Before Rosine Icyitegetse, a cross-border fruit vendor, enrolled her daughter at the early childhood development (ECD) centre located in Rubavu District, near the DR Congo border, the child’s health was declining due to undernutrition, even with a housekeeper.

The ECD centre at the Petite Barriere run by ADEPE, an NGO, caters for up to 50 children as young as six months to three years, from morning to evening. Icyitegetse said sending her daughter to the daycare facility has served her and her 18-month-old daughter well.

"When I hired a housekeeper to look after my baby, she lost two kilogrammes in two weeks and that was really shocking,” she said.

"But here at the ECD centre, the caregivers feed her well, she plays with other kids, she gets enough time to sleep, and at midday, I come to breastfeed her. All that added to hygiene that’s exemplary.”

Before the ECD centre was built, some of the traders had to use school-going children to look after the young ones, leading them to miss classes.

For Tonzi Umuhirwa, who uses a cart that transports goods from Rubavu to Goma in DR Congo, the ECD facility has not only been a good place to leave the young children but also complements their efforts to get a balanced diet.

"Sometimes, you cannot afford to buy fruits and vegetables, and protein-rich foods every day. But the ECD has a vegetable garden, and with our little incomes, we contribute to the budget to buy the food items,” Umuhirwa said.

When the children turn three, they are enrolled at a nearby ECD offering preschool services.

The ECD centres are one of the initiatives that were introduced to tackle malnutrition and stunting rates across the country. In Rubavu alone, there are more than 1,300 ECD facilities, most of them offering home-based daycare. About 10 are centre-based ECD facilities and 16 are run by churches.

With funding from the World Bank, the government of Rwanda launched the Stunting Prevention and Reduction Project (SPRP) to support community-based approaches to improve the delivery of high-impact nutrition and health interventions.

The five-year project launched in 2017 targeted 13 districts with the highest stunting rates, including Rubavu.

The stunting rate in Rubavu declined from 46 per cent in 2015 to 40 in 2020, according to the Demographic and Health Survey by the National Institute of Statistics of Rwanda (NISR).

The national rate declined from 38 per cent to 33 per cent over the same period. The government's target is to reach 19 per cent in 2024.

Though Rubavu recorded a modest decrease compared to the other districts, Pacifique Ishimwe, the district vice mayor in charge of social development, said they have since launched critical interventions that are expected to drive the stunting rate further.

The interventions include the mobilisation of civil society organisations and the community to support the drive to uproot malnutrition and stunting.

Across the district, households are encouraged to have vegetable gardens, which not only improve nutrition but also reduce household expenses on buying foodstuffs.

At least 1,800 low-income households have been given chickens to support their nutrition by enabling children to eat eggs, Ishimwe said. A village kitchen, where parents are taught how to prepare a balanced diet, is organised once every month.

Another initiative has donated small livestock, sheep and goats, to some of the needy households. And across the districts, villagers are asked to contribute to the efforts.

All the interventions are in addition to government efforts to improve child and maternal health, such as antenatal care visits to health centres by pregnant women.

At the health centres, pregnant women get iron and folic acid tablets, which help them prevent anaemia and stunting in babies during pregnancy.

Pregnant and breastfeeding mothers are given fortified porridge flour, known as Shisha Kibondo, to complement their diet.

"Over the past years since 2020, Rubavu District administration has been able to mobilise the community more than we had done in the previous period,” Ishimwe said.

"We know that cutting stunting from 40 per cent to 19 is a very demanding task. But we have no doubt that with all the interventions and changing the attitude of the community towards stunting, we will reach the set target.”