Tanzania SBCC Landscape Analysis 2012

SBCC Landscape Analysis

Tanzania’s readiness to accelerate
the implementation of the National
Nutrition Strategy using Communication
for Social and Behavior Change (SBCC)
2012

Contents
1. Landscape Objectives
2. Salient Background
– NNS
– TFNC/WHO Landscape Analysis
3. SBCC Landscape Assessment Process
4. Assessment Findings
– Communication Climate
– Nutrition Communication Materials
– Institutional SBCC Capacity
5. Conclusions: SBCC “Readiness”
6. Recommendations
2

Contents
– NNS
6. Recommendations
3

1. Assess:
– Current status of Tanzania’s communication capacity
and efforts to address social and behavioral barriers
to improve the nutrition status
– The potential to meet the goals of the NNS for
advocacy and communication given present status,
including untapped opportunities
– National capacity to develop, lead and implement a
robust SBCC Nutrition program
2. Make recommendations for the development
of a National SBCC Nutrition Strategy

4

Contents
– NNS
6. Recommendations
5

The National Nutrition picture:
• Stunting rates indicative of chronic under-nutrition
are high (42% of <5 years) and stagnant
• Stunting rates are not always aligned with food
insecurity:
– high maize and rice producing areas also have
high stunting rates
• Anemia rates are 53% for pregnant women and
40% for women of reproductive age: indicative of
supply and adherence problems:
• Optimal nutrition practices not followed:
– E.g.: no more than 30% of children in any age
group are receiving minimal acceptable diets
– E.g. only 4% of pregnant women take 90+ days
of IFA
6

The National Nutrition Strategy
NNS Priority Areas
1. Infant and young child feeding
2. Vitamin and mineral deficiencies
3. Maternal and child malnutrition
4. Nutrition and HIV and AIDS
5. Children, women and households in
difficult circumstances
6. Diet-related non-communicable diseases.
7. Household food security
8. Nutrition surveillance, surveys and
information management
7

NNS Strategies
1. Accessing quality nutrition services
2. Advocacy and behaviour change communication
3. Legislation for a supportive environment
4. Mainstreaming nutrition into national and sectoral
policies, plans and programs
5. Institutional and technical capacity for nutrition
6. Resource Allocation
7. Research, monitoring and evaluation
8. Coordination and partnerships
8


Other NNS sub-strategies include important actions for
SBCC:
• Develop and implement a social marketing program
for nutritious and fortified foods.
• Nutrition incorporated into primary and secondary
curricula.
• Develop multi-level nutrition advocacy strategy.
• National Food and Nutrition Policy.
• Staffing and training with appropriate job aids.

9

Guidance on SBCC
• Focus on action: “Enhance behaviours, customs and traditions of men, women,
caregivers, family and community members, and those who influence them-
which impacts positively on nutrition.”

• Cover the full range of nutrition issues, including:
– Breastfeeding and complementary feeding
– Dietary diversity
– Hygiene and sanitation
– Home care of illnesses, and utilization of health services

• Ensure that programmes and projects use consistent community messages, tools
and materials

• Insert nutrition behaviour change counseling and support into all points of
contacts between women, caregivers and service providers

10

Guidance on SBCC cont’d:
• Be guided by a BCC strategy, which is informed by formative research that
establishes the key behaviour issues and the barriers to and facilitators of
interventions to prevent malnutrition.

• Focus not only on the primary target groups, such as women, but also on those
who influence the primary target groups at all levels, including family
members, employers and health service providers.

• Utilize a broad range of channels, including individual and group counseling,
informal gatherings at community level, formal sessions through health
services, school curricula and mass media.

