The health of Alvera Nyirahabimana, a mother from Nyarure cell, Munini sector of Nyaruguru District and her child knows no malnutrition, thanks to the Government of Rwanda and the World Bank for the support through the Stunting Prevention and Reduction Project (SPRP) that provided her with nutritious porridge flour known as ‘Shisha Kibondo’ when she was pregnant.

The project is being implemented by Rwanda Biomedical Centre (RBC) in collaboration with the National Child Development Agency and districts.

‘Shisha Kibondo’ flour is used to make a highly nutritious complementary porridge for infants and young children older than six months to prevent stunting.

Stunting is the impaired growth and development that children experience from poor nutrition, repeated infection, and inadequate psychosocial stimulation.

The porridge is a complementary food that contributes to a child’s good health and development while they continue to breastfeed till at least two years of age.

It is a blend of maize, soya, milk powder, sugar, vitamins and other minerals.

The ‘Shisha Kibondo’ porridge, provided to vulnerable pregnant women at Munini Health Centre, is essential to the health of the woman and her unborn child.

Nyirahabimana, from the first category that is considered the most vulnerable in Rwanda, is among thousands of mothers who were given the nutritious flour produced for pregnant and breastfeeding mothers.

A mother with a baby aged between nine to 11 months old gets four packs per month (each weighing 1.5 kg).

From 12 to 23 months, the mother gets five packs of flour.

"I could not afford such nutritious flour as I come from the low-income earning category. The project prevented my child from stunting. I received five packs each month when I was pregnant.

"When the baby was nine months old, I would receive four packs of the porridge. At one-year-old, I received five packs of nutritious porridge, until now. She will be two years old in April this year and the baby is in good health,” Nyirahabimana said, adding, "Hadn’t the project intervened, my child would have been stunted,” she noted.

She said that in addition to nutritious food support, they were educated on practices to fight malnutrition and stunting.

"We planted fruits and established kitchen gardens. We were trained on how to prepare a balanced diet. We were also taught about the role of hygiene in reducing malnutrition,” she said.

Francine Mukeshimana, a mother from the second category considered as poor, from Munini sector, also got ‘Shisha Kibondo’ when she was pregnant.

"I received the nutritious flour. My child has not been stunted thanks to the support. A kitchen garden at the village level was also established as a demonstration to train us on fighting stunting and malnutrition. Our children are regularly screened to assess the progress in terms of child health improvement,” she said.

Mukeshimana said that she also got seeds to plant various types of fruits and vegetables.

"I planted tree tomatoes, orange trees, and avocado trees among others. We also formed saving groups so that even when we are not getting support from the project, we afford nutritious food for the whole family,” she noted.

Malnutrition goes down by 80 per cent

Christine Kampire, a nutritionist at Munini Health Centre, said that under-nutrition has decreased by 80 per cent among the project’s beneficiaries.

"Before they were given nutritious flour, we used to record many cases of malnutrition among the children. Besides the package of ‘Shisha Kibondo’ flour to pregnant and breastfeeding mothers and their children, these children are also taken to Early Childhood Development Centres (ECDs) where they also get milk among other nutritious foods,” she said.

The health centre is currently supplying the nutritious flour to 738 pregnant and breastfeeding mothers.

"We would record seven cases of malnutrition among children per month at the health centre. In the recent month, I didn’t find a single case,” she said.

For people already affected by malnutrition, the project provides milk to children at ECDs, sosoma flour, and ready-to-use therapeutic food (RUTF) which treats severe wasting in children— children who are too thin for their height and is the result of recent rapid weight loss or the failure to gain weight.

FelicienNdagijimana, the head of Munini Health Centre, said that mothers from the first and second Ubudehe categories are the most targeted to benefit from Stunting Prevention and Reduction Project (SPRP) interventions.

"The project also focused on behaviour change because we realised that malnutrition is also caused by poor mind-set. People had to know how to prepare a balanced diet and prevent poor hygiene which also worsens malnutrition,” he said.

Ndagijimana said that parents are also sensitised about family planning.

Vice Mayor in Charge of Economic Development in Nyaruguru District, AssoumptaByukusenge, said that the district, before 2017, would record between 40 and 50 cases of malnourished children per month.

"From 2017 up to now, we can record between six and eight children who are malnourished per month,” she said.

"Stunting was at 41.7 per cent in 2015. The latest 2020 survey shows that stunting has decreased to 39.1 per cent. As of 2022, our assessment shows that it has reduced to 34 per cent although it is not yet approved at the national level. We hope that by 2024, stunting and malnutrition will have drastically decreased,” Byukusenge said, mentioning the project’s interventions.

Vulnerable mothers started to receive ‘Shisha Kibondo’ in 2017. "When the project started at least 2,345 mothers with 5, 215 children were being given 19 tonnes of ‘Shisha Kibondo’ flour to prevent stunting. Going forward, 71 tonnes of nutritious flour have been provided to 5, 687 mothers with 9,412 children in a period of two years,” she said.

Over the past six years, about 150 tonnes of ‘Shisha Kibondo’ have been distributed to reduce stunting.

"We commend the government of Rwanda and World Bank for having financed our efforts in reducing stunting and malnutrition,” she added.

Countrywide, the rate of stunting has decreased by 11 per cent in the last 10 years but more effort is needed to reach a targeted 19 per cent by 2024, or a 14 per cent decrease.

Byukusenge said that the beneficiaries were sensitised about family planning and antenatal care services which play a big role in reducing stunting and malnutrition.

"The uptake of antenatal care services has increased from 43 per cent in 2018 to 72 per cent in 2022. This is followed by family planning. Uptake of post-antenatal care increased from 38 per cent to 86 per cent,” she said.