds ratios (ORs) at 95% confidence intervals (CIs). Prevalence rate of anemia among under-fives was found to be 84.6% (n=369). Multivariable logistic regression identified the following predictors of anemia; low birth weight (adjusted OR (AOR): 2.1, 95% CI: 1.1–3.8), not consuming meat (AOR: 6.4, 95% CI: 3.2–12.9), not consuming vegetables (AOR: 2.1, 95% CI: 1.1–4.1), drinking milk (AOR: 2.5, 95% CI: 1.1–5.2), and drinking tea (AOR: 4.5, 95% CI: 1.5–13.7). It was concluded that low birth weight and dietary factors (ie, low or nonconsumption of iron-rich foods like meat, vegetables, and fruits) were predictors of anemia among under-five children living in this rural setting. Community education on exclusive breastfeeding and introduction of complementary foods should be improved. Mothers and caretakers should be educated about nutrition, in general, as well as potential use of micronutrient powder to improve the nutritional quality of complementary foods.

Childhood undernutrition is a global health challenge impacting child growth and survival rates. This deficit in nutritional status contributes to the increasing chronic disease prevalence and economic burden in individuals and throughout developing contexts. A community‐based cross‐sectional study was conducted in Arusha District of Tanzania to determine the prevalence and predictors of undernutrition in 436 children. A structured questionnaire was used to collect data on demographic and socio‐economic factors as well as feeding practices and prevalence of preventable childhood diseases. Anthropometric data were collected through the measurement of length/height and weight of all children. The prevalence of undernutrition was estimated based on Z‐scores indices below −2SD of the reference population for weight for age (underweight), height for age (stunting), and weight for height (wasting). Fifty percent, 28%, and 16.5% of the children were stunted, underweight, and wasted, respectively. The age above 2 years and being a male were associated with stunting. The age above 2 years, nonexclusive breastfeeding children, and living at Seliani and Oturumeti were associated with being underweight. Similarly, morbidity, none exclusively breastfed children, living at Oturumeti, and being born to a mother 35 years and above were associated with wasting. In this study, we found the prevalence of child undernutrition in Arusha District is high in comparison with national and regional trends and appears to be associated with being a male. It is recommended that nutritionists and health planners should focus on these key predictors when planning nutrition interventions to address the problem of undernutrition among underfive children in Arusha District.

Malnutrition among children of school-going age is a challenge of serious concern in developing countries especially Sub-Saharan Africa. Many programs focus on mothers and under-5-year-old children, leaving the school going age unattended. It has been shown that school meals can reduce school absenteeism, improve concentration in class and reduce early dropouts. In Tanzania, successful home-grown school feeding programs are localized in few areas but have not been scaled-out. The objective of this study was to analyze the policy and organizational environment which enables or promotes home-grown school feeding approaches. The study consisted of a systematic review, key informant interviews and focus group discussions in Arumeru and Babati Districts, Tanzania. In total, 21 key informant interviews with 27 participants and 27 focus group discussions with 217 participants were conducted. The results show that Tanzania lacks a clear policy on school feeding; there are no guidelines for school meal quality, participation in school feeding programs is not mandatory, leading to many students being left out and going hungry. Students in private schools tend to be better off than those in public schools in terms of provision and quality of school meals. We recommend that policies and practices are developed based on positive experiences of home-grown school feeding programs implemented in Tanzania by the World Food Programme and Project Concern International and emphasize that these policies need to be developed in a multi-sectoral manner. A conceptual framework for improving home-grown school feeding in public schools in Tanzania highlights four critical components: leadership and public awareness; operational modalities; contributions from parents; and meal diversity and nutrition. The home-grown school feeding model provides mechanisms to improve diversity of meals and their nutritional value, increase participation of communities and inclusion of students. Parents will still be responsible for the largest part of food supplies, but the model also requires participation of multiple stakeholders, and provision of natural resources such as land and water by the local government for production of nutritious food for young students. Minimum levels of social protection are recommended to ensure that no student is denied school meals.

In Tanzania’s Arusha District, anaemia is a significant public health problem. Recently, home fortification with multiple micronutrient powder was recommended, and daily use of one sachet has shown to be effective. However, it is a challenge for deprived families with low income to afford the daily sachet. The aim of this study was to compare the efficacy of different administration frequencies of micronutrient powder in reducing anaemia in children aged 6–59 months. This research used a community-based, randomized longitudinal trial design with the intent to treat anaemia. Children aged 6 to 59 months (n=369) were randomly assigned to one of four intervention groups which received, on a weekly basis, either five sachets (n=60), three sachets (n=80), two sachets (n=105), or one sachet (n=124) for six months; 310 children completed the study. Using the HemoCue technique, a finger-prick blood was taken at baseline, middle, and end points of the intervention to determine haemoglobin levels. The effect of treatment on haemoglobin was assessed with analysis of covariates with Bonferroni post hoc to test group difference (p>0.05) from each other. At the end, haemoglobin levels were significantly higher in participants who received three or five sachets of micronutrient powder per week compared to those who received one or two micronutrient powder sachets per week (p<0.05). The prevalence of illnesses was reduced from 65% to 30.5% in all groups. This finding indicates that economically challenged families may opt for three times per week sachet administration rather than a more costly daily administration. This trial is registered with PACTR201607001693286.