• As individual and group counseling is one of the most effective channels,
enhance the capacity of health service providers to counsel women, caregivers
and family members on the changes in behaviour needed to prevent
malnutrition.
11

NNS Strategy 2.1: Behaviour change communication
STRATEGIC OBJECTIVE EXPECTED RESULT INDICATORS MEANS OF
VERIFICATION

SO 2.1: Enhance the Women, caregivers, Proportion of Survey
nutrition behaviours family and community caregivers who
of women, caregivers, members practice practice minimum
family and community behaviours that support set of key
members, and those improved nutrition behaviours for
who influence them nutrition

12

NNS Strategy 5.2: Technical capacity for nutrition
STRATEGIC EXPECTED RESULT INDICATORS
OBJECTIVE
SO 5.2: Improve the Pre-service curricula and training Proportion of training
knowledge and materials for service providers includes institutions using up-to-date
skills of professional appropriate content on nutrition. curricula.
and community- In-service training materials, guidelines, Proportion of service providers
based workers at all protocols and job aids are available that have relevant job aids
levels to give
adequate support in Pool of trainers in nutrition for training of Pool of trainers available for
nutrition. service providers is developed. training of service providers
and community-based workers
in nutrition.
Follow-up and supportive supervision of Proportion of service providers
service providers and community-based and community-based workers
workers is improved to sustain their who receive at one least
knowledge and skills. supportive supervision contact
following training.
13

TFNC/WHO Landscape Analysis
Findings relevant to the task of SBCC:
• Commitment to accelerate action
– Problem of stunting and micronutrient deficiency not well recognized
or understood (lack of recognition that all children have potential to
grow adequately)
– Nutrition problem seen as one of food availability; not of caring
practices or insufficient services
– “Nutrition is nobody’s responsibility”
– Policy link not made between nutrition and needs of vulnerable groups
– Funding not meeting program needs
– Programs/action not reaching areas of most nutritional need—scale-up
is critical

TFNC/WHO Landscape Analysis
Findings relevant to the task of SBCC:
• Capacity to accelerate action
– Human resources: nutritionists and nutrition focal people in ministries
and districts available for scale-up

– Training inadequate: standards, harmonization, scale-up and post-
training follow-up lacking

– Although HWs report implementing more basic preventive nutrition
measures than treatment, their knowledge is higher on treatment /
HIVHWs lack confidence and skills to counsel caregivers appropriately

– Overall lack of capacity and programming for reaching the community
level

Therefore…
1. Recognition that poor nutrition situation is not a supply or
health services problem only; changed attitudes, practices and
social norms are critical to good nutrition outcomes.

2. NNS provides general guidance for SBCC Nutrition.

16

Therefore…
3. All assessments combined show a need for a robust SBC
Communication program that:

– builds multi-sectoral commitment
– mobilizes and strengthens the capacity of agencies & personnel at all
levels in SBCC
– blends the power of mass media, traditional media and Tanzanian oral
tradition to scale-up pro-nutrition opinions, positive role models, and
actions
– harmonizes the focus on a core set of behaviors and “tipping points”
for positive social change

17

Contents
– NNS
6. Recommendations
18

1. Review of SBCC literature, materials, program evaluations,
lessons learned and best practices from other health sector
areas in Tanzania and globally
2. Review of available nutrition education/IEC/BCC materials in
MBNP regions and among stakeholder organizations at
national level
3. Inventory of cultural resources in MBNP regions
4. Review of evidence base, efficiencies and potential for new
technologies to support behavior change communication to
expand reach and scale

19

(continued)

5. Rapid assessment of social change climate based on 10
“tipping points1” or indicators of social change, included:
• SBCC/Nutrition institutional capacity assessments of TFNC and
COUNSENUTH
• Review of TFNC/WHO Nutrition Landscape Analysis findings
• Interviews with key informants at different levels, across
multiple sectors and from government and NGO sectors
• Participant-observation during work sessions and meetings with
nutrition stakeholders and stakeholders in other health sector
areas (RH/FP, malaria, HIV/AIDS)
1The “10 Tipping Points for Pro-Nutrition Social Change Framework” (Clemmons, L; MBNP 2012) is adapted from theories and ideas originating in
The Tipping Point: How Little Things Can Make a Big Difference by Malcolm Gladwell, 2000; and from Women's Funding Networks' Making the
Case™ Framework for 5 Indicators for Social Change.

