FEATURED - Gikuriro Kuri Bose Programme: How ‘Nurturing Care Hubs’ are eradicating malnutrition among children

Elizabeth Nyirandorimana, the mother from Gatovu village, Rugari cell, Rwerere sector in Burera district, recalls cases of children with malnutrition being recorded before Gikuriro Kuri Bose-Inclusive Nutrition and Early Childhood Development (INECD) programme interventions. Today, the resident witnessed that the community is no longer recording malnutrition cases thanks to the Nurturing Care Hubs established by the $38 million USAID-funded. The five-year project aiming to improve maternal, infant, child, and adolescent nutrition and development, as well as functional and health outcomes is implemented by a consortium led by Catholic Relief Services. The Gikuriro Kuri Bose programme promotes integrated nutrition and early childhood development services across 4,592 villages in 10 districts to promote children's and mothers' well-being and health in Rwanda. The districts where the program is implemented are Burera, Rulindo, Nyabihu, Rwamagana, Nyarugenge, Nyanza, Nyamasheke, Ngoma, Kicukiro, and Kayonza, Some of these districts with the highest stunting rates within the country. The programme addresses child development gaps and ensures social inclusion for infants, children, and adults with disabilities by integrating them into all services that promote their health and well-being. At Gatovu Nurturing Care Hub in the Rwerere sector of Burera District, children receive a balanced meal that includes legumes, vegetables, eggs, fruits, and milk- to improve their nutrition, in addition to other services such as brain stimulation, early learning, school readiness, playing, growth monitoring and promotion in addition to positive parenting education for parents to increase their skills to provide nurturing care services. Parents formed Savings and Internal Lending Communities (SILC) groups to improve their families’ economy, get the means to start income-generating activities that support their family's nutritional needs, and address food insecurity and malnutrition. Parents at the Nurturing Care Hub are trained on improved nutrition, preparation of a balanced diet, and preventing stunting and malnutrition among children through a ‘Village Nutrition School’ which takes place to learn about food preparation and rehabilitating malnourished children. “When we realized that some children were malnourished, the parents joined their efforts and through the support of the Gikuriro Kuri Bose, we were able to set up the Nurturing Care Hub in our village which has two classes, a playground, a kitchen garden, and parents attend to learn about a balanced diet preparation. Thanks to the Gikuriro Kuri Bose program, we have a well-renovated and equipped Nurturing Care Hub,” Nyirandorimana said. She added that the Nurturing Care hub has changed both the lives of children and parents, especially women of reproductive age. “Before, when a parent would go to work for a living, children used to remain on the streets which was very risky. Currently, the children spend their time at the hub, with trained caregivers, where they learn and get a balanced diet and parents get more time to work to earn a living. The children have grown well both physically and intellectually as their learning abilities have also improved,” she said. The nurturing care hub is currently caring for 58 children in the Gatovu village of Burera district. Saving and lending groups The parents in Gatovu village have also formed saving and lending groups and members meet at the Nurturing Care hub once a week. “We use some of the savings to purchase nutritious food for our children in order to prevent malnutrition. Each member of the group has a layer of chicken, which provides eggs to children in their families. The Gikuriro Kuri Bose Programme was timely and it should be expanded across the country,” Nyirandorimana, a member of the SILC group said. Betty Uwitonze, another resident, added that they initiated the Income income-generating activity of making handicrafts, which enabled the members to generate income for savings. “The hygiene for our children has improved and with the savings we afford basic needs including soaps to improve our families’ hygiene,” she added. Felicien Mpungirehe, the president of the Saving and Internal Lending Community (SILC) Group called “Twiteze Imbere Mu Mirire: Striving for improving nutrition” said that each member saves Rwf250 per share once a week and each member is allowed up to five shares. The group with 20 women and 10 men was launched in July 2022. “The Gikuriro Programme trained us on how to operate the saving group. Members gather four times per month. The savings are loaned to the members. Some use their loans to start small businesses, pay health insurance fees, and afford other basic needs without difficulties. I, myself, pay Rwf30,000 health insurance fees to my family,” he said. He said that each member has a chicken to produce eggs for the children and there is a target to secure a pig for each member by next year so that they easily get manure for growing vegetables and other crops. Epiphanie Nyirahabineza in charge of nutrition and Gikuriro Kuri Bose Programme implementation in Burera district said that the initiative of the Nurturing Care Hub has increased the number of children benefiting from early childhood development services. “After realizing the growth of children in Nurturing Care Hubs, more parents are sending their children including those with disabilities to these hubs. The parents have also gained life skills enabling them to generate income,” she said. So far, the programme has renovated 124 Nurturing Care Hubs (NCHs) through the existing partnership with the communities and districts in the 2022/23 fiscal year, and 52 NHCs are under construction this financial year, in all the districts the program operates in. The 124 NHCs are now functional and provide integrated nutrition and ECD services. In total, 17 NHCs were established in Burera district and other five hubs are under construction. The Acting Mayor of Burera district, Jean Baptiste Nshimiyimana lauded the program for its contribution to reducing stunting and malnutrition among children which was at 41 per cent. “Community health workers, health centres, and parents have been trained and we have seen improvement in hygiene and prevention of stunting. We hope the project interventions will drastically reduce stunting in the coming years,” he said. At least 3, 344 District Plan of Eliminating Malnutrition (DPEM) members were trained in leadership, and resource mobilization. The project is working to strengthen the capacity of service providers including 30,000 frontline workers and facilitate the delivery of high-quality ECD, health, assistive technology, nutrition, protection, and disability inclusion services to ensure more effective provision of integrated and inclusive nurturing care to 725,000 children under six years old, their families as well as 820,000 women of reproductive age. The Gikuriro Kuri Bose program is timely given that according to a 2020 Demographic and Health Survey report by the National Institute of Statistics of Rwanda, one in three children in Rwanda still suffer from stunting and three in four are at risk of poor development outcomes. Rwanda seeks to reduce stunting to 19 per cent by 2024. Hans Fly, Catholic Relief Services (CRS) country Representative, reiterated how the project is improving livelihood and contributing to the country’s development through nutrition promotion. “Early childhood development and nutrition is key in human development. The project is contributing to this,” he said, adding that saving groups and Nurturing Care Hubs are playing a big role. “We are promoting a self-reliance and sustainability model among the beneficiaries to reduce malnutrition. Community members can use few resources and convert them into wealth to eradicate malnutrition,” added Alemayehu Gebremariam, Chief of Party for Inclusive Nutrition and Early Childhood Development (INECD)-Gikuriro Kuri Bose program. He said that collaboration with different partners is making the project bear fruits as it enters the second year of implementation. The Gikuriro project is also aiming to complete the six research projects to bolster learning in partnerships with the University of Global Health Equity (UGHE).

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FEATURED - Gikuriro Kuri Bose Programme: How ‘Nurturing Care Hubs’ are eradicating malnutrition among children