‘Akarima k’Igikoni’: How vegetable gardens have reduced malnutrition and stunting in Kayonza

Malnutrition is something Christine Vuguziga knows a thing or two about, given her son occasionally got ill due to poor feeding. Vuguziga, a resident of Kayonza District, watched her son’s health deteriorate as she lacked the right foods to feed him and could barely fend for his other siblings. However, thanks to the World Bank-sponsored ‘Stunting Prevention and Reduction Project’ (SPRP), which supports community-based approaches to improve the delivery of high-impact nutrition and health interventions, Vugiziga, among others, can now confidently say that malnutrition and stunting are in the past. The project involved training rural communities in Kayonza on how to start vegetable gardens and, thereafter, prepare a balanced diet. With this, Vuguziga’s son, now seven years old, recovered from malnutrition and side-stepped the risk of stunting, owing to the vegetables she started including in his daily meals that she grows herself. The 34-year-old now has a garden in her compound that is packed with a variety of nutritious foods such as spinach, amaranth (commonly known as dodo), beetroots, tubers and banana trees. “Before I planted all these vegetables, we used to eat potatoes, cassava, mostly starchy foods, and rarely vegetables, and my son was always sick,” Vuguziga said. “He became healthier after we started eating vegetables on a daily basis. Because we cannot eat all the vegetables we grow, I sell part of the harvest and buy eggs and milk for my son,” she said, gleefully. Part of the money goes to a savings group Vugiziga joined a few years ago, and she now shows other households how to start vegetable gardens called ‘akarima k’igikoni’ in Kinyarwanda. Kayonza District’s stunting rate reduced from 42 per cent in 2015 to 28 per cent in 2020, according to the Demographic and Health Survey by the National Institute of Statistics of Rwanda (NISR). The national rate declined by five percentage points from 38 per cent in 2015 to 33 in 2020. Kayonza is one of 13 districts that benefit from SPRP. With a 30 per cent decrease in numbers, the district has made significant gains in stunting reduction. According to Alphonse Ngarambe, the Director of Health in Kayonza District, the results are attributed to a host of interventions that include early childhood development (ECD) centres, the campaign to ensure every household has a vegetable garden, antenatal care services offered at every health centre, and sanitation practices. Ngarambe said Kayonza has the highest rate of women attending antenatal care visits to health centres. These visits help track the health of the pregnant mother and the unborn child. At the health centres, expectant and breastfeeding women from the low-income categories are given fortified cereal flour called Shisha Kibondo, to complement their diet. They also get iron and folic acid tablets during pregnancy. These tablets help women prevent anaemia and stunting in babies during pregnancy. During antenatal visits, women are also taught how to prepare a balanced diet with the available resources. At Mukarange Health Centre, Aloysie Uwimana, who is pregnant with her second child, said the antenatal care visits she had during her first pregnancy helped her give birth to a healthy child. Uwimana, who is also a community health worker, said the improved maternal and child services keep pregnant and breastfeeding mothers informed about their nutrition and health status, leading to better results in the fight against stunting. The government's target is to reduce stunting levels to 19 per cent in 2024. With all the interventions and support from the government and partners, there is no doubt that a targeted 19 per cent will be realised in Kayonza, Ngarambe said. “If we were able to reduce the stunting rate by 14 percentage points in five years,” he said, “cutting another 9 percentage points will be easier.” As she tended to her lush, green garden, Vuguziga vowed her son would never slide back to the low nutrition status. “No parent wants a malnourished child,” she says, “So, I better take care of my greens.”

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‘Akarima k’Igikoni’: How vegetable gardens have reduced malnutrition and stunting in Kayonza