Preventing malnutrition among children in Rwanda during Covid-19: what has been done?

Despite widespread reductions in child poverty in Africa, malnutrition remains widespread. Rwanda is no exception. Progress has been made but more than one in every three children under five continue to be malnourished.

The recent Demographic Health Survey of 2015 [1]revealed that the prevalence of stunting (low height-for-age) among children under five dropped from 44 percent in 2010 to 38 percent in 2015. On the other hand, the nutritional data from the Rwanda 2018 comprehensive food security and vulnerability analysis report[2] indicated a slight decrease in national prevalence of stunting from 37.9 percent in 2015 to 35 percent in 2018. This report states that since 2015, Infant and Young Child Feeding Practices (IYCF) remain poor as only 17 percent of children under five achieved the minimum acceptable diet (MAD) based on dietary diversity and meal frequency. Only children between 6-23 month eating an average of three food groups per day twice a day. The same report indicates that children from poor households with food insecurity and or with three of more children under five were more likely to be malnourished. Despite the slight drop in the stunting rate recorded between 2015 and 2018, the report presents geographical location of malnutrition. Among thirty districts in the country eleven of them recorded stunting rate above the WHO critical threshold of which majority are found in the western province.

Considering these numbers, malnutrition among infants emerged as one of the vital issues discussed in the 2018 Government high level National Dialogue (Umushikirano) and was captured in the list of meeting resolutions that needed special and immediate attention. Government’s involvement in solving this health problem is a solution to putting an end to malnutrition among young children but also a long-term measure towards ensuring a healthy and a capable adult force that will sustain the economy.

In response, practical measures were adopted to boost low nutrition levels among children under five.

One such measures was the establishment of the National Early Childhood Development Programme, a separate national structure that coordinates efforts on combating malnutrition. It also included piloting and scaling up of programmes such as the Early Childhood Development Intervention Programme, the scaling up of nutrition products and the focus on first 1000 days of life (pre-pregnancy, pregnancy, and children under 5 years). Having nutrition of young children prioritised in the national development strategy with defined national performance targets monitored and reported on an annual basis is a commendable step towards the overarching goal for the Social Transformation Pillar under the National Strategy for Transformation one[3] “Developing Rwandans into a capable and skilled people with quality standards of living and a stable and secure society”.

However, Covid-19 has had a big impact on all aspects of life in Rwanda and the Government must make sure that the pandemic does not derail efforts to improve the wellbeing of Rwandans children. Covid-19 is not business as usual. These are not normal times. Rwanda recorded its first COVID19 case on March 14 2020, the government imposed nationwide lockdown to avoid overwhelming the capacity of Rwanda’s health system. The lockdown put both public and private activities at a stand-still with exception of only essential services. The confinement severed social ties that normally provide a shock absorber in times of crisis. Much of the economic activities in Rwanda are informal, such workers surviving on a daily wage were hit the most and the vulnerable in this situation were children and the elderly. The Government, having noted this challenge, has responded to address the vulnerabilities exacerbated by attempts to curb the spread of Covid-19.

Response measure one: Continued provision of nutritious products and treatment among the most vulnerable groups. 

Despite the national lockdown, Rwanda has set necessary conditions needed to maintain momentum on nutrition-related actions. The nutrition-sensitive direct support program under the childhood development program is among the core categories of social protection programmes in Rwanda. The programme provides healthy diets to children under two years of age, pregnant women and lactating mothers from lower wealth household quintiles – Ubudehe One and Ubudehe Two.

In normal circumstances, these nutritious commodities are distributed at health centres and the early childhood development centres. However, in response to lockdown restrictions, nutritious products have been distributed door-to-door within communities instead. Distribution is managed through decentralised structures of the Ministry of Health represented by the health centres in partnership with local government authorities and community health workers. In addition, the Government also introduced a national programme of providing three eggs per child per week for all children under five years of age. This was initially defined until June 2020 with potential to extend the timeframe. This programme launched In the Northern Province has rolled out across the country and intends to continue beyond Covid-19. By end of June, 250,000 eggs had been distributed to children across to the country costing 14 million Rwanda francs.

Response measure Two: Food Distribution among casual workers affected by Covid-19.

