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Supporting maternal, infant and young child nutrition in the context of COVID-19: the Rwanda risk communication and community engagement (RCCE) response

This is a summary of a Field Exchange field article that was included in issue 65. The original article was authored by Annet Birungi, Ken Limwame, Desire Rwodzi and Youssouf Koita

Annet Birungi is a Communication for Development Specialist at UNICEF Rwanda.

Ken Limwame is currently working on the COVID-19 RCCE in the Middle East and North Africa with the UNICEF Regional Office.

Desire Rwodzi is a former Knowledge Management Officer for the Nutrition Section with the UNICEF Eastern and Southern Africa Regional Office (ESARO).

Youssouf Koita is the Chief of Nutrition Section at the Rwanda Country Office.

To tackle COVID-19-related nutrition misconceptions, Rwanda quickly developed a risk communication and community engagement strategy. Central to the strategy’s success was:

  • A centralised coordination structure led by the Ministry of Health
  • Use of existing strategies and available data to develop key nutrition messages to address knowledge gaps and dispel myths and misconceptions related to nutrition and COVID-19
  • Capacity strengthening and training of community health workers using remote platforms
  • Engaging members of parliament and the use of a wide range of communication channels to deliver nutrition messages, such as radio talk shows and social media platforms

Approach

Nutrition interventions in Rwanda continued during the COVID-19 pandemic as directed by the Government of Rwanda and the United Nations National COVID-19 Joint Taskforce. Programme adaptations were developed to ensure that nutrition activities, such as growth monitoring and severe acute malnutrition (SAM) treatment, continued with minimal risk to staff. Implementing an effective risk communication and community engagement (RCCE) response was critical to the continuation of nutrition services. This provided Rwandans with continuous access to accurate information about the pandemic, including the related impacts on nutrition, and allowed them to make appropriate decisions to protect their own and their family’s health.

Development of Rwanda’s RCCE strategy

The COVID-19 RCCE strategy was developed by the Ministry of Health (MoH) and nutrition partners, including UNICEF. The following activities were central to the strategy’s development and success:

Led by the MoH, two sub-committees were set up to develop and implement the RCCE strategy. One focused on nutrition data management and the other on social behaviour change and communication.

The RCCE strategy was built upon the national plan for Ebola preparedness. Information from government reports, mainstream media and social media reports was used to identify knowledge gaps and perceptions on nutrition and COVID-19, as well as any related myths and misconceptions. This information was supplemented with insights from community health workers (CHWs) and used to generate key maternal, infant and young child nutrition (MIYCN) messages in the context of COVID-19 and to develop related information, education and communication (IEC) materials (see Box 1). These were revised regularly as the pandemic shifted.

Box 1: Main themes of the information, education and communication (IEC) materials

  • Breastfeeding in the context of COVID-19
  • Precautions for pregnant and lactating mothers
  • Feeding and care practices for newborns with suspected/confirmed COVID-19
  • Precautions needed during delivery and immediately after birth
  • Precautions to be taken during breastfeeding
  • When and why a mother should express breastmilk
  • Safe complementary feeding
  • Food safety, handwashing and sanitation
  • Appropriate care and feeding practices for infants and young children

Since COVID-19 was a new and ever-changing disease, the training and capacity strengthening of nutrition staff and CHWs was essential. This was achieved through simplifying digital MIYCN training material and conducting remote training using Zoom, WhatsApp, email and telephone conversations. In a report produced by the Rwanda Biomedical Centre in December 2020, CHWs reported being confident in conducting nutrition counselling, growth monitoring and home visits during the pandemic as a result of the training.

To ensure broad engagement, nutrition messages were shared widely across all available communication channels. These included print and electronic media (WhatsApp, group emails and virtual/telephone briefings) as well as mass media communication channels such as community radio stations. Members of Parliament (MPs) were engaged to share nutrition and health messages through local radio stations. During radio talk shows, MPs were able to discuss issues related to food security and MIYCN as well as to answer listeners’ questions. Media channels were also used to share testimonials from mothers to address rumours and misinformation.1 The UNICEF-led initiative, Internet of Good Things, was used to reach those with low connectivity.

Results

Results in several key areas suggest the success of the RCCE strategy:

Challenges

Conclusion

As the COVID-19 pandemic continues, it is vital to continue adapting RCCE messages, broadening ways of communicating and tackling myths and misperceptions. Vital learnings that will inform this process include:

As a next step, the Government of Rwanda intends to conduct a rapid assessment to understand the impact of RCCE messages on behaviour and further support improvements to nutrition-related RCCE interventions.  

For more information, please contact Annet Birungi at abirungi@unicef.org

 

Read more...

[1] ‘COVID-19: A Good Friday as New Cases in Rwanda Decline and a Baby is Born’ https://www.ktpress.rw/2020/07/covid-19-a-good-friday-as-new-cases-in-rwanda-decline-and-a-baby-is-born/

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Annet Birungi, Ken Limwame, Desire Rwodzi and Youssouf Koita (). Supporting maternal, infant and young child nutrition in the context of COVID-19: the Rwanda risk communication and community engagement (RCCE) response. FEX 65 digest , November 2021. www.ennonline.net/fexdigest/65/covid19rwanda

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