Introduction

•In Rwanda, chronic under-nutrition and micronutrient deficiencies remain important public health issues. DHS 2015 found

38% prevalence of chronic malnutrition. Among the complex underlying causes are lack of diverse diet, limited knowledge

about nutrition principles and appropriate complementary feeding practices, small plot sizes, and lack of financial resources to

purchase nutritious foods.

•Through its EKN project, CRS/Rwanda is applying the integrated approach to address these interlinked challenges in support

of the Government of Rwanda’s national priority to eliminate malnutrition. The integrated approach is a flexible, effective

methodology which CRS has applied in programs including KGM Coffee Livelihoods and Higa Ubeho, which targeted,

respectively, smallholder coffee growers, and OVCs and pregnant and lactating women and children under five.

•During the first year of EKN, a series of activities were implemented in collaboration with government counterparts to set up

multi-sectoral coordination mechanisms, build capacity of service providers, improve BCC, and implement activities to

improve food security and resilience for vulnerable households with children under two and pregnant and lactating women.

EKN activities were written into district officials’ performance contracts, and this facilitated collaboration between CRS and

government stakeholders, a critical component of project success.

Abstract

One of Rwanda’s biggest development challenges is to secure sufficient and healthy food for all, especially for children under

two years and to do so in an environmentally sustainable manner. This review explores the interrelationships of food, health,

and environment, and their role in addressing chronic malnutrition, or stunting. CRS has scaled up its integrated approach

aiming at improved diet diversity and incomes to reach household level. Sustainability of the integrated approach to reduce

stunting depends upon community ownership and support of local leaders.

Methods

EKN interventions were implemented through the

CRS/Rwanda integrated approach, which includes the

combination of nutrition through Village Nutrition Schools

(VNS), agriculture and food security through Farmer Field

Learning Schools (FFLS), and economic strengthening

through savings and internal lending communities (SILC).

Groups are led by volunteers linked to government

extension services.

FFLS is a participatory learning-by-doing approach by

which 20-30 beneficiaries learn through field observations

and experimentation of improved bio-intensive agricultural

techniques (BIAT) to increase household crop production

even on small plots.

CRS developed Village Nutrition Schools (VNS) as a

community-based approach built on the Positive Deviance

Hearth (PD/H) methodology to increase group members’

knowledge to quickly rehabilitate malnourished children and

prevent future cases of malnutrition.

To address stunting, CRS Rwanda applied PD/Hearth, a

globally recognized methodology for identifying positive

deviant practices found for recuperating children who are

moderately malnourished. As VNS seeks to sustain nutrition

gains through socio-economic changes, this approach

encompasses nutrition activities, such as growth monitoring

and nutrition education, along with agriculture and financial

education and savings. Applying BIAT will improve

productivity, while SILC is a mechanism for increasing

household access to income and assets.

•Activities under VNS focus on improving nutrition during

the first “1,000 days of life, a window of opportunity”

through promotion of locally available, culturally

appropriate, and affordable food products while at once

promoting behavior changes including hygiene, dietary

practices, and health care.

Author: Odette Uwera Kamanzi, CRS – Rwanda, EKN Project Director

CRS – Rwanda Integrated approach as a strategic support to reduce stunting

Districts targeted in the CRS integrated

approach through EKN-funded project

Cooking demonstration session

Growth Monitoring session

Farmer Field Learning Schools (Learning by doing)

Feeding practices session

Example of food processing: soya into milk by mothers

Promotion of hygiene practices/handwashing

The final step of implementation of EKN project is to measure the percentage of

beneficiaries who adopt practices learned from FFLS, VNS and SILC in their

household.

CRS - RWANDA Theory of Change

Savings and Internal Lending Communities (SILCs) are a type of

community-based savings groups promoted by CRS and its partners

and provides a safe place for its members to save and obtain credit

for small businesses.

= Household

adoption

Findings

CRS’ experiences with the adoption of integrated approach activities at household level has led to

the following results.

The May 2015 KGM final evaluation found that among 3,600 small-scale coffee producing

households:

• Household income from non-coffee IGA increased from $66 to $213.2.

• Vulnerable smallholder HHs increased food security from 7.3 months to 9.9 months

• Households increased dietary diversity scores from 2.9 to 4.5

• Farmers increased production of food crops per household from 241kgs to 708kgs

• Vulnerable households increased in good sanitation from 56% to 79.8%

The Higa Ubeho final evaluation (2008-2013) found that:

• 51% of beneficiaries initiated IGA and 50% of them purchased health insurance

• 98% of household retained more than one small animal

• 99% of households had a year-round kitchen garden

The EKN nutrition project is currently in its second year and uptake at HH level is ongoing. Its

2014 annual report showed that:

• 859 FFLS groups established (98.8%) and received vegetable seeds, bio-fortified crops and

agriculture tools

• 859 VNS groups established (98.8%) and received cooking demonstrations kits

• 859 SILC groups created (98.8%) and are functional

• 40% have adopted BIAT, nutrition best practices and SILC in their households

Discussion and Conclusions

When best practices from BIAT, VNS and SILC are adopted at household level, good nutritional

practices, income and crop production increase at household level. Close collaboration with

government structures at all levels contributes to achieving project results and longer-term community

commitment to ending malnutrition.

Acknowledgements

Acknowledgements and sincere appreciation to Bridget Kimball, CRS – Rwanda and Burundi Head

of Programs, and Grace Funnell, CRS - Nutrition Regional Advisor, who have generously

contributed to the development of this poster. We are sincerely grateful!

Catholic Relief Services – Rwanda gratefully acknowledges the generosity and support of the

Government of Rwanda, the Embassy of the Kingdom of the Netherlands, UNICEF as donors who

have supported CRS to provide services to vulnerable people in Muhanga and Karongi districts. We

appreciatively acknowledge their generosity.