NUDEC Conducted an Evaluation of the In-service Nutrition Training Program (IST) in Tanzania

in collaboration with JIMAT Zimbabwe with financial support from UNICEF

The evaluation found the following:

1. Relevance of IST program
   • The IST program approach was found to be relevant and consistent in addressing various Government policies and strategies such as the National Nutrition Survey (NNS,) National Multisectoral Action Plan for Nutrition (NMNAP) and the Government commitment to the
   • The IST program was relevant to the needs of the Nutrition Officers (NuOs) as was based on the fact that it improved their technical capacities in planning, budgeting, coordination, management, monitoring and evaluation. About 86 percent of NuOs interviewed rated the program approach highly relevant as the course objectives were clear and met their expectations.
2. Efficiency of IST program
   • The program was efficiently implemented in terms of use of human and material resources. The drivers of efficiency included the recruitment of facilitators and trainers through an open and competitive process. Also the knowledge and skills of facilitators, course delivery approaches and availability of important training facilities and adequacy training materials facilitated the implementation of program timely
   • Funds for the program implementation were timely received from UNICEF and used for the IST as planned.
3. Effectiveness of the IST program
   • All IST three program outputs were fully achieved.
   • The training program was designed and training packages developed. These included TNA conducted and training materials were developed. Also training reports from all training zones were made available.
   • All 25 regions of Tanzania mainland and 5 regions in Zanzibar were covered. However, not all NuOs were covered in the training course ( 87 percent of DNuOs and 60 percent of RNuOs in mainland; 80 percent district nutrition focal persons and 100 percent of NuOs at nutrition unit Ministry of Health in Zanzibar were trained).
   • According to regional and district reports availed by UNICEF, it was observed that, planned budget spending for nutrition activities in the districts have increased. For example in 2011/12 the budget expendture was 58 million Tsh while in 20115/16 the budget increased toTsh. 199million.
   • It was observation that the effectiveness of the nutrition capacity building initiatives has been highly recognized by key politicians in the country. This led to a directive given by PO-RALG that, for the 2017/2018 budget each district had to allocate Tsh. 1000 for every under five child.
4. Impact of the IST program
   • The IST improved the capacity of NuOs in four specific dimensions of roles of NuOs in coordination, planning and budgeting, program management and monitoring and evaluation.
   • Coordination: Many of the NuOs reported that their capacity in the coordination role had improved after the IST.One District NuO stated that “Following the IST course, I attained some skills on coordination and was able to coordinate the nutrition Steering Committee meetings and all sectors related to nutrition played their roles as required”. However, some of NuOs reported that insufficient funding for coordination, inadequate support from CMTs and CHMTs, and being subordinate officers under the DMO were among the challenges they faced.
   • Planning and Budgeting: NuOs had the capacities to prepare relevant annual nutrition work plans and obtained funding. However, the improvement in the capacity to plan and budget for nutrition interventions was not attributed to IST program alone. UNICEF supported capacity building initiatives using other sources of funding. The annual Nutrition Bottleneck analysis exercise that was initiated in 2014 also contributed in the improvement of capacity of NuOs in planning and budgeting. However, effective implementation of annual planning and budgeting was hindered by insufficient funds and delayed/ or non disbursement of funds for budgeted nutrition activities.
   • Program Management: NuOs had the capacity to manage nutrition interventions following the IST program. In the absence of a budget line for nutrition it was observed that the NuOs incorporated nutrition activities under the District and Regional Reproductive and Child Health budget line and aligned their supervision visits with R/DRCH . However, inadequate of funds was a major challenge. About 82 percent of NuOs interviewed reported that, financial issues and absence of budget line for nutrition affected their capacities in program management
   • Monitoring and evaluation: Nutrition officers were capable of collecting, analyzing and reporting relevant nutrition data and information at district, regional and national levels. The NuOs rated monitoring and evaluation as high (4) among the 4 key specific dimensions of the work of nutrition officers. The high rating for monitoring is not attributed to the IST program alone but rather to the synergy between IST and other capacity building initiatives by UNICEF that had established methods, procedures and indicators, to monitor and evaluate nutrition program performance
5. Gender
   • Gender perspective did not feature strongly in the IST training program. In module one the trainees discussed only data disaggregation of malnutrition by age, sex and income. The component of gender did not feature in the training curriculum.
6. Sustainability
   • IST program achievement is likely to be sustained to a good level. Factors that might contribute to the sustainability of the achievements of the IST program include:
   • Existence of a training curriculum and related training materials with technical inputs from local and international experts; existence of a pool of potential trainers will provide training to other officers; the NMNAP national multi-sectoral action plan for nutrition will continue to guide plans for nutrition interventions; existence of tools to trainees which can continue to be applied and improved capacity of NuOs.
   • Commitment of the Government of Tanzania to increase budget allocation to nutrition activities.
   • Existence of the Multi-sectoral Nutrition Steering Committees formed at higher level, regional and district levels through advancing the nutrition agenda and guide DNuOs and RNuOs to incorporate nutrition activities into regional / district plans and budgets
   • Willingness of donor community, NGOs and CSOs to continue providing financial and technical assistance.