Dar es Salaam, Tanzania

Tanzania is a lower-middle-income country in Eastern Africa, where almost 50% of Tanzanians live in poverty. The national prevalence of children with stunting and wasting is 34.5%, 4.5%, respectively. Among older children and adolescents, 24.3% are classified with undernutrition, nearly 15% overweight or obese. Micronutrient deficiencies are a major public health concern in Tanzania. Anemia is present in almost three quarters (72%) of preschool children, mainly due to the low level of animal products consumption, but malaria and other parasitic diseases contribute to the problem. Vitamin A deficiency is prevalent in 24% of children under-five and over 1 million infants remain unprotected from iodine deficiency disorders.

Each year, Tanzania expects approximately 3,500 children and adolescents between the age of 0-14 years to be diagnosed with cancer, but population-based pediatric cancer incidence is unknown since there is no national cancer registry or early detection program in the country.

IIPAN Center & Collaborators

The Upendo Children’s Cancer Ward at the Muhimbili National Hospital (MNH) is the only children’s cancer center in the country. About 70 percent of the hospital’s funding comes from the Tanzanian government, but it is also supported by several organizations, such as the Interchurch Medical Assistance World Health, to ensure all children and adolescents receive quality health care totally free of charge.

The implementation of the IIPAN nutrition program is overseen by Dr. Trish Scanlan, a pediatric oncologist and CEO of Tumaini La Maisha Tanzania (TLM), a non-governmental organization, working to bring free and curative childhood cancer treatment. The IIPAN nutritionist, Anna Henry, has been trained in the recommended IIPAN standards of practice and works alongside Dr. Scanlan establishing an evidence-based nutrition program for the children and adolescents receiving care at MNH. Ms. Henry has established a repository of locally made, nutritionally dense homemade shakes to reduce the severe wasting that often is associated with treatment for cancer while also minimizing vitamin and mineral deficiencies that are endemic to the region. Prior to IIPAN, there was no established nutrition program within MNH.

Site Challenges

• High burden of severe acute malnutrition at diagnosis.
• Limited access to most essential nutritional supplies.
• Extensive education in nutritional care for clinicians caring for children with cancer.
• Limited supplies shift reliance to homemade preparations to deliver recommended nutrition therapy necessitating family education.

Site Needs

• Consistent supplies for medical nutrition therapy, including RUTF, F-75, F-100, specialized formulas and multivitamin micronutrient powder.
• Institutional training in the timely and effective delivery of nutritional care and management for children with cancer.

(Image Source: www.pubichealthpost.org)