Rwanda’s stunting trends reduced from 38% (in 2022) to 33% to date and the country is looking at attaining a 15% target by 2029 as indicated in the 2nd National Strategy for Transformation (NST2).
While other districts could be struggling with reducing cases of malnutrition, community-based innovative models have been deployed in Huye district with a sustainable impact that can be replicated.
It all started in 2017, with Benedictine nuns sitting down with the Sovu community to find a love and faith based practical solution to address the issue of malnourished children.
At the meeting held at Sovu health center-a facility managed by the Benedictine Sisters, it was discovered that while most of the children were getting nutrition food supplements there was lack of follow up and the children who were brought to the center (for attention), instead added a financial burden to their parents.
This was the birth of the “Kundwa Kibondo” (love a child) initiative- a multi-faceted comprehensive community-based approach which has three components-pooling funds for children’s eggs, empowering health worker’s associations, and ‘god parenting’ where officials take in affected children under their wings.
This initiative involves all health workers, health center and administrative officials- who contribute between Rwf100 and Rwf500 monthly to pool funds into the “Igi ry’Umwana” (An Egg for A Child) initiative.
Collected funds are saved in a local savings and credit financial scheme which is managed by the Head of Mother and Child Health program and according to officials, these funds are used for different purposes.
“We collect contribution, which are used to take care of the malnourished children staying at the health center, where we provide not only an egg per child, meals, hygiene equipment but support their needs to reduce the financially burden of parents,” says Sister (Sr) Solange Uwanyirigira, the health center Director.
Sr. Solange Uwanyirigira (right) and staff at a MCH visitation
Through the intervention of Community Health Worker (CHWs) associations, the fund’s savings are also used to address village level nutrition needs such as building vegetable gardens, providing seeds and fertilizers for families to have access to nutritious food varieties.
Beathe Mutesire, the MCH Program and account manager said that the center has a vegetable demonstration farm where CHWs and parents are given hands-on skills on how to grow and feed their children with greens- which makes it cheaper to afford instead of worrying about purchasing them in the market.
“After gaining skills, the health workers work with their respective communities to replicate the models. This requires financial support and depending on the needs, we agree on how to fund their nutrition projects” said Mutesire.
Data from Sovu nutrition program shows that since the establishment of the Kundwa Kibondo initiative with 64 children who recovered from acute malnutrition, the sector has since January-December 2024 not recorded any case due to the above interventions.
Kundwa Kibondo health workers
This success leads us to the ‘god-parenting’ component, in which health and administrative officials take one or two formerly malnourished children under their personal responsibility, care, and follow up on progress made after leaving the center.
At Sovu, they found out that while children and mothers get nutritional support, there was lack of follow up at some levels in feeding, in hygiene and maternal healthcare especially attending recommended 8 pregnancy consultations.
“These become the responsibility of god parents to monitor all these aspects and some of them even take it further to support the children’s education and welfare. This is what creates impact,” Uwanyirigira said.
Prof. Luk Cannoodt
Belgian nationals- Prof. Luk Cannoodt and spouse- Claudine Mukeshimana(RIP) started the Umubano IMPORE (Improving Maternal and Pediatric Outcome: the Rwandan Experience) with an approach to address stunting that is built on supporting existing healthcare systems in Huye district.
This was after research findings (2015) indicated that 20% of low weight babies (LBW) discharged from Kabutare District Hospital to go home, died within 2 years after and 75% malnourished.
The organisation initiated the Reducing Infant Mortality and Malnutrition Among Preterns (RIMMAP) program which collaborates with the hospital to use available data to identify post neonatal newborns (with less than 2000 grams), children under 5 years and their parents.
Once they have this information, the organisation visits the families, assesses their needs to provide nutrition, welfare, and child growth support needs,but also follow up on their progress to prevent deaths, malnutrition and stunting as they grow up.
“Most of them come from very far away. So we provide them with transport fees and some of them stay at the NGO house (Chez Marianne) to enable them get to the hospital in time,” Cannoodt said.
Statistics show that these interventions have increased the number of mothers visiting health facilities for check ups, and numbers of child mortality have reduced.
“For example, when we started there were 20% infant deaths and now it is only 2%. That means we must have saved about 200 babies. More that 1,093 have grown up to more than one year old and only 37% still malnourished,”
To empower beneficiary mothers, the organisation set up the Mothers Against Malnutrition Associations (MAMAs) self help groups where mothers work together to grow vegetables, monitor child malnutrition and growth which has seen 96% of the children no longer malnourished in the 500 families so far.
Sustainability:
Huye district Mayor, Ange Sebutege said that these local initiatives have enabled the district to reduce malnutrition cases from 42.6% (2015) to 29% in 2020 (DHS) and now at 16.1% (as of 2024), thus more innovations need to eliminate stunting cases.
Sebutege also revealed that these initiatives have been a model for others and have been replicated or re-modified in other districts in the southern province.
