Inside Rwanda's five-year plan to halve child stunting
Monday, August 26, 2024
Children enjoying a nutritious meal at an Early Childhood Development Centre (ECD) in Nyamasheke District, thanks to the “Gikuriro Kuri Bose” programme that aims to combat stunting. Photo: Craish Bahizi.

The government is set to implement a comprehensive strategy aimed at reducing child stunting across the country rate to 15 per cent by 2029 from 33 per cent.

To achieve the target, the Ministry of Health, in collaboration with various stakeholders, has launched a two-year multisectoral plan designed to accelerate stunting reduction.

Isaac Bikorimana, a food and nutrition specialist at the National Childhood Development Agency (NCDA), explained that one of the cornerstone initiatives is the Community-Based nutrition Program, which engages local communities in nutritional education and practical support.

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"Through cooking demonstrations, basic parenting education, and regular anthropometric measurements, the program identifies malnourished children early and refers them to health facilities for treatment. The program also promotes the establishment of home gardens, ensuring that every household can access fresh vegetables, contributing to better overall nutrition,” he said.

"We encourage every household to have its own home garden, this is not only a way to save money but also ensures a steady supply of nutritious vegetables, which is crucial for preventing malnutrition.”

According to NCDA, the government also conducts maternal and child health week campaigns twice a year, providing essential services like vitamin A supplementation and fortified blended foods to children under two, as well as to pregnant and lactating mothers.

Different foodstuff that parents give to their children to fight stunting in Nyamasheke District

These efforts have already shown significant improvements in child nutrition, according to recent studies.

"A home fortification program is also in place, where micronutrient powders, rich in 15 essential nutrients, are provided to children under two to combat deficiencies such as anemia and vitamin B12 deficiency,” said Bikorimana

"The Milk Support Program supplies milk to malnourished children identified through community health workers. This program not only addresses immediate nutritional needs but also educates parents on the importance of incorporating animal-sourced foods into their children&039;s diets for optimal growth.”

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The agency has launched a national campaign to encourage families to include animal-sourced foods like eggs, meat, and fish in their children's diets. These foods are rich in essential nutrients and help mitigate micronutrient deficiencies, such as anemia, which remains prevalent in the country.

"We have focused our efforts on the first thousand days of a child's life, a critical window where proper nutrition can prevent stunting and promote healthy development. Our programs aim to ensure that every child has the opportunity to grow and thrive, since they are young,” Bikorimana emphasized.

Women breastfeed their children at ECD centre in Nyamasheke District

There is also a plan that is being implemented in 10 districts, selected based on their high stunting rates or recent increases in stunting. These districts will receive targeted interventions, including the distribution of chicken to vulnerable households to provide a daily source of eggs, a proven strategy to reduce stunting.

"Eggs have been identified as one of the most accessible sources of animal protein in Rwanda, making them an essential part of efforts to improve child nutrition,” he said.

In addition, there is a strong emphasis on scaling up the production and consumption of biofortified crops, which are crops that are enhanced with additional nutrients through laboratory processes.

They are crucial in addressing micronutrient deficiencies. In Rwanda, two significant varieties of biofortified crops are being promoted: orange-fleshed sweet potatoes and iron-rich beans. These crops are intended to supplement traditional diets and provide essential nutrients to vulnerable populations, he said.

"Water quality management is another critical area of intervention. Ensuring access to safe drinking water is fundamental for the health of children, particularly those under two years old, as well as pregnant and lactating mothers. To address this, the government is working to ensure that every household with young children has access to water purifiers.”

Furthermore, efforts are underway to connect schools, health facilities, and Early Childhood Development (ECD) centers to improved water supply systems, thereby enhancing access to clean water in these key institutions.

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A comprehensive social and behavior change communication campaign has also been launched to support these efforts. The campaign, which is already in progress, seeks to raise awareness about the consequences of stunting and promote positive nutritional practices.

The campaign’s slogan, which translates to "A child without stunting is the pride of the family," underscores the importance of preventing stunting and ensuring the healthy development of children.

The primary audience for this campaign includes parents and guardians of children under five, with a particular focus on teen mothers and young couples. Secondary audiences include local government leaders, frontline workers, community caregivers, and farmer promoters, as well as health workers.

The campaign&039;s objectives are broad and multifaceted. Key areas of focus include educating the public on the irreversible consequences of stunting, promoting the use of child growth monitoring tools, and encouraging the consumption of animal-source foods and biofortified products.

The campaign also aims to improve water-related interventions at both the household and community levels, and to enhance the quality of antenatal care, particularly in the first trimester of pregnancy. Improving nutrition counseling services for mothers is also a priority.

These concerted efforts are part of a broader national strategy to reduce stunting from the current rate of 33 per cent to 15 per cent by 2029.

According to NCDA, historically, Rwanda has achieved a one per cent annual reduction in stunting, a trend that the government aims to accelerate through intensified interventions.

By doubling or even tripling efforts, the government hopes to achieve its ambitious target and improve the health and well-being of its population.

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"Our goal is to ensure that by the end 2024, Rwanda is no longer seen as a country grappling with stunting as a major public health concern, which will be indicated by the results of the upcoming Demographic and Health Survey (DHS) for 2024-2025," Bikorimana said.

NCDA says the journey to this goal has been fraught with some challenges including global shocks, notably the COVID-19 pandemic and various geopolitical conflicts, that disrupted food security and nutrition efforts.

"The agricultural sector, vital to our food systems, was severely impacted, with rising food prices and reduced household incomes, many families faced food insecurity, which inevitably affected the nutrition and growth of their children," he said.

A women holds two packages of a nutritious flour that are given to pregnant women to fight stunting