20

Contents
– NNS
6. Recommendations
21

Assessment findings are presented in three parts:

Nutrition
Communication Institutional SBCC
communication
climate capacity
materials

22

Nutrition
communication
climate capacity
materials

History of Nutrition Communication
• Tanzania has a rich history of nutrition education -
Fugelsang, etc.
• Integrated programming – 70’s & 80’s recognized as a
productive time for community nutrition, although
nutrition education not emphasis
• Over past 2 decades, nutrition education/BCC
languished, efforts were directed to more one-off/single
topics:
– HIV and nutrition
– Breastfeeding
• Improvement in nutrition-related practices is recognized
as a stubborn problem
23

TFNC: Funds for nutrition 2010 SUN
Established in programming decrease movement;
1974 and leads as Family Planning, RH Renewed
state of the art and HIV/AIDS programs donor interest
in Nutrition IEC receive bulk of donor and funding
Transitions in Communication funds for nutrition
State-of-the Art in Tanzania

Nutrition
HIV/AIDS,
RH/FP,
Malaria

24

Nutrition
communication
climate capacity
materials

Mass media
• Radio: pervasive; long-running soap operas for
HIV/AIDS and FP, nutrition programs; programs for
farmers
• Television: TV spots for Safe Motherhood as part
of the Wazazi Nipendeni Campaign, TV drama
serial for FP
• Film and video: booming informal sector industry
(“Swahiliwood”)
– ~10 films made in Dar every week
– Over 10,000 video bandas (informal video halls)
country-wide in Tanzania; video bandas average 62
customers a day- usually young people and men
– Informal sector now producing enter-educate films
for malaria
25

Nutrition
communication
climate capacity
materials

Telecoms/Cell phones
• m-Banking, m-PESA money transfer, purchases,
iPhones to watch TV, films, access Internet
• Successful SBCC initiatives with new technologies:
• MOHSW Tanzania m-Health Partnership and
Wazazi Nipendeni National SM Campaign
• Radio linked with SMS and IVR (Farm Radio
programs)

Private sector
• Rapid expansion of creative agencies, advertising
and marketing firms
• Growth of Corporate Social Responsibility

26

Nutrition
communication
climate capacity
materials

Other health sectors, primarily
RH/FP, HIV/AIDS and malaria:
• Have materials and strategies designed
for men
• Promote couple communication and
positive gender norms
• Use wide variety of media and
materials; experiment with new
technologies
• Include advocacy awareness-raising
materials for Tanzanian opinion
leaders, including religious leaders

27

Nutrition
communication
climate capacity
materials

Inventory of Cultural Resources for
Communication:
• Religious gatherings, elders’ and their groups, and
traditional birth attendants
• Other venues:
– girls’ initiation ceremonies (unyago)
– harvest celebrations
– celebration @ 40 days after birth (arobaini)
– men’s gatherings, such as fishermen (magenge ya
wavuvi), sporting events, pubs, coffee and tea
houses, bao and draft games
– circumcision rites
– women’s gatherings: hair plaiting, ufinyanzi /
ceramics, kitchen parties
28

Nutrition
communication
climate capacity
materials

Inventory of Cultural Resources for Communication:
• Other media or symbols:
– traditional songs and poems
– drums, music, dance (ngomas and ngonjera)
– traditional clothing (mgolole, khanga)
– gourd (vibuyu)
– mats and wooden cook spoons
– beads
– writing on house walls
– caps (balaghashia)
– khangas

29

Therefore, given the current communication
climate…
• TZ’s communication climate rich with lessons and best practices
in behavior change communications, including the use of new
communication strategies and technologies to rapidly expand
reach and impact
• Abundant cultural communication resources for nutrition,
including Tanzanian society’s strong oral tradition
• The time to recapture Tanzania’s former leadership in the state-
of-the-art nutrition communication is NOW:
– Time for a more robust, holistic, and dynamic approach to promote pro-
nutrition behavior and social change– under the mandate from the NNS

30

Nutrition
communication
climate capacity
materials

Strengths:
• Factual print materials covering key topics exist: optimal
breastfeeding, complementary feeding, dietary diversity,
Vitamin A, and HIV/AIDS and nutrition
• New materials available on micronutrient powders,
blended flours, food fortification, and food processing
• Materials target primarily mothers of young children, but
also health workers, community health workers and
volunteers
• Radio scripts for live or pre-recorded nutrition education
radio programs have been developed by TFNC and
COUNSENUTH
• Most or all materials are available in Kiswahili; some are
also in English
31

Nutrition
communication
climate capacity
materials

Gaps:
• Limited IEC/BCC nutrition materials in health facilities,
communities and households:
– TFNC review (2011): 2/3 of facilities lacked IEC materials

– MBNP review (3 regions-2012): approx. 80% of facilities had some IEC
materials although these were limited in variety and numbers

• Advocacy materials to promote a pro-nutrition
environment absent for policy makers and public.

