Formative research, pilot study, and phased national scale-up of home fortification with micronutrient powders programme for children 6 to 23 months (supported by the Embassy of the Kingdom of the Netherlands through UNICEF Rwanda, the Ministry of Health and the University of British Columbia) 

Background

Great progress had been made in terms of poverty reduction and social development since the 1994 genocide in Rwanda, yet improvements in household food security and child nutrition have been slow (Rwanda DHS 2010, 2012; Rwanda DHS 2014-15, 2015). The prevalence of stunting remains high at 38% of children under five and anaemia has only decreased by 1% since 2010, with 38% of children under five categorized as anaemic (Rwanda DHS 2010, 2012; Rwanda DHS 2014-15, 2015). Adequate nutrition for children is recognized as essential to sustainable national development in Rwanda. Recognizing this, Rwanda’s National Food and Nutrition Policy states that ‘strategies [are] needed to solve serious and persistent problems including the high prevalence of child stunting and high levels of anaemia in children and women’ (National Food and Nutrition Strategic Plan 2013-2018, 2012). An environment in which current theoretical frameworks behind implementation science could be aligned with operational methodologies was presented in Rwanda where the government is highly supportive of evidence-based nutrition interventions.

Our work

Since 2011, our team has provided technical support to UNICEF and the Government of Rwanda to develop the world’s first national most successful home fortification with MNP programmes, with a coverage rate of nearly 90% in the 19/30 districts covered by the intervention at the end of the initial scale up in 2016. The Nourish team has designed the programme development through the formative research, pilot programme and effectiveness study, and the phased national scale-up. We developed country specific packaging, brochures, training materials and a policy brief along with other communications materials. The local name, Ongera Intungamubiri, was also incorporated into a song which is used in mother’s group meetings on how to improve the nutrition and health of young children. Currently the programme has been scaled up to all 30 districts representing the first country where all children will receive the vitamins and minerals needed for growth and development in the period of life from 6 – 23 months of age.