The Government of Rwanda, having recognised that there is a proportion of its citizenry who survive on a meager daily wage, unable to sustain themselves during the forced lockdown, and yet who have families to care for, has provided food rations for vulnerable casual workers. Rations account for household size and categories of household members as unique factors to determine the quantity and types of food to allocate per household. Households with children receive an additional ration of porridge and milk. This intervention has prevented both economic and nutrition crises during the pandemic.

Response measure Three: Securing food supply.

The government has also intervened in other sectors such as the agricultural sectors and some specific food manufacturing industries to keep them in operation, thereby preventing food shortage. These sectors are key stakeholders in the acceleration of nutrition improvement and play a crucial role in ensuring food security in the wake of the pandemic.

It is worthy to recognize the Government of Rwanda’s efforts to design and implement a national food support response plan only a week after national lockdown had been announced. Preventing hunger among children is vital for current and future wellbeing.

According to Evode Micyomyiza a nutritionist and BCC technical advisor, a one-week period of hunger may cause a child to become malnourished and at a certain age, the impact of malnutrition on the development of a child is irreversible. Some studies in Indonesia shows that for every dollar invested in the nutrition of a young child  will be returned about 48 dollars in improvement of health[4], education and economic development where as in the United Stated the returns was found to be 16 dollars for every dollar invested on child wellbeing[5].

The Government’s response during Covid-19 has helped to prevent an increase in malnutrition because of the pandemic. By doing so, the Government remains in a good position to meet its national goals defined under the social transformation pillar in the National Strategy for Transformation one “Eradicate all forms of malnutrition and other global goals on nutrition target for 2025 and a response to key relevant indicators of the Sustainable Development Goals (SDGs).

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[1] https://www.statistics.gov.rw/publication/demographic-and-health-survey-dhs-20142015-key-findings

[2] https://docs.wfp.org/api/documents/WFP-0000103863/download/?_ga=2.224784410.1294625559.1600071161-1625625251.1600071161

[3] http://www.minecofin.gov.rw/fileadmin/user_upload/NST1_7YGP_Final.pdf

[4] https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.12080

[5] https://www.unicef.org/earlychildhood/index_69851.html

“Let us all Strive to Give Justice to Children” A Reflection on the Day of the African Child

Every child has the right to live a healthy, protected, and supported life to live up to their full potential. However, in Africa, 1 in every 4 children lives in conflict.  Among the 375 million children impacted by conflict, 14% of them are in Africa.The Day of the African Child is a great opportunity to recognize significant contribution achieved at continental and national levels in promoting and protecting the rights of all children. At global level, a number of frameworks have been adopted on the subject matter including the convention on the rights of children, the African charter on the rights and Welfare of the child and the Geneva Conventions and their two additional Protocols. In the same spirit several UN resolutions, AU summit and peace and Security Council policy decisions and frameworks have been developed to protect the rights of children in conflicts. The Vancouver Principles launched in 2017 on the prevention of the recruitment and use of child soldiers to date have been endorsed by more the 100 countries across the world. The instrument has supported the global movement on raising the voice among member states to essentially commit to engage into actions that end wars on children and find sustainable ways to prevent the recruitment and use of child soldiers. It is important to highlight that Governments and other stakeholders on the continent are working together to achieve this vision.

While there is a lot to celebrate, the African child still face grave violations especially those associated to conflict. Wars are taking away children’s happiness to grow in families but above all children as young as eight years are being recruited and used as child soldiers denying them the opportunity to enjoy their childhood. Many children in Africa are left with no shelter or belonging. Today, the dynamics of war has changed. The center of these dynamics and tactics is the use of children which is an inhuman activity and extended terror to the African child. Recruitment of child soldiers constructs challenges in protecting children. It is therefore our responsibility to join efforts towards the eradication of any forms of violence on children and stigmatize the culture of the recruitment and use of child soldiers. The annual UN CAAC reported, 49,640 cases of boys and girls recruited and used as soldiers from 2005 to 2016. In 2016 alone, the UN new verified cases of child soldiers in Africa was 8,000. Protracted conflicts also expose children to other forms of violence. Statistics shows that between 2014 and 2018, 55,000 children experienced grave violations. In 2016 alone, 12 Million children were denied access to education because of war.  It is also reported that every child who is recruited is not reintegrated. This pause serious threat to the society and the future of the child.

