Menu ENN Search

Understanding how Rwanda created an enabling environment for improvements in nutrition

View this article as a pdf

Research snapshot1

Rwanda has made substantial progress in reducing malnutrition, with reductions in stunting and anaemia of 14 and 15 percentage points respectively between 2005 and 2015. However, stunting reduction has been uneven across the country and prevalence remains very high at 38%. To facilitate further progress, a ‘stories of change’ study was conducted to identify drivers of stunting and anaemia reduction and potential barriers and facilitators to future progress in Rwanda. Qualitative methods included semi-structured interviews with 90 key stakeholders in nutrition, and 40 focus-group discussions with community members in five districts that experienced reduction in stunting and five that did not. Quantitative data from Demographic and Health Surveys (2005, 2010 and 2015) were also analysed. 

Key drivers of change based on the qualitative data were: leadership, peace and security and decentralisation of government; political commitment to nutrition and multi-sector programming, facilitated by national policy (in particular the National Food and Nutrition Policy 2013-2018) and nutrition coordination mechanisms; and increased provision of community-level, nutrition-related services and programmes, especially in health and agriculture (e.g. nutrition counselling, antenatal care, kitchen-garden programmes). Quantitative data revealed that factors that contributed most to reduced stunting were related to maternal health, including quality of prenatal visits; proportion of women giving birth at a health facility; and the number of children a woman had. Household wealth, parental education and insurance coverage were also important.

Districts without reduced stunting had weaker horizontal and vertical coherence of policy and programming; less robust, multi-sector and integrated monitoring and evaluation for nutrition; and decreased food availability at community level. For further improvements, Rwanda must keep up the momentum of positive change and further strengthen existing plans, systems and approaches. Remaining challenges must also be addressed, including those around financial constraints; gaps in policy; institutional, horizontal and vertical coherence and monitoring and evaluation for nutrition; and community-level issues such as poverty, food security, gender relations and health, nutrition, and water, sanitation and hygiene practices.

Read more...

Endnotes

1Iruhiriye, Elyse; Olney, Deanna K.; Ramani, Gayathri V.; Heckert, Jessica; Niyongira, Emmanuel; and Frongillo, Edward A. 2019. Stories of Change: Rwanda: Understanding how Rwanda created an enabling environment for improvements in nutrition and the challenges that remain. Stories of Change Rwanda Program Brief 1. Washington, DC: International Food Policy Research Institute (IFPRI). https://doi.org/10.2499/p15738coll2.133378

More like this

FEX: How countries can reduce child stunting at scale: lessons from exemplar countries

View this article as a pdf Summary of research1 Location: Nepal, Ethiopia, Peru, Kyrgyz Republic, Senegal What we know: Global levels of stunting remain unacceptably high;...

FEX: Impact evaluation of a nutrition-sensitive social protection programme in northern Nigeria

View this article as a pdf Lisez cet article en français ici By Caroline Antoine, Stella Esedunme, Céline Sinitzky Billard, Sabi'u Suleiman Shehu and Gladys...

NEX: Nourishing Millions and Stories of Change in Nutrition

Statistics are important in fighting global hunger and malnutrition, but it is also critical not to forget the names, faces and stories of those who experience them first-hand....

en-net: Concern is looking for a consultant for Zambia to design baseline survey and monitoring tools

Realigning Agriculture to Improve Nutrition (RAIN+) Terms of Reference for a Consultancy to Design a Baseline Survey and Monitoring Tools and provide analysis and...

Resource: Zambia’s First 1,000 Most Critical Days Programme: a case study

Executive summary It is more than ten years since Zambia joined the Scaling Up Nutrition (SUN) Movement. The country is now in the second phase of its flagship stunting...

FEX: Global Hunger Index Report

The 2014 Global Hunger Index (GHI) report - the ninth in an annual series - presents a multidimensional measure of national, regional, and global hunger in the shape of the...

FEX: Triple trouble: The triple burden of child undernutrition, micronutrient deficiencies and overweight in East Asia and the Pacific

View this article as a pdf Research snapshot1 Young children in East Asia and the Pacific region are failing to thrive in large numbers as indicated by stagnation in the...

FEX: Building a case for causality through the NCA approach in Satkhira, Bangladesh

Marijka van Klinken, Matthew Parnaby, Paulina Acosta and Julien Chalimbaud Marijka van Klinken was the NCA Analyst conducting this study. She holds an MSc of Public Health...

FEX: Impact evaluation of a DFID programme to accelerate improved nutrition for the extreme poor in Bangladesh

Summary of evaluation1 Location: Bangladesh What we know: There is little evidence of the impact of integrated livelihoods and nutrition programmes. What this article adds:...

FEX: Higher heights: a greater ambition for maternal and child nutrition in South Asia

Research Summary 1 Poor nutrition in early life threatens the growth and development of children, which has a knock-on effect on the sustainable development of nations. This...

en-net: Deputy Director of Implementation (Africare Project in Tanzania)

Deputy Director Implementation (DDI) USAID funded MWANZO BORA NUTRITION Program Client: Africare ([url]http://www.africare.org/[/url]) Location: Dar Es Salaam,...

en-net: IYCF inteventions impact on Stunting

Dear friends, I really appreciate If you can provide me list of documented success stories where IYCF programmes implemented and 'significant' gains in reduction of Stunting...

FEX: Assessing progress in implementing Uganda’s Nutrition Action Plan: District-level insights

Summary of Research1 Agaba E, Pomeroy-Stevens A, Ghosh S and Griffiths JK. Assessing Progress in Implementing Uganda's Nutrition Action Plan: District-Level Insights. Food and...

FEX: Research snapshots

Factors influencing pastoral and agropastoral household vulnerability to food insecurity in Kenya Kenya has a population of more than 38 million, 10% of whom are classified as...

FEX: The REFANI Project in Pakistan: adapting research to a multi-sectoral programme for impact measurement

By Zvia Shwirtz, Bridget Fenn, Riccardo Mioli, Ghulam Murtaza Sangrasi and Maureen Gallagher Zvia Shwirtz is currently the REFANI Communications and Research Uptake Officer,...

FEX: Undernutrition risk factors and their interplay with nutrition outcomes: nutrition causal analysis pilot in Kenya

By Kristy Manners, Muriel Calo, Imelda Awino and Jacob Korir Kristy Manners specialises in Nutrition and Public Health and has worked extensively in the horn of Africa. She is...

FEX: Recommendations for multi-sector nutrition planning: Cross-context lessons from Nepal and Uganda

By Amanda Pomeroy-Stevens, Heather Viland and Sascha Lamstein Lisez cet article en français ici Amanda Pomeroy-Stevens is a Research and Evaluation Advisor on the...

FEX: Improving nutritional outcomes of rural households through a community-based approach in Ethiopia

This article has been updated since the original version was published in March 2020. View this article as a pdf Lisez cet article en français ici By Haimanot Abebe,...

FEX: Adolescent nutrition in Mozambique: putting policy into practice

Research By Erin Homiak Erin Homiak MPH is seconded to SETSAN Manica as Nutrition Advisor. Her role is funded by UKaid/DFID. She has been working for Concern Worldwide since...

FEX: Global Nutrition Report

This Global Nutrition Report (GNR) is the first in an annual series. It tracks worldwide progress in improving nutrition status, identifies bottlenecks to change, highlights...

Close

Reference this page

Understanding how Rwanda created an enabling environment for improvements in nutrition. Field Exchange 61, November 2019. p39. www.ennonline.net/fex/61/enablingenvironment

(fex.61.561)

Close

Download to a citation manager

The below files can be imported into your preferred reference management tool, most tools will allow you to manually import the RIS file. Endnote may required a specific filter file to be used.