Health experts say that good nutrition is a cornerstone of child survival, health and development, while malnutrition in childhood and pregnancy has many adverse consequences for child survival and long-term well-being.
Rwanda has made a significant progress in eradicating malnutrition and fighting stunting, where, according to the Demographic Health Survey (DHS,2020), the percentage of stunted children under the age of five dropped from 38 per cent to 33 per cent in five years ranging from 2015 to 2020.
However, there is need for sustained efforts to reach the national target of reducing stunting prevalence up to 19 per cent in 2024.
This will only be possible through paying special attention to Early Childhood Development as an entry point to delivering health interventions, inter-sectoral activities from national to the village, and introducing age-specific packages and regular supplementation and education to the families of malnourished children.
It is in this context that USAID Rwanda funded "GIKURIRO KURI BOSE” programme which aims at promoting health and nutritional status of women of reproductive age and children under six years of age.
It also aims at strengthening inclusion of children and adults with disabilities, through its existing partnerships with the government and communities, through its unique approach, the ‘Nurturing Care Hubs’, a village-based centre where children and mothers receive such services.
Gikuriro Kuri Bose was launched in March 2022 through partnership with the government especially the National Child Development Agency and the National Council of persons with Disabilities to build capacity of village based volunteers to follow up on the nutrition, and wellbeing of mothers and children including those with disabilities and promote the early childhood development of children with the focus on the first 1000-day of a child, as a window of opportunity.
The volunteers include Community Health Workers, caregivers, model parents and the Community Based Rehabilitation Volunteers
At the Nurturing Care Hub, children and mothers are able to get services such as brain stimulation, growth monitoring and malnutrition screening, nutrition counseling, early learning, positive parenting education and promotion of social and emotional skills.
Parents also form saving and lending groups, where they can access a loan to invest in income generating activities as well as purchase nutritious food for their children.
Other services accessed at hub include those offered to people with disability where volunteers create awareness and assess people with disability and through the existing partnership with hospitals, severe cases are referred to hospitals for further support and treatment.
Adeline Mukabayizi, a mother who benefits from Rwinkuba Nurturing Care Hub in Nyamasheke District said that the facility has been instrumental in empowering parents in her village have been able to get skills on childhood development, among other services.
"We learnt that feeding children isn’t enough, they must be fed right. We have to go an extra mile to feed our children with a balanced diet and the children are now happy and healthy,” she said.
This year, Gikuriro Kuri Bose was able to work with the community to renovate 124 Nurturing Care Hubs across the 10 districts where the programme operates.
To ensure ownership and sustainability, the construction of the hubs is done by the community, then Gikuriro Kuri Bose supports with industrial materials such as iron sheets, doors and windows, glasses, cement, sand and paint, among others.
Angelique Mukarwubaka said that children at the hub have time to play together and learn basics and be able to feed well. She said that the hub is inclusive even for children with disabilities.
"We are encouraged to take care of them since all the children are the same,” she said, which is a departure from the old practice where children with disability were mostly locked up in homes.
In an Interview with The New Times, Appolonie Mukamasabo, the Mayor of Nyamasheke said that as per the 2020 survey, the stunting rate in the district was at 37.7 per cent (DHS,2020) but due to the different interventions, it is significantly reducing.
"We are working with different stakeholders, especially the Gikuriro Kuri Bose programme which is establishing inclusive Nurturing Care Hubs, where parents are trained on how to prepare a balanced diet and take care of their younger ones,” she said.
Mukamasabo added that the saving and lending groups started by parents at the hubs are allowing them to be able to buy chicken, which helps them get nutritious foods like egges for their children.
"We will continue to work with the programme to promote initiatives that improve families’ wellbeing.”
According to Dr. Alemayehu Gebremariam, the Chief of Party for Gikuriro Kuri Bose, parents need to understand their primary role in raising healthy children and other stakeholders can only come in to supplement their efforts.
The Gikuriro Kuri Bose programme also promotes male engagement in nurturing care and positive masculinity, where fathers are encouraged to support and help mothers in nurturing care.
In villages where the hubs are yet to be established, Gikuriro Kuri Bose works with NCDA and local authorities to promote home based ECDs, where all the integrated nutrition and child early development services are provided in a home setting.
The 5-year USAID Rwanda programme is implemented by a consortium led by Catholic Relief Services (CRS). Other organization members are Humanity and Inclusion, Umuhuza, Three Stones International and University of Global Health Equity (UGHE).
At the field level, the programme is implemented by four sub-partners that are Caritas Rwanda, Young Women Christian Association (YWCA), Duhamic-Adri and African Evangelical Entreprise (AEE).
The programme is targeting to reach 725,000 children under six, and their families as well as to reach 820,000 women of reproductive age in 10 districts, Kayonza, Ngoma, Nyabihu, Nyanza, Kicukiro, Nyarugenge, Rwamagana, Burera, Rulindo, and Nyamasheke.