Even though people are aware and have basic knowledge regarding nutrition, health experts worry that many haven’t put this into practice, especially in their homes. Rwanda Demographic Health Survey (RDHS) of 2014 to 15 shows that 38 per cent of children under five years are stunted, and two per cent suffer from acute malnutrition. This, according to the survey, is a challenge to the community and country at large. Meanwhile, some districts, like Nyabihu in Western Province, the stunting rate was extremely high at 59 per cent. In response to this challenge, the government has trained nutritionists and health practitioners to help address the issue through clinical nutrition and community outreach programmes. Since 2010, a lot of effort has put in place, like community outreach programmes, to make people understand nutrition in order to change mindset on a balanced diet. In 2015, 30 nutritionists, the first graduates in the nutrition unit in the country, advanced from University of Rwanda’s College of Medicine and Health Sciences. The nutritionists have joined efforts with different sectors of the government to help address the malnutrition challenge. Emmy Ntamanga, a nutritional consultant in Kigali, says nutrition education has been carried out through social media and other community gatherings, such as parent evenings (Umugoroba w’ababyeyi), community-based nutrition programmes — like village cooking demonstrations — monthly growth monitoring, among others, with the aim of making the public understand what it means to eat well and stay healthy. He says many people can now describe energy giving foods (carbohydrates), bodybuilding foods (proteins) and protective foods (fruits & vegetables), thanks to these outreach initiatives. “Policymakers can only do so much, nothing will be achieved if it is not put into practice. I think there is a need to empasise putting the knowledge people have on nutrition into practice,” he says. WHAT IS NEEDED? Caleb Karangira, a nutrition and gender officer at Rwanda Development Organization (RDO) - Hinga Weza Project, Kigali, says people should not sit back and relax because they’ve heard about nutrition. He notes that instead, they should put it into practice, not only at the community level, but most importantly, the household level. “They say practice makes perfect, so people should always put effort in adapting to new benefits,” he advises. On the other hand, Karangira says it’s the role of nutritionists to support the public, especially on nutrition education and counselling at the community level and households — and to conduct home visits with the aim of accessing if nutrition practices are implemented. He goes on to add that nutrition education should shift from just dissemination of knowledge to more practical approach which should be done by everyone in the community. Venuste Muhamyankaka, Executive Director of Scaling up Nutrition (SUN) Alliance – an umbrella of civil society organisations in Rwanda aimed at promoting sensitive and specific nutrition actions, says although most people know the basics of nutrition on how to prepare a balanced diet, there is still a lot when it comes to promoting the best nutrition practices. For instance, he says knowledge on food groups, nutritious foods promoted, recommended dietary intakes, multi-sectoral nutrition interventions promoted in Rwanda and their relevance, among others, are the practices that should be taken into considerations. He further notes that this is the strongest reason why the government, private sector and non-governmental organisations should put effort in hiring licensed professional nutritionists to help address these issues, mostly at the community level. Ntamanga says that it’s also important for people to first start with knowing and understanding nutrition requirements before practicing it. In addition, he says, a regular visit to a nutritionist for more advice and counselling on what to improve while practicing nutrition at home is important. Another important aspect, the nutritionist points out, is that it’s fundamental that people start considering nutritionists as health practitioners, rather than ‘food handlers’ as many think. Adding that when this is understood, it’s easy to get the help needed as far as nutrition is concerned. “The role of nutritionists is more of prevention than cure, as well as counselling when it comes to preventing non-communicable diseases that come with poor nutrition,” Ntamanga says. Also, they are in a good position to advise people on how to practice and be consistent with a balanced diet always. Esther Batetiwabo, a nutritionist at King Faisal Hospital, says people should always remember that good nutrition is the prevention of all diseases and other problems related to poor nutrition. She says that when this is understood, one will always follow the rules of a balanced diet in their daily lives for their children to live healthily. Nutritionists, Batetiwabo says, should guide people on how to prepare food, and help them understand the various nutrients found in those foods and their role in the health of the body. CHALLENGES According to Private Kamanzi, a nutritionist at Amazon Cabinet Clinic in Kigali, when it comes to following and practicing healthy eating, it’s hard for many people, because this is something that requires patience and regularity. He notes that because people are used to their unhealthy ways of eating, convincing them to switch is a big problem, and in most cases, it doesn’t work out. “It’s important to note that one learns and adapts to a way of eating at an early age, and they grow with this culture until they are adults. This is why it’s important for parents to get the right information on nutrition and move it to their daily lives to ensure health in the future,” he says. Also, he adds, overweight or obesity is normally a result of a poor lifestyle, including nutrition, and when they seek advice on what to do, they do not stick to it because they do not have that discipline. It is this, he explains, that makes them go back to their unhealthy eating habits yet they are aware of what is supposed to be done as far as staying healthy is concerned. Karangira notes that some people are uneducated and so, they tend not to comprehend what they are enlightened about regarding practicing good nutrition. He further adds that lack of time to prepare healthy food is another challenge. He says there is also the issue of ignoring responsibilities. Here, Karangira says, parents leave all responsibilities to house helps, including preparation of food for the family. “They don’t follow-up on what is being prepared and how, and yet these people in most cases have no knowledge whatsoever on how to prepare a balanced diet. This is among the leading causes of malnutrition in children,” Karangira says. Batetiwabo adds that some people don’t have enough knowledge on nutritional facts, so they are in need of experts to help them understand and provide guidance in practicing what they have been told. editor@newtimesrwanda.com