32

Leaflets and Posters in Health Facilities
Title in Kiswahili English Translation
1 Lishe Wakati wa Ujauzito na Kunyonyesha Nutrition During Pregnancy and Breastfeeding
2 Ulishaji wa Mtoto Baada ya Miezi Sita Feeding a Child After Six Months/
Complementary Feeding after 6 Months
3 Jinsi ya Kumlisha Moto Maziwa Mabichi ya How to Feed your Baby Fresh Cow’s Milk
Ng'ombe
4 Unyonyesahaji Bora Good Breastfeeding Practices
5 Jinsi ya Kunyonyesha Mtoto How to Breastfeed your Baby
6 Zuia Magonjwa na Vifo vya Watoto Wadogo Prevent Illnesses and Deaths among infants and
young children
7 Afya Bora kwa Mtoto ni Msingi wa Maendeleo Good Child Health is a Basis for Development
8 Nyongeza ya Vitamin A kwa Watoto Vitamin A Supplementation to children
Title in Kiswahili English Translation
1 Jinsi ya Kunyonyesha Mtoto How To Breastfeed Your Child

2 Ulishaji wa Mtoto Baada ya Miezi Sita Child Nutrition After Six Months
3 Mahitaji ya Mama Mjamzito Needs of Pregnant Woman
4 Jinsi ya Kunyonyesha How to Breast Feed
5 Lishe wakati wa Ujauzito Nutrition During pregnancy
6 Chanjo Moja Dhidi ya Magonjwa Sita One Vaccination Against Six Diseases
7 Lishe Wakati Wa Ujauzito Na Nutrition During Pregnancy and Lactation
Kunyonyesha
8 Ulaji Bora Ni Muhimu Kwa Afya Yako Good Nutrition Is Important For Your Health
33

Nutrition
communication
climate capacity
materials

Nutrition IEC Materials Available in Print Forms
(Brochure, Poster, Flipchart/Cue Card)
Title Brochure Poster Job Aid
1 How to Provide Fresh Cow’s x x
Milk to your Child
2 How to Breastfeed your x x x
Child
3 Child Nutrition after Six x x x
months
4 Nutrition During Pregnancy x x
and Breastfeeding
34

Nutrition
communication
climate capacity
materials

Gaps:
• The majority of materials use a written instruction-
based format, require moderate-to-high levels of
literacy
• Few nutrition materials address behavioural barriers
and motivators
• Although many are attractive, most are devoid of
emotional appeal
• Very few maternal anemia materials exist (only 1
poster and 1 leaflet)
• The programmatic use of cultural resources for
nutrition communication (e.g. music, arts, dance, and
drama) is nearly non-existent

35

Nutrition
communication
climate capacity
materials

SBCC analysis notes on complementary feeding leaflet:
Strengths:
• Attractive
• Technically sound information
• Clear instructions and illustrations
• Clear audience: mothers with infants

Gaps:
• Not linked to audio; requires moderate literacy
• Information relayed in print format
• Limited emotional appeal
• Not based on a behavioral analysis of key barriers to
implementing behaviours; focuses primarily on knowledge
• No accompany materials for key influencers (e.g. men,
mothers-in-law)
• No call to action
36

Nutrition
communication
climate capacity
materials

Gaps:
• Few nutrition materials are designed for men
• Few nutrition materials are designed for
farmers, or integrate maternal and child
nutrition issues into agricultural activities in a
way that addresses the needs and interests of
farmers
• Radio broadcasts of nutrition topics are
primarily educational, with limited diversity in
style or format, and little interactive
programming

37

Nutrition
communication
climate capacity
materials

Gaps:
• No nutrition materials address social norms or
promote pro-nutrition social change, particularly
positive gender norms:
– increased dialogue and joint decision-making
among couples
– increased spousal support for the role of men as
husbands, partners and fathers
– grandmothers as influential advisors and supporters
– women’s increased empowerment to participate in
decision-making and dialogue
• Only one nutrition campaign to date has used
mobile phone technologies to promote behaviors
(Maziwa Campaign; TFNC/MBNP August 2012).