The effects of war on children is insurmountable at individual, society, and the national levels. More so, girls and boys experience these effects differently. Rwanda is the first African country to endorse the Vancouver Principles and thus has certainly contributed to the achievement of the global call on the prevention of the recruitment and use of child soldiers during their UN peace keeping mission but also serves as a regional hub on the continent where nations across the globe gather to learn from Rwanda’s experiences in preventing and protecting children in conflict. Rwanda has framed the issues of children in armed conflict as a specific priority concern for the security sector, and particularly their recruitment and use as soldiers. The Dallaire Institute has had a long standing contribution towards achievement of these efforts through great cooperation with the Government of Rwanda on joint interventions implemented by the Rwanda Defence Force. At the Vancouver Principles workshop held in Kigali, 2019 the Minister of Defence of Rwanda, Mr. Albert Murasira emphasized on the importance of "Protecting children as a key to the future of humanity and attainment of sustainable Peace and Security Agenda on the continent but also domestically”. The child protection development approach taken by Rwanda is a great example to the world. Rtd Gen. Dallaire, founder of the Dallaire Institute for Children, Peace and Security during the same occasion alluded in his speech that "Protecting Children builds Hope for the Continent".  

Let us not forget that the extraordinary challenges of COVID19 pandemic has contributed to widening the gap on protecting the rights of children especially in countries burdened by civil wars and unending conflicts. These gaps therefore require global responses which only the re commitment of governments towards protecting of children can bring about a positive change in the lives of children. The Dallaire Initiative is committed to support global efforts that aim at ending violence that harm child soldiers. “We can’t achieve peace without protecting children from violence, and we can’t guarantee them justice if we don't stand up for their rights”, Dr Shelly Whitman the Executive Director of The Dallaire Institute Children, Peace and Security said at the Vancouver Principles Workshop, 2019 in Kigali.

This year’s theme on the Day of the African Child reminds us our common responsibility to give Justice to Children. Any form of violence committed against a child takes away their rights but, in most cases, justice is denied for children because they are voiceless. Therefore, failure to protect and care for children is denial to justice. Justice for children should not be a pre-requisite but a right and each one of us is accountable for not standing out for the rights of children. The national theme on this day encourages every Rwandan to become a Guardian Angel for children, “Malaika Murinzi” so that each child has a family that care for their well being.

Let us all join efforts and commitments towards promoting the rights of every child and make it a reality. For we can only achieve our sustainable development goals if we are able to reduce violence committed to children. We will continue to fight until one day we will make Recruitment and Use of Children Soldiers Unthinkable.

Fancisca Mujawase, Manager of Research and Evaluation for the Dallaire Institute for children, Peace and security. 

ACCOUNTABLE GOVERNANCE, A KEY VARIABLE IN THE EQUATION OF THE RWANDA'S SUCCESS STORY

Authors: Francisca MUJAWASE and Didas KAYITARE

Rwanda is a small country in terms of geographical size compared to many African countries but one of the sub-Saharan countries with a unique development approach which is defined and characterized by citizen oriented rapid economic growth that is designed and driven by Rwandans themselves. A country that faced unspeakable devastation of the 1994 Genocide against the Tutsi which caused loss of a million lives and left the nation in shambles. The post conflict story of Rwanda remains an exceptional success in history of the world. Many people are intrigued by the magnitude of resilience and the level of social cohesion among Rwandans and their urge for development.

My friends from all over the world ask me to lament the story of Rwanda and how the country managed to achieve remarkable development success in the last two decades and how the state managed to overcome all the challenges of reconstructing a fragile state that was left with nothing after the 1994 Genocide. My answer to them is relevant and driven by facts around three drivers of success shared in this paper. Rwanda is a country with “A GREAT VISION” which is driven by an outstanding Governance System and Accountability Practices that has shaped the style of leadership and service delivery practices. The new governance system originates from the Rwandan culture and the positive values that defines Rwandans and how they deliver. While speaking about the new approach of governance and the Rwandan culture, another important aspect of the Rwandan success is attributed to the human capital of Rwandans who gathered their experiences and efforts from across the globe and the region with different backgrounds to rebuild a nation that had been completely destroyed. 

In the past, the country had suffered bad governance that led to the killings of innocent Rwandans. The success of Rwanda however has proven that poor governance in not an African style of leadership but rather the theory stands for bad leaders who are self centred and want to own more than they deserve while others carelessly adapt to the wrong theories of governance that leads to conflict and wars. We have also witnessed sustained conflicts in other African countries that is mainly driven and associated to ethnicity and tribalism.

