and mental development including mental and physical congenital defects in new-borns, low learning capacity, impaired growth and poor health and low productivity among the general population. The principal cause of iodine deficiency is inadequate iodine in foods. The fortification of salt with iodine is the most common method of preventing iodine deficiency. The Tanzania’s salt iodisation program is on a good track poised to attain the goal of eliminating iodine deficiency when 90 percent of the households are using iodised salt. 150. The TDHS 2010 shows that 55 percent of children live in households that use adequately iodised salt. The prevalence of IDD basing on goitre prevalence shows that 7% of school children were found to have goitre (TFNC, 2004).183 (xi) Vitamin A Deficiency (VAD). VAD is manifested by low levels of serum retinal and / or exophthalmia. Vitamin A is an essential for strengthening the immune system that plays an important role in maintaining the epithelial tissue in the body. Severe VAD is a major cause of eye damage and preventable blindness, increased severity of infections such as measles and diarrhoeal diseases in children, and slow recovery from illness. Vitamin A is found in breast milk, other milks, liver, eggs, fish, butter, red palm oil, mangoes, papayas, carrots, pumpkins, and dark green leafy vegetables. The liver can store an adequate amount of the vitamin for four to six months. Periodic dosing (usually every six months) of vitamin A supplements is one method of ensuring that children at risk do not develop VAD. The 2010 TDHS shows that 62 percent of children age 6-35 months, consumed foods rich in vitamin A the day or night preceding the survey. The proportion of children consuming vitamin A-rich foods increases with age, from 53 percent at 6-8 months to 87 percent at 18-23 months, but consumption declines to 22 percent at 24-35 months. 151. Night blindness is a symptom of severe VAD, which pregnant women are especially prone to suffer. According to the 2010 TDHS, 4 percent of women with a recent birth reported experiencing night blindness. After adjusting for women who also reported vision problems during the day, an estimated 1 percent of women suffered from night blindness. Furthermore, it is likely that the prevalence of VAD in children has been reduced considerably during the last decade due to the high coverage of twice yearly vitamin A supplementation (VAS). An indication of VAD in the wider population is considered only when prevalence of night blindness among pregnant women is 5 percent or more (IVACG, 2001). The policy of the Ministry of Health and Social Welfare regarding maternal vitamin A supplementation (VAS) is to provide a high-dose vitamin A capsule (200,000 IU) within the first four weeks after delivery (MOHSW, 1997). This is aimed to increase the mother’s vitamin A status and the content of the vitamin in the breast milk for the benefit of the child. 152. However, the policy is currently under review to be in line with new WHO guidelines that VAS should be provided to all postpartum mothers within six weeks after delivery or within eight weeks to those who are breastfeeding (WHO 2003). TDHS 2010 indicates that only one out of four women who gave birth in the five years preceding the survey received vitamin A supplementation within two months after childbirth. TDHS further shows that the coverage of Vitamin A Supplementation among children age 6-59 months years of age is 61 percent. While Pemba North and Unguja South have the highest proportion of vitamin A supplementation (87 and 90 percent, respectively). Challenges 153. Nonetheless, the State Party faces the following challenges with regard to implementation of the nutrition activities: (a) There is poor coverage of many essential nutrition interventions, including the prevention and control of anaemia and management of severe acute malnutrition in children and women. This is particularly disadvantageous for addressing nutritional problems that are multifaceted in nature and require multiple different interventions, such as the prevention and control of anaemia. (b) There are inadequate linkages with programs and projects in other sectors that could provide synergistic services to address the underlying causes of malnutrition. Under these circumstances, actions do not create synergy and therefore do not cumulate to produce 42