38

Therefore, given the current status of nutrition
communications materials…
1. While some existing materials meet the need of the
NNS mandate, there are few that address the broad
social and behavior change vision of the NNS; few
materials in use now will close the KAP gap.
2. Materials do not address behavioural barriers or
resistances nor emotional motivations.
3. Disproportionate reliance on print materials in a
society with a strong oral tradition and culture.
4. New communication technologies and traditional
media remain untapped.
39

Nutrition
communication
climate capacity
materials

Strengths of the current SBCC capacity of Government
and NGOs:
• Staff comprised of experienced nutrition scientists and other
professionals who are key players in the Tanzania nutrition
community.
• Well connected and respected by nutrition stakeholders:
positioned to influence implementation of NNS.
• Recognition of the importance of developing staff expertise in
state-of-the-art SBCC processes and programming insights;
highly motivated staff.
• Substantial experience in development and production of
nutrition IEC materials in print, radio, film and television.

Nutrition
communication
climate capacity
materials

Gaps in the current SBCC capacity of Government and
NGOs:
• Diminished donor funding
• Limited exposure to or engagement in shifts leading up to today’s practice
of SBCC; materials and activities are out of sync with today’s knowledge
base and best practices in SBCC programming
• Little to no prior exposure of staff to SBCC theory or practice; lack of
training and mentoring to upgrade SBCC capacity
• Respect for nutrition expertise; not SBCC expertise/experience
• Current institutional mandates and structures not fully aligned with role of
developing and managing a national SBCC nutrition strategy and
programming
• Lack of behavioural or social change indicators and methods to measure
progress

Nutrition
communication
climate capacity
materials

Gaps in the current SBCC capacity of Government and
NGOs (continued):
• Nutrition counseling not yet fully recognized as a priority professional area
of expertise:
– Not operationalized in current health systems and structures (e.g. work
load, insufficient time with clients).
– Training curriculum (workshops, seminars) more aligned to skills
building in nutrition education, but not really nutrition counseling
(HWs, CHWs).
– Peer counseling/peer education for nutrition (e.g. through mothers’ or
fathers’ support groups, CHWs, etc.) not yet fully developed or
operationalized.

Nutrition
communication
climate capacity
materials

Other institutional resources:
• Muhimbili University of Allied Health Sciences is initiating a
social and behaviour change and communication course of
study (graduate and professional development degrees)
• Strong private sector capacity for communications
– Creative agencies
– Production agencies
– Media and telecommunications
– Marketing, warehousing and distribution companies

Therefore, given the current institutional SBCC
capacity…
Actions necessary to strengthen Government and NGO
SBCC capacity include:
• Developing and vetting a strategy for building SBCC capacity
within government and among local NGOs
• Updating institutional structure, mandates and core functions
of technical departments and staff to better align with SBCC
capacity development
• Prioritizing SBCC training and mentoring using a learning-by-
doing approach alongside formal coursework
• Building alliances and partnerships with other institutions such
as universities, creative agencies, private sector, media, etc.

Contents
– NNS
6. Recommendations
45

Q: What is the state of readiness of communication to
support pro-nutrition social change and the specific
behavior shifts that will impact nutrition outcomes?

A: Within the nutrition community, current readiness is
poor, but momentum and willingness is high and the
broader climate is good for SOTA SBCC/Nutrition
development and implementation.
The door is open, we must ensure that opportunities
are not missed!
46

Tipping Points
for Pro-Nutrition Status Readiness
Social Change 1
1. Public • Low visibility in the public domain
Definition and • Public concept of nutrition is “food”
Visibility of • Level of magnitude and consequences of childhood
“Nutrition” stunting and maternal anemia not well recognized or
understood; not drivers of action
2. Nutrition • High level commitment to champion nutrition at PMO
Leadership • Multi-Sectoral Coordination Structures established at
national and local levels but not fully mobilized or
operational; their SBCC mandate needs to be identified
• TFNC identified as lead government agency for National
Nutrition Strategy coordination and implementation;
TFNC also has SBCC implementation mandate
• Areas such as supply chain systems for nutrition
commodities (IFA, Vit. A, de-worming, SP) not being
sufficiently addressed; hampers behaviour change
programming
47

