Giving quality care to babies from the time they are conceived all the way through their infancy is very important, as it boosts their health and facilitates their growth.

Medics say that stunting starts before birth, largely caused by poor maternal nutrition, poor feeding practices, poor food quality, and infections such as malaria and HIV.

The risks of stunting continue after birth, particularly during the age of 6-24 months, and therefore, this calls for efforts to regularly follow up on the babies to make sure that nothing jeopardizes their health and growth.

The Ministry of Health (MoH) has put in place some mechanisms for following up on children’s development, one of which is the Child Scorecard – locally known as "Ifishi y’imikurire y’umwana,” a document that Community Health Workers (CHWs) use to monitor the health, growth and nutrition of babies before birth until they are 2 years old.

Community Health Workers monitor the health, growth and nutrition of babies before birth until they are 2 years old.

The scorecard is given to pregnant mothers who always present it to the CHWs when they visit them to check on their health and that of their children.

It has space where the CHWs feed data regarding things like vaccination, growth, illnesses of the child or the mother, so that in case of any gaps, they can easily recognise them and act accordingly.

"The scorecard assists us to monitor the children so that they do not stunt from the womb. We use it to follow up on pregnant women to make sure that they are living healthy lifestyles, doing what they have to do, and avoiding what they have to avoid,” Pascal Simpenzwe, the Vice Mayor in charge of Citizens’ Welfare in Nyabihu District, said recently.

"It is a mechanism for us to monitor whether the pregnant mothers are taking the iron-rich pills which increase their blood levels. It also assists us to follow-up on them to know if they are going for the four antenatal visits that are recommended by the Ministry of health during pregnancy. We also use the scorecard to report about the illnesses the mothers suffer, if any, and know if they got treatment in time,” he added.

A Community Health Worker serves Shisha Kibondo porridge at an ECD centre during the countywide initiative to fight against stunting.

When the babies are born, the CHWs continue to use the scorecard to monitor their growth and health.

Here, they always visit the children to know if they were vaccinated, if they are breastfed for six months without being given any other food – as recommended by the MoH, and if they are given some food after the six months, among other things.

Pélagie Izabayo, a resident of Mukaka village, Mpinga cell, Shyira sector in Nyabihu District, told the media about the importance of the scorecard, saying it was used by the CHWs to monitor the health of her child.

"They (the CHWs) used to visit and check on me, to know whether I was complying with the vaccination activities that my child had to undergo, for example. They also taught me about how to breastfeed him properly, how to give him the vitamin pill, and how to take care of him,” she said.

The scorecard is complemented by a number of measures including government’s support for needy families, for example, the provision of the nutritious "Shisha kibondo” flour to families that are in the first and second category of Ubudehe.

In addition to this, there are many more measures for fighting stunting in Nyabihu, for example, the "Igikoni cy’umudugudu,” a monthly exercise where parents gather to cook a balanced diet for their children under the age of 5.

The practice is also aimed at sensitizing parents about the importance of good nutrition for their children, and giving some skills to those who may not be knowing how to prepare a balanced diet for their children.

Anne Marie Uwajeneza, a resident of Vunga village, Mpinga cell, Shyira sector in Nyabihu District told media that she benefited from the "Igikoni cy’umudugudu” as it taught her more about how to feed her baby, having given birth when she was only 20 years old and did not know a lot about taking care of babies.

"When I came with my baby here, I learned that green vegetables are good for babies’ feeding. I also learnt that silverfish can be mixed with other food stuffs to make a nutritious meal. I have learnt a number of things from here and when I practised them, my baby made good progress,” she said.

According to the Demographic Health Survey (DHS) 2020, the stunting rate of children under 5 in Nyabihu District was 46.7 per cent.

However, the district is putting effort into measures to fight the problem, and there are some good results so far.

For instance, in an interview with media last week, Chantal Niyitegeka the Executive Secretary of Mpinga cell said the area that she heads did not have any malnourished child at the time.