Challenges and Stakeholders' Views on Achievements of Multi-Sectoral Governance in Improving Child Nutrition in Buhigwe District, Tanzania.

Background: In recent years, Tanzania has made good progress in addressing the problem of chronic malnutrition in children, but the levels are still unsatisfactory, at almost three in ten of its children are stunted. The government of Tanzania has taken significant measures to establish and strengthen multi-sectoral governance as part of national efforts to reduce the unacceptably high level of malnutrition. However, few studies have qualitatively documented stakeholder's perspectives at sub-national and community level with regards to performance of multi-sectoral governance in improving nutrition status of children in Tanzania. Objective: This study aimed to explore the achievements, facilitating factors and challenges of multi-sectoral governance in improving child nutrition in Buhigwe District Council. Methods: This was cross-sectional study, which employed qualitative method of data collection whereby semi-structured interviews were used to conduct in-depth interviews with members of the multisectoral steering committee for nutrition in Buhigwe Council and parents/caregivers of under-five children. Results: There is significant improvement in allocating funds for multisectoral governance interventions targeting under five children across sectors, improved inter-sectoral coordination and increased knowledge on feeding practices among parents/caregivers. Strong leadership and political commitment, inter-sectoral linkage and Presence of Non-Governmental Organizations (NGOs) supporting nutrition were identified as factors for improving child nutrition in the context of multisectoral governance. The issue of insufficient funding, inadequate spending of allocated funds, inadequate capacity, lack of cross-sectional financial mechanism and tools to collect nutrition information were raised by stakeholders as factors hindering the implementation of multi-sectoral governance in improving child nutrition. Conclusion: Smooth implementation of multi-sectoral interventions targeting under-five children requires strong multi-sectoral governance, which is supported by adequate spending of the allocated funds, strong leadership and political commitment, presence of NGOs supporting nutrition and inter-sectoral linkage among line sectors. However, key stakeholders including central and local government authorities should address the challenge of insufficient funds, inadequate capacity, lack of cross-sectoral co-financing mechanism and tools to collect nutrition information, which were reported as barriers to the implementation of multi-sectoral governance in improving child nutrition.