The Public Accounts Committee (PAC) has pinned the former National Early Childhood Development Program (NECDP) for failing to manage its supply chain system which could adversely affect the country’s ambitions to reduce malnutrition.
A recent Cabinet meeting approved changing the NECPD to a National Child Development Agency (NCDA) and charged with improving child nutrition and early development.
Fortified Blended Food (FBF) known as “Shisha Kibondo” is a product produced by Africa Improved Food (AIF) that is distributed in all health centres countrywide through district pharmacies (currently Rwanda Medical Supply branches).
FBF is given to children from 6 to 23 months old, pregnant and lactating women that are economically vulnerable in all districts.
Details presented during the PAC hearing on NCDA this September 5, 2022 showed that little is being done to ensure the beneficiaries get the supplies on time and also that there is not systematic management of stocks leaving some beneficiaries waiting and going without fortified foods for weeks.
For instance, PAC showed cases where 150 children in Muhoza sector in Musanze district didn’t get fortified foods for two months in 2020 and 65 mothers missed out in six months from 2019-2020 while in Cyanika in Burera district 140 children didn’t get it in a month and 45 other women likewise spent three months hanging.
At Musha and Nyakariro health centers in Rwamagana district, 148 women (67 pregnant + 81 lactating women enrolled in the program did not obtain expected Fortified Blended Food (FBF).
Review of available documentation from eighteen district pharmacies revealed insufficient supply of FBF compared to quantity requisitioned by district pharmacies as described below.
On FBF for children, it was noted that out of 3,302,310 Kgs of FBF requested, only 2,279,214 Kgs were received by district pharmacies. The quantity of FBF not supplied to the district pharmacies is totaling 1,023,096 Kgs, representing 31% of total FBF requisitions.
For FBF of pregnant and lactating women, it was noted that out of 1,251,681Kgs of FBF requested, only 659,628 Kgs were received by district pharmacies. The quantity of FBF not supplied to the district pharmacies is totaling 592,053 Kgs, representing 47% of total FBF requisitions.
Article 15 of FBF guidelines No 003/NECDP/2018 specifies that each head of Health center is responsible to enroll the eligible beneficiary of Fortified Blended Food in FBF tracking system (module of HMIS).
District pharmacies consolidate all the requisitions made by health centers in the district based on the number of eligible beneficiaries and related quantities of FBF needed and submit the consolidated requisition to NECDP using Electronic Logistics Management Information System (ELMIS).
NCDA didn’t have matching data on the quantiles supplied to the one received in the stocks and none of the officials could submit the stock files during the OAG audit visit.
PAC said that there is no data base of beneficiaries supported in the program, yet NCDA claimed they have it and submitted it after the audit.
The commission also showed that NCDA officials met with the FBF producer (AIF) and were advised to pick up the fortified food within a month of production but the pickups were delayed and likewise were the supplies to beneficiaries.
MP Christine Bakundufite said that NCDA spent four weeks before submitting what the OAG’s requested, which is “a possible sign they were forging the records.”
“The Director General was not outside the country and you were informed of the audit, how come you didn’t submit?” Bakundufite asked.
Nadine Umutoni Gatsinzi, the NCDA Director General said they work with many organs who delay but now the entry of data on stocks is being done on time.
Gatsinzi also noted that the FBF shortages were cause of budget limitations and transport challenges but assured that the problem was solved.
Besides Shisha Kibondo, One cup of milk program is implemented countrywide targeting malnourished children aging between 6 and 59 months.
A review of available documentation of milk supply in two (2) districts (Bugesera and Gisagara) revealed that out of 158,565 litres of milk ordered, only 140,691 litres were supplied. Hence, 17,874.5 litres, representing 11%, were not supplied to districts.
PAC also showed that there are shortages and unused Early childhood development (ECDs) despite the government plans to have an ECD in each sector and cell.