Undernutrition in Tanzania – is private sector growth the answer?

5th June 2014
Steve Lewis, Head of Global Health Advocacy at RESULTS UK writes for Eldis on a recent report from Tanzania which raises questions on the link between private sector growth and improved nutrition.

A recent RESULTS report on nutrition and education in Tanzania, “You can’t study if you’re hungry…” found that levels of undernutrition are worryingly high, at 42% of all children under five, and, surprisingly, that buoyant economic growth levels are having little impact on nutrition figures. These findings are important as UK government aid is increasing its programmes to support private sector development.

Community programmes deliver nutrition education advice to young mothers but only if the parents have time to attend

Photo: Steve Lewis. Community programmes deliver nutrition education advice to young mothers but only if the parents have time to attend

The report was informed by the authors visiting Tanzania with British MPs in late 2013. Travelling with MPs allowed the authors better access to high-level officials in the Tanzanian government (such as the Minister of Education and Health) and UK officials.

In Tanzania, 42% of children under five are chronically malnourished (stunted) whilst 5% are severely malnourished (wasted). Undernutrition causes and perpetuates an intergenerational cycle of poverty. From the 2013 Lancet Nutrition series we know that undernutrition contributes to 45% of all child deaths.

Undernutrition irreversibly damages the physical and cognitive development of a child, and the work of Meeker and Haddad and others show that the key period for a child is the first thousand days of life. “Poor foetal growth or stunting in the first 2 years of life leads to irreversible damage, including shorter adult height, lower attained schooling, reduced adult income, and decreased offspring birth weight. The human and economic costs are enormous”. In Tanzania, a lack of essential nutrients in the average child’s diet is one of the key determinants of undernutrition. So it is not necessarily a lack of food, but a lack of nutritious and varied food. Micronutrient deficiency is widespread in Tanzania and contributes to the high level of stunting.

Yet, Tanzania’s Gross Domestic Product (GDP) Annual Growth Rate averaged 7% from 2002 until 2013, reaching an all-time high of 11% in 2007 (World Bank). But the sectors which have driven Tanzania’s economic growth are mainly those which are capital intensive and urban. So while the urban middle class are expanding there is little benefit in rural areas. The fastest growing economic sectors are communications, financial services, construction, and a new natural gas sector.

These findings are especially relevant in Tanzania, a country where the DFID budget is growing steadily and which the DIFD Secretary of State visited twice in 2013. Since 2010, DFID has emphasised the importance of a vibrant private sector for development. In 2011, DFID set up a unit to focus on private sector development and said it would "help private enterprise work its miracles as the engine of development". As part of this new emphasis on private sector development the UK agreed in late 2013 to fund four private sector interventions in Tanzania.

But this week a report from UK aid watchdog, the Independent Commission on Aid impact (ICAI) has cast doubt on the success of the government strategy to develop markets and boost private enterprise. The report criticised the strategy as unfocused, unrealistic and excessively ambitious, and said that "DfID needs to recognise that the private sector is not a developmental panacea. References to 'the miracles' that companies are able to perform risks underplaying the role that donors like DFID and country governments have in ensuring that economic development provides benefits to the poorest in society."

Coalition ministers have repeatedly argued that encouraging more business opportunities in poor countries is a key route to ending aid dependency and should be a bigger part of what DFID does. But in Tanzania the RESULTS report found one further worrying fact. In a meeting with Tanzanian MPs on the Parliamentary Group for nutrition the MPs who were especially concerned were from the area of the country described as the ‘agricultural growth corridor’. Precisely the rural areas of the country that have been targeted for private sector growth are those constituencies with highest rates of stunting. One MP said that the emphasis on export-led growth means that parents are now so busy that they do not have the time to focus on the adequate nutrition of their children.

Economic growth on its own is not sufficient to reduce undernutrition. The report recommends that the Tanzanian government, supported by donors like the UK, should invest directly in nutrition programmes to effectively achieve nutritional outcomes. This has been proved to be among the world’s most cost-effective development interventions. Maybe DFID funds currently invested in private tea plantations would be better spent on traditional social programmes in basic education, health or nutrition?