Overweight and Obersity

Information sheet 6

N4G COMMITMENT TO CONTROL OVERWEIGHT AND OBESITY AMONG ADULTS

1.0 The magnitude of overweigh and obesity Overweight and obesity constitutes the third major form of malnutrition that currently undermines national nutrition and health status in Tanzania. Combined with undernutrition and micronutrient deficiency, the country currently faces a triple burden of malnutrition, compounding the resultant health and development effects that Government and partners have been grappling with over the years.

The prevalence of overweight and obesity which is related with diet related non-communicable diseases (DRNCDs) has been increasing among children and adults, especially women of reproductive age. Overweight/obesity increased significantly among women of reproductive age in Tanzania from 1990’s to 2015.

Specifically: overweight in under-five children increased from a prevalence of below one percent in the 1990s to about 5 percent in the 2010-2015.

In the 2012 National STEPS survey [15] the prevalence of obesity in men was 2.5 percent while that of women was 15 percent.

The overweight prevalence was 15 percent in men and 37 percent in women, an indication of future higher levels of obesity.

2.0 National trends in Overweight/Obesity in women of reproductive age, Tanzania, 1992-2015

Source: TNNS 2018

3.0 Progress/achievements Over the years, the Government has pursued various policies and interventions to reduce overweight and obesity.

At policy level, efforts include various policy guidelines for the control and prevention of DRNCDs including:

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National Guideline for Prevention and Control of NCDs

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National Diabetic Guidelines

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National Cancer Control Strategy

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National Healthy Eating Style Guideline

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The National Food Based Dietary Guidelines (NFBDG)

Key interventions for improvement of institutional capacity and service delivery include:

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Establishment of a national Non -Communicable Diseases Surveillance Programme in the Ministry of Health to monitor trends in risk factors and support an integrated approach to the reduction of risk factors in the population.

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Strengthening capacity of the health system for the treatment and management of DRNCDs at national, zonal, regional and district level.

These are in addition to a package of interventions implemented under NMNAP I. Despite these efforts, the problem of overweight and obesity continue to raise particularly in adults aged 25-69 years. The prevalence particularly among women increased from 29 percent in 2014 to 32 percent in 2018. Comparatively, the trend of overweight among under-five children declined from 3.5 percent in 2014 to 2.8 percent in 2018.

4.0 Challenges/bottlenecks KEY CHALLENGES INCLUDE: ●

Overweight and obesity and are not adequately prioritized as major nutrition problems in the community and among nutrition stakeholders compared to the focus put on undernutrition.

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Inadequate data on coverage of some preventive interventions including promotion of healthy lifestyles, tobacco and alcohol use, minimum acceptable diet among adults etc.

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Many DRNCDs are due to unhealthy lifestyles which unfortunately many people in the community, at the prime of their productive lives, “like”-too much food rich in fat, sugar, salt, carbohydrates, decrease in physical activity, high alcohol consumption etc.

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The cultural perception that being obese or overweight is “admirable for women” and respectable for men”, and a sign of wealth, health and satisfaction.

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Inadequate integrated multisectoral approaches to address obesity and overweight.

5.0 The way forward The bottom line: prevention of obesity and overweight is the key to reducing the multiple health and socio- economic effects in the population. The NMNAP II has earmarked overweight and obesity a as a priority key result area. Due to the importance of maintain low levels of overweight and obesity: The government of Tanzania in collaboration with stakeholders will strive to maintain prevalence of overweight and obesity below 26% by 2026 by implementing high level impact interventions relating to diets and physical activities in line with NMNAPII. The estimated cost of these interventions is TZS 12.8 billion (USD 5.5 million) and monitoring will be under the NMNAPII laid framework.

NMNAP II INTERVENTIONS INCLUDE AN ARRAY OF KEY PREVENTION MEASURES: ●

Social behaviour change communication on healthy diets and healthy lifestyles to increase nutrition knowledge and skills for reducing the risk of obesity and overweight and associated DRNCDs.

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Enhancing community participation in health and nutrition programmes particularly on prevention of overweight and obesity.

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Strengthening nutrition services in RCHs during pre-natal to post-natal for the purpose of preventing excessive weight gain and improve infant feeding practices.

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Strengthening nutrition interventions at formal workplaces

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Improvement of Pre-School and School feeding environment for healthier food choices and physical activities.

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Promoting production and distribution of healthy foods among food producers and distributors

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Promoting availability of nutrients rich and diversified foods

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Strengthening fiscal policies, regulation of food marketing and labelling for a more enabling food environment that promotes consumption of healthy and safe food

Besides prevention, the increasing prevalence of DRNCDs in the population calls for health system strengthening for management of the DRNCDs down to health facility level. Thus, NMNAP II has outlined several measures including: ●

Development of a guide/SOPs on nutritional management of DRNCDs and chronic diseases at facility level.

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Training to Health Care Workers (HCWs) on nutritional management of NCDs

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Review of IYCF guidelines to include prevention and management of overweight and obesity.

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Training of Trainers on prevention and management of overweight and obesity

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Advocacy to CHMT/RHMT to integrate screening for overweight and obesity into other existing health programs e.g TB, HIV as part of vital assessment in the health facilities.

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Advocacy for inclusion of nutrition commodities into national health insurance schemes.

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These measures are expected to considerably strengthen prevention and nutritional management of diet related non –communicable diseases and chronic diseases at health facilities.

N4G COMMITMENT TO CONTROL OVERWEIGHT AND OBESITY AMONG ADULTS