Leaders in Eastern Province have renewed efforts to tackle child stunting after acknowledging that the problem persists in several districts despite years of government interventions.

The renewed push emerged during a consultative meeting held on March 4 that brought together provincial and district leaders, health officials, and development partners to assess progress, strengthen coordination, and agree on practical actions to address persistent child malnutrition.

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According to the Rwanda Demographic and Health Survey (DHS) 2025, the country reduced stunting among children under five from 51 percent in 2005 to 27 percent in 2025. However, officials say the burden remains significant in rural districts, particularly in Eastern Province.

The survey shows varying levels of stunting across the province. Kirehe records the highest rate at 31.7 percent, followed by Gatsibo at 29.4 percent, Nyagatare at 27.8 percent, Ngoma at 26.9 percent, and Kayonza at 26.1 percent. Bugesera has the lowest rate in the province at about 20.8 percent.

Officials say teenage pregnancy remains one of the key drivers of child malnutrition.

Nadine Gatsinzi Umutoni, the Chief Gender Monitor, said the DHS report indicates that 21 percent of teenage mothers have never attended school, while 14 percent ended their education at the primary level.

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Many girls who become pregnant while still in school drop out, limiting their access to health information and support systems needed to care for their children.

"When children become mothers, there is a high risk of having stunted children,” she said. "We should focus on keeping girls in school because schools are safe spaces where they learn about the risks of early pregnancies. This could significantly reduce child stunting.”

Officials also noted that some nutrition programmes fail to achieve expected results because they are not fully embraced at the household level.

Assoumpta Ingabire, Director General of the National Child Development Agency (NCDA), called for stronger follow-up and greater awareness among parents.

"Some leaders do not consistently follow up on programmes meant to eliminate stunting, and some parents do not take them seriously,” she said. "Others simply lack awareness or ignore the issue. If we are to eradicate malnutrition, we need joint action.”

Limited access to nutritious foods, particularly animal-source foods, also remains a challenge in some communities.

According to NCDA, many households still have few small livestock such as poultry, which could help improve children’s nutrition through eggs and meat.

Ingabire said increasing the number of small livestock in households could improve children’s access to nutritious foods. She also noted that the cost of fortified foods remains a barrier for low-income families.

"NCDA is currently engaging the Ministry of Trade and Industry to explore ways to reduce the price of fortified foods so that more households can afford them,” she said.

In Kirehe District, which records the highest stunting rate in the province at about 31 percent, local leaders say some families do not follow advice from health workers on proper child feeding practices.

Janviere Mukandayisenga, Vice Mayor in charge of Social Affairs, said the district has begun identifying vulnerable households and strengthening monitoring through community health workers and para-social workers.

"We have started identifying households facing such challenges. Community health workers and para-social workers are now monitoring children’s nutrition more closely,” she said. "In many of these families, we have also noticed household disputes, which eventually affect children.”

She added that migration also contributes to the challenge.

"We receive many residents moving from Northern and Western provinces, and some arrive with children who are already stunted. We are working with village leaders to ensure such children are identified early and supported,” she said.

Residents say poverty also affects how families use nutrition support provided through government programmes.

Leah Mugabekazi, a resident of Kiramuruzi Sector, said some parents sell Shisha Kibondo, a fortified porridge flour meant for malnourished children, because they struggle to support their families.

"I think the solution is to address the root cause, which is poverty. Some parents sell the flour meant for their children because they are struggling to support their families,” she said.

Provincial authorities say changing household behaviour will be key to reducing stunting.

Dr Jeanne Nyirahabimana, Executive Secretary of Eastern Province, said some families prioritise selling animal products such as milk and eggs instead of reserving some for their children.

"Our province has food, but the challenge is still mindset,” she said. "Some families sell all animal products and do not reserve enough for their children’s nutrition. Changing this behaviour will help reduce stunting.”

She said the province has intensified nutrition awareness campaigns and joint poverty reduction programmes, targeting a reduction of stunting to 15 percent by 2029.

"Joint actions from partners and leaders to lift vulnerable families out of poverty will help reduce these worrying figures. But first, we must create a sense of ownership among residents if we are to achieve the targets,” she said.

The DHS 2025 also shows that stunting rises sharply during the first two years of life, peaking at about 46 percent among children aged around 22 months.

Nationally, 27 percent of children under five are stunted, one percent are wasted, and six percent are underweