In 2017 we started a nutritional project for children embedded in the network of the St. Francis Referral Hospital and the Chronic Diseases Clinic of Ifakara with the support of a grant from AfricaViva. The project established screening at the hospital level and takes care of malnourished children on an in- and outpatient basis integrating educational activities for care-givers. This project enabled the training of hospital nurses on performing standardized evaluation of malnutrition and management of children according national guidelines. Through links with the national programmes and UNICEF, therapeutic foods are now available to the hospital for care of malnourished children. Dr. G. Mollel has become member of the National Guideline Committee in Tanzania.
On this basis of the malnutrition clinic, we could attract an ESTHER Switzerland Grant to implement a programme for decentralization of malnutrition services in the district. Through training of healthcare workers in remote areas (train the trainer), further improvement of malnutrition screening and management was achieved. A referral strategy for severely affected children was established. Through mass screening and targeted screening, affected children were identified and treated. In addition, caregivers and village health workers were trained in recognition and management of malnutrition. We linked healthcare centres to national supplies of therapeutic foods and performed training on locally made therapeutic foods. The project activities were closed in 2021, however trainings and regular interaction with the district health centers are ongoing. The project hired a nutritionist at the hospital for the first time, who now has a permanent contract with the hospital and supports all nutrition-related activities at the hospital and in the community.