Tipping Points
Social Change1

3. Institutional • SBCC Nutrition capacity-strengthening needs assessed
Capacity for for lead government and civil society institutions; road
SBCC Nutrition maps in place
programming --High capacity / expertise in nutrition subject matter
and --Low-to-moderately-low SBCC Nutrition
implementation (communications) expertise:
• SBCC Nutrition skill at implementation levels is weak;
eg. counseling not yet fully recognized as a priority
professional area of expertise; little experience using
traditional media
• Strong private sector institutions for capacity building
and implementation
• Guiding SOTA SBCC examples from other sectors

48

Tipping Points for
Pro-Nutrition Status Readiness
Social Change1
4. Nutrition Policy • Nutrition Policy in place
and Strategy • National Nutrition Strategy and Implementation Plan
in place; not yet operationalized through the 9 Line
Ministries’ plans and strategies
• NNS clearly defines mandate for and expectations of
communication activities, especially related to
achieving pro-nutrition practices
5. Social • “Nutrition is nobody’s responsibility”
Engagement • No sense of urgency or unity within society
(Ownership) in • Private sector not mobilized to support nutrition
Nutrition • Other sectors (arts, culture, traditional, religious,
media) not mobilized

49

Tipping Points
for Pro-
Status Readiness
Nutrition
Social Change1
6. Pro- • Men’s supportive roles as husbands/fathers not
Nutrition galvanized; men not “engaged”
Gender Norms • Women’s gender roles constrain self-efficacy necessary
for adopting nutrition-related behaviors, including
accessing nutrition information and services
• Limited couple/family dialogue and joint decision-
making about nutrition choices; allocation of resources
7. Collective • No cohesive strategy or campaigns to mobilize society
Actions/Social to focus on key behaviours or social norms
mobilization • Local civil society structures not engaged to implement
supporting community nutrition activities, nor SBCC programming
Nutrition • Limited guidance provided to help LGAs, CSOs and
communities to plan, budget and implement
meaningful collective actions to reduce malnutrition

50

Tipping Points
for Pro-
Status Readiness
Nutrition Social
Change1
8. Resources • Nine Lead Ministries and their respective sectors have
Mobilized for been mobilized, but advocacy to support budgeting poor
Nutrition • Government has mandated a budget line for nutrition, but
not a minimum percentage
• Donors have increased investments in nutrition through
multiple global and national mechanisms
• Resources for a robust national multi-year SBCC program
lacking; will have to be raised
• Human resources: nutritionists and nutrition focal people
in ministries and districts available
• Local civil society structures in place but not fully
mobilized and resourced
• Funding not meeting program needs, especially for
nutrition commodities and scale-up

51

Tipping Points
Social Change1
9. Diffusion of • More cell phones than adults: 26 million cell phone
Innovations & subscriptions in Tanzania; adult population is 24
Technologies to million
Support Pro- • Other health sector areas already using radio,
Nutrition Social television, film, and mobile phone platforms and
and Behavior technologies (e.g. MOHSW’s mHealth initiative)
Change • Innovative approaches to promote social change (e.g.
gender) exist in other health sector areas
10. Maintaining • Vitamin A supplement supplies not as available in the
Past Gains past; weaknesses in government systems for supply
chain and disbursement of funds
• Recapture community mobilization and collective
action efforts for nutrition
1 “10Tipping Points for Pro-Nutrition Social Change Framework” (Clemmons, L., MBNP 2012) is adapted from theories and ideas originating in The
Tipping Point: How Little Things Can Make a Big Difference by Malcolm Gladwell, 2000; and from Women's Funding Networks' Making the Case™
Framework for 5 Indicators for Social Change.
52

Contents
– NNS
6. Recommendations
53

6. Recommendations
1. Develop a multi-year, multi-sectoral National SBCC
Nutrition Strategy to address nutrition behaviours and
“tipping points” for pro-nutrition social change
2. Update structures, mandates and core functions of
technical departments and staff of lead government and
civil society agencies to better align with state-of-the-art
(needed) SBCC Nutrition program implementation
3. Establish a high level SBCC Task Force / Communication
Board that can support strategic decision-making and
resource mobilization for the implementation of the
National SBCC Nutrition Strategy

54

6. Recommendations
5. Forge alliances and partnerships with universities, creative
agencies, private sector, media, to ensure reach, appeal and
long term capacity development
6. Prioritize SBCC Nutrition on-the-job training and mentoring
using a learning-by-doing approach
7. Establish an implementing partners group that will ensure
harmonization of SBCC efforts, support SBCC monitoring and
encourage innovation to overcome implementation bottle-
necks
8. Establish SBCC fora at the regional or district levels to ensure
that approaches are relevant, understood and localized

55

Annex A: Social Change Indicators for SBCC Nutrition1
INDICATOR DEFINITIONS
1. Shift in Definition and An issue or idea is given new meaning. Society sees the issue differently as a result of SBCC for nutrition. “Nutrition” ,
minimum acceptable diet and diet diversity, anemia, childhood stunting and other forms and consequences of
Perception
malnutrition, are defined and perceived differently in the community or larger society.
2. Shift in Leadership Opinion Leaders, Decision-makers and Policy-makers, including government, Parliament, civil society, private sector,
religious leaders are participating in creating a Vision, supporting a Vision, setting direction, championing and motivating,
and holding people, organizations and systems accountable for achieving the goals and objectives of the National Nutrition
Strategy.
3. Strengthened Individual staff have technical capacity to understand and apply SBCC-related theories and best practices, design
Institutional Capacity for evidence-based strategies, develop effective messages and materials, and manage, implement and evaluate
SBCC Nutrition SBCC/Nutrition programs. Institutions have structures and systems aligned to support each major phase of SBCC
programming.
4. Shift in Engagement A greater number and a more diverse array of people, organizations and stakeholders in Tanzanian society are engaged in
nutrition as a result of advocacy and SBCC. Ideally, enough people get involved that they are noticed, voices are heard, i.e.
(Ownership)
a critical mass is reached . More and more individuals and multi-sector stakeholders, including private sector buy into
“Nutrition is MY Responsibility”.
5. Shift in Gender Norms Men and women are behaving and interacting differently as they support pro-nutrition actions. New or enhanced gender
roles supportive of nutrition are considered “normal”, appropriate, and positive in the community and wider society.

6. Increase in Collective Community groups, peer support groups, social support networks, communities, neighborhoods act or work together for a
common cause and collective action to support nutrition.
Actions
7. Shift in Policy An institutional, organizational, or legislative policy or practice has changed. Organizational, local, regional, state, national
or international policy or practices have changed to better serve social change ideals (e.g. specific laws change and/or
institutional systems change or practices change).
8. Shift in Resources Greater resources (human, financial, logistical, etc.) are mobilized from a wider and more diverse array of sectors of
society, including government, civil society, religious, entertainment, private, for-profit, etc.
Mobilized
9. Diffusion of Innovations New or improved technologies from different sectors (e.g. agriculture, water, livestock, telecommunications/ICT, etc.) are
used to support pro-nutrition interventions, behaviors and social norms.
& Technologies
10. Maintaining Past Past gains have been maintained ; funding for nutrition is saved from budget cuts; gains made in
addressing one nutrition priority, such as Vitamin A, are not sacrificed for other nutrition priorities such as maternal
Gains 56
anemia.

Acknowledgements
The 2012 SBCC Landscape Analysis was conducted by the Mwanzo Bora
Nutrition Program and funded by the United States Agency for International
Development with support from the American people.

This report would not have been possible without the support and
collaboration of many institutions and individuals in sharing their information
and materials with us, including: the Ministry of Health and Social Welfare, The
Tanzania Food and Nutrition Centre, Centre for Counselling, Nutrition and
Health Care (COUNSENUTH), Media for Development International, Feed the
Future/Tuboreshe Chakula program, Johns Hopkins University Center for
Communication Programs/Communication and Malaria Initiative (COMMIT)
project, the EngenderHealth/CHAMPION Project, and the District teams in
Morogoro, Manyara and Dodoma regions.

The SBCC Landscape analysis was conducted by Lydia Clemmons, Tuzie Edwin,
Peter Riwa, Lunna Kyungu, and Restituta Shirima. This report was compiled and
written by Lydia Clemmons and Marcia Griffiths with support from Neha Shah.

57

Tanzania SBCC Landscape Analysis 2012

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