When Vestine Batamuriza’s one-year-old daughter was screened by community health workers in December 2022, her results indicated that she suffered from acute malnutrition.

A resident of the Gatare sector in Nyamagabe District, Batamuriza’s child was immediately referred to ‘Ishuri Mbonezamirire’ at the Rugege Health Centre for treatment.

‘Ishuri Mbonezamirire’ loosely translated as ‘nutrition education school’ is an initiative in Nyamagabe District to reduce stunting and malnutrition among children under the age of two.

Every Thursday, parents take their children to the nutrition education corner at the health centre to learn how to improve nutrition and prepare a balanced diet.

"Our children are provided with nutritious food, and we are taught how to do it ourselves. We also learn how to improve hygiene because even with a balanced diet, a child can still be prone to stunting and malnutrition if good hygiene is not maintained,” Batamuriza says.

Batamuriza says when she joined the centre, her child weighed six kilogrammes.

"With the help of ‘Ishuri Mbonezamirire’, my baby currently weighs over seven now. She has graduated from ‘red’ (danger zone) to yellow (out of danger) and is about to be classified in green which is a good status,” she says.

To maintain a good nutrition status, the parents are also provided with vegetable seeds to plant in kitchen gardens back home.

"We have carrots and other types of vegetables as well as different types of fruit trees. In our community, we also meet to continue learning about nutrition to fight stunting,” she says.

Batamuriza commends the Stunting Prevention and Reduction Project (SPRP), the district and health centres for the innovative solution to help reduce stunting.

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

"I urge all parents to have their children regularly screened so that they know their nutrition status for quick intervention,” she says.

Vincente Nyirahabineza, another mother who joined the nutrition centre two months ago, also had a child suffering from acute malnutrition.

"My baby was in red status with less than seven kilogrammes, and thanks to the nutrition support, she weighs eight now. We receive vegetable seeds to plant in our homes’ kitchen gardens,” she says.

Nyirahabineza also previously received the nutritious Shisha Kibondo, a porridge provided to vulnerable pregnant and breastfeeding women.

Forming savings groups

The beneficiaries have created a savings group that could help them continuously afford the nutrition needed by the children to grow well.

"We started a savings group of 31 women. We gather every Thursday after being educated at the centre, and contributions to the group are Rwf100. We have a target to buy chickens which can provide eggs to the children. The savings will also help us afford other nutritious foods needed by the children,” Nyirahabineza says.

Therese Ahishakiye, a nutritionist at Rugege Health Centre, said the centre opened in 2022 and was timely to avoid recurrence of stunting and malnutrition cases among the children.

"We realised that education on nutrition will be helpful to eradicate stunting. After being screened by community health workers, those with acute malnutrition are referred to our health centre, and we educate the mothers every Thursday as a way of monitoring so that the children do not fall back into a bad condition,” she said.

She said that currently, 25 women with babies under the age two suffering from acute malnutrition are being educated as the children are catered for in the nutrition centre.

"They learn about nutrition, how to prepare a balanced diet and how to rear small animals, like poultry, to provide protein that can help reduce stunting. After recovering, we task community health workers to constantly monitor them at the village level using village kitchens where they keep gaining knowledge to eradicate stunting,” she said.

Ahishakiye said that since July last year, at least 50 children were received at the health centre and treated as their mothers were educated, adding that parents were grouped and supported to plant fruit trees and vegetables.

"They plan to spend the savings from their groups to buy chickens for every family. The health centre also provided the mothers with piglets,” she noted.

One egg per child

Ahishakiye said workers in the Gatare sector, each also committed to contributing Rwf 100—or more—per collection in the savings groups so that the vulnerable families can buy chickens and eradicate stunting through ‘Igi ry’Umwana’ (one egg per child) initiative launched this year.

The initiative was embraced because a chicken is not expensive, and can easily reproduce more, and does not require too many conditions to grow well. Moreover, the children need proteins which eggs provide.

Agnes Uwamariya, the Vice Mayor in Charge of Social Affairs in Nyamagabe District, said the interventions by Stunting Prevention and Reduction Project (SPRP) have drastically reduced stunting among the children.

"Ishuri Mbonezamirire started in Nyarusiza Health Centre in the Kamegeri sector and was replicated in all health centres. The project was supported because it provides nutritious food and teaches parents how to feed their children. The interventions are necessary when children are still under the age of two. Otherwise, they can reach three when it is not possible to treat the stunting. If it exceeds two years old, it is difficult to treat the condition,” she said.

Uwamariya added that thanks to the initiative, stunting keeps decreasing in Nyamagabe District.

"We could screen 4,000 children and find between 200 and 300 with malnutrition issues. The recent screening found only 149 children. We hope that ‘Ishuri Mbonezamirire’ will help us achieve our goal. All the 19 health centres are in competition to ensure successful implementation of the initiative,” she said.

She said some health centres are growing mushrooms to be used in ‘Ishuri Mbonezamirire’.

"Other health centres are contemplating rearing chickens as a way of easily getting eggs to feed the children,” she noted, saying that vulnerable parents will be facilitated to maintain their savings groups which will enable them to rear chickens and farm mushrooms.

"For instance, that has already been done in the Kaduha sector where they bought chickens, and Buruhukiro where they started mushroom farming,” she said.

Stunting has decreased from 51.8 per cent to 33.6 per cent in Nyamagabe District. The target is to reach 19 per cent in 2024.

"We have a Google sheet where results from screening are reported. This helps us to track all children with malnutrition issues and take immediate intervention,” she said.

Donatha Ayinkamiye, the Director of Health in Nyamagabe District, said that the Stunting Prevention and Reduction Project (SPRP) has helped a lot in providing nutritious food to pregnant and breastfeeding mothers as well as children under two and five.

"The project also put together capacity-building for health workers in reducing stunting, we have also made efforts in the uptake of antenatal care services, hygiene, village kitchen and kitchen gardens,” she said.