Kizazi Kijacho

Overview

We know that the first 1000 days period of a child’s life – from conception until age 2 – is significant for human development and is often thought of as the first “window of opportunity” for parents and society to help a child reach its developmental potential. Although the importance is well understood, there are still major unknowns about the design of cost-effective and sustainable services that help parents and other caregivers provide nurturing conditions for children to thrive.

As in many countries in Sub-Sahara Africa (SSA), the population of Tanzania is young, the group of children in their early years of life is large, and many of these children do not reach their development potential. According to the 2022 Demographic and Health Survey (DHS), three out of ten Tanzanian children under-five are stunted and more than half the children aged 24-59 months are not developmentally on track in health, learning and psychosocial wellbeing. Limited access to quality healthcare persists despite improvements in maternal services, indicating potential issues with healthcare infrastructure and accessibility.

In this context, we started the Kizazi Kijacho programme to focus on establishing facts about the constraints to child development and the effectiveness of potential policy tools to alleviate or relax these barriers. To this end, we aim to use a combination of quantitative and qualitative methods, collect information, and conduct research across Tanzania. We have gathered a distinguished group of researchers representing seven different research institutes, spanning six countries and four continents. We work with an impressive implementation team in Tanzania, to increase our knowledge base on early childhood development, existing constraints, and innovative ECD solutions.

In this report, we focus on presenting the design and baseline findings of a state-of-the-art Randomised Controlled Trial (RCT) launched in October 2022 in the Dodoma region of Tanzania. We obtained several important findings, most notably that a significant number of community health workers (CHWs) report too high workload. On average, CHWs report to be responsible for 90 families at any point in time, and to work 26 hours per week (either in community or at a health facility), which is 10 hours per week more than what they would if they were given a choice. More than one in five CHWs reported their CHW workload to be challenging. Moreover, the majority of households in the Dodoma region have very basic living conditions, with minimal amenities and assets. The reported food consumption indicates that about half of the households consume below the food poverty line and that diets are not sufficiently diverse.

Despite the challenges, we are hopeful about the opportunities to improve on the conditions for children growing up in Tanzania. Not only has the government of Tanzania shown promising initiative through the introduction of the National Multi-Sectoral Policy (NM-ECDP) and the establishment of the national task force for ECD, but we have also through the work on this, been amazed by the strength that parents show. The attention and care that Tanzanian mothers and fathers are able to give to their children in the first 1000 days is both impressive and promising for the future. We therefore believe, that should appropriate policies be put in place, Tanzania’s young demographic profile may turn into a blessing: The region could reap a demographic dividend if scalable policy programs to promote child development are implemented. We hope that our research programme will contribute to the understanding of the challenges and the identification of appropriate policies.