In 2018, Rwanda and the World Bank launched the Stunting Prevention and Reduction Project (SPRP) to speed up the government’s efforts to reduce the national stunting rate to 19 per cent in 2024.
The $55 million (then approx. Rwf46bn) project contributed to the reduction in the stunting rate among children under five years of age, with a focus on those under two, in 13 districts with the highest stunting rates as well as pregnant and breastfeeding women. The project will run until 2025.
The target districts are: Nyabihu, Ngororero, Karongi, Rubavu, Rutsiro, Rusizi, Nyamagabe, Huye, Nyaruguru, Ruhango, Gakenke, Kayonza and Bugesera.
It supported community-based approaches, improved the delivery of high-impact nutrition and health interventions, incentivized frontline community health workers and health personnel, strengthened accountability mechanisms, and promoted behaviour-change approaches.
The interventions supported by the SPRP include the distribution of fortified cereal flour known as Shisha Kibondo, which is given to expectant and breastfeeding women from the low-income categories to complement their diet.
There is also the Early Childhood Development (ECD) programme that aims to ensure proper breastfeeding until a child is two years old, and feeding a balanced diet until they are five years old, among other things, to prepare children for primary school.
Apart from preschool services offered at ECD centres, children are fed eggs, milk and food supplements, such as porridge.
The SPRP project supports behaviour change campaigns that encourage households to plant vegetable gardens and fruit trees, as well as encouraging men to prioritise the wellbeing of their children instead of making it a responsibility of only women.
The project also supports antenatal care services offered at every health centre. Pregnant women attend antenatal care (ANC) visits to the health centres to prevent the child’s risk of stunting.
During these ANC visits, they get iron and folic acid tablets for the pregnancy. These tablets help women prevent anaemia and stunting in babies during pregnancy.
Also supported by the SPRP are the activities of community health workers deployed at every village, as well as growth monitoring and malnutrition screening exercises.
Results of SPRP
The national rate of stunting declined from 38 per cent in 2015 to 33 per cent in 2020, according to the Demographic and Health Survey of the National Institute of Statistics of Rwanda.
Within that period, six out 13 SPRP target districts recorded more than 10 per cent decreases (see chart). Some of these include Nyamagabe which recorded an 18-percentage point decline in the stunting rate from 51.8 per cent to 33.5 per cent. Nyabihu reduced the stunting rate from 59 per cent to 46 per cent; Kayonza reduced the stunting rate by 14 percentage points, from 42 per cent to 28 per cent.
Stunting decreased by 11 percentage points between 2010 and 2020, but more effort is needed to reach a targeted 19 point by 2024.