substantial and durable impact on nutrition. Further efforts are needed to ensure that nutrition is firmly mainstreamed in sector policies, strategies and programmes. (c) There is low coverage of health services in remote areas and among other hard-to-reach populations. The use of special strategies to reach these groups is rare. (d) Key decisions about priorities and resource allocations are made at the local government level, where the understanding of the importance of malnutrition and how to deal with nutrition problems is limited. Very few nutritional professionals exist to provide high quality technical support to Local Government Authorities (LGA) efforts to address malnutrition. In particular, there are no district staff that are accountable for nutrition and who are responsible for coordinating the design, planning and implementation of nutrition interventions. Consequently, there is a lack of prioritization of nutrition in council plans, including the Comprehensive Council Health Plans, and nutrition is not allocated adequate financial and human resources to provide quality nutrition services. In light of the decentralization process in the country, the institutional arrangements for nutrition need to be reviewed so that the LGAs have the organizational structure necessary to implement nutrition services and are supported by appropriate structures at the regional and national level. (e) There is an acute shortage of health service providers who are adequately trained to deliver nutrition interventions at facility and community levels. Pre-service and in-service curricula and training materials need to be updated, based on latest policies, guidelines and scientific knowledge. There is little follow-up to ensure that health workers use the acquired knowledge and skills from in-service training thus the need to strength monitoring and supportive supervision. (f) Legislation that is needed to create a supportive environment for nutrition is not yet fully developed, updated, enacted and enforced. This includes the National Regulation for Marketing of Breast Milk Substitutes and Designated Products (1994); Code of Hygienic Practice for Foods for Infants and Children, Maternity Leave Legislation and legislation for the fortification of food, including salt iodation. The legalisation is not fully understood by all who have responsibilities for its implementation and enforcement. (g) Nutrition needs to be better integrated into existing national surveys in all relevant sectors and management information systems. The Nutrition Surveillance System is not fully functional and needs further revitalization so that it can provide timely and accurate data that is used to monitor nutrition and guide decisions. The use of data for decision-making at all levels, including the district level, needs to be strengthened so that resources are directed where they are needed most. 168. Taking into account of the emerging challenges in nutrition, the State Party has undertaken the following measures to address them: (h) Establishment of a High Level National Nutrition Steering Committee led by the Government with representatives from ministries, Development Partners and Civil Society Organizations. (i) Effective in the financial year 2012/13, establishment of a designated line in the national budget for nutrition. (j) Establishment of nutrition cadres in regional secretariat and Local Government Authorities (k) Development, dissemination and implementation of the multisectoral National Nutrition Strategy and production and dissemination of Essential Nutrition Interventions Packages for Councils. . (l) Devising innovative approaches for controlling PEM and micronutrient deficiency including early case identification and management and micronutrient supplementation. (m) Stronger integration of nutrition into agricultural activities as outlined in Tanzania Agriculture and Food Security Investment Plan (TAFSIP). (n) Gazetting and finalization of the national standards for oil, wheat and maize flour. (o) Awareness creation and counselling on optimal child feeding and nutrition practices and protecting maternity benefits of women including those who are employed in the informal and private sectors through the RCH Services, mass media and community contact meetings. 43

Select target paragraph3