To change the history of Rwanda, HE Paul Kagame the President of the Republic of Rwanda introduced a new model of governance that is driven by protection and rule of law and set ACCOUNTABILITY at the core business of governance. To make sure these mechanisms are fully integrated in the governance system and bring about the significant amount of result the country intended to achieve, all public institutions had to adopt to the new approach of governance that is driven by transparent and accountability systems. Instruments such as Imihigo Performance Contracts, public finance management systems, decentralization governance program and citizen participation approaches were introduced and made functional.

The governance approach in Rwanda is unique in a way that every aspect that concerns the well-being of the people is a priority. The homegrown solutions have facilitated the development evaluation processes to ensure that the national development performance targets are achieved in an efficient and effective manner. The new structure of governance introduced not only reflects public service delivery but goes beyond institutional performance to describe progressive change in behaviour of the leaders and citizens accounting for the overall transformation of the Rwandan society.

In addition to the mentioned above, the new governance approach has shaped the model of development that is visionary, and citizen centred in the sense that all Rwandan citizens have equal access to public services which has never been the case before. It isn't easy to identify a single example of national development project that is outstanding because every sector has recorded its own success which all aligns to the vision of the country. However, some of the remarkable national projects introduced two decades ago that have had significant impact on the lives of the citizens include education and health financing as development priorities; the universal free 12 Year Basic Education and the universal health care services has directly impacted on health and education indicators that were unpleasant in the past. The social protection programmes for the poor households that aims at achieving zero extreme poverty by 2020, the one cow per poor family, massive infrastructural investment programmes have been significant contributors to poverty reduction among others. Other core programmes enjoyed by the citizens include peace and security, the country’s approach to unity and reconciliation after the 1994 Genocide against the Tutsi and remarkable economic growth has remained positive over the years. Gender equality success stories for Rwanda have become a best practice for many countries and child protection programme has been given the attention it deserves. 

“Rwanda has proved to the world that nothing is impossible if you are determined to bring about change especially on developments that touches the lives of the citizens”. The uniqueness about Rwanda is that political will is driven by high level commitment and immediate actions to solve issues that may hinder achieving development results. If the development targets aren’t met as planned, the leaders owe the president and the citizens an explanation on what delayed the process. This system of governance of holding leaders to account both at local and central level is unique, transparent and effective. The practice has changed the way leaders operate and deliver on their mandates. For they know if they don't fulfill their responsibilities, they will be put to account. This keeps them at their toes to deliver effectively. Imihigo and Umushyikirano are national platforms where an honest dialogue is held between the national leadership and the citizens on an annual basis to discuss on what has been achieved verses failures. Leaders who lack explanations for failures recorded at institutional level face the consequences. In the past we have witnessed immediate changes made in public offices after such gatherings are conducted.

Another valued concept of the governance approach on Rwanda is the level of citizen engagement in public programs. The process is positive because the citizens not only learn about their rights but also participate in selecting the urgent needs of the citizens at district level but also participating in the implementation and evaluation process of the development priorities. By doing so the government instils in the people of Rwanda the culture of working and participating in public programs but also improving their readiness to claim for services they are denied by their leaders.

Rwanda has been defined as a success story across the world. Her story is unique and incredible. The credit for the Rwanda’s success goes to the leadership of HE Paul Kagame and the Rwanda people who refused to be held with the bad history but rather came together to build a nation that is peaceful and enjoyed by everyone. Strong institutional mechanisms and individual capacities have been introduced are operational and functioning to ensure the country achieve sustainable peace and economic growth. Having achieved the MDGs at an outstanding level, the country is on the right path to become a middle-income country and the progressive achievement of the SDGs is promising. The current National Strategy for Transformation (NST) feeds the Vision 2030 which comes at the right time where Rwanda has changed the development approach that has embraced globalization with access to the utilization of new and advanced technological, and innovation driven business efforts. Several multi-national companies have been established in Rwanda supporting the great idea of inventing and working in Rwanda but also creating thousands of jobs to the youths. Education institute of sciences that shape the body of knowledge and development of human capital capabilities have been introduced in Rwanda which supports the vision of becoming a Knowledge based economy. some people like to debate about the vision of Rwanda as Ambitious but i like saying, "yes the vision of Rwanda is ambitious but achievable because we set the pace on which we deliver”. with the unique approach of governance and accountability system, there is no doubt the country is yet to achieve more than expected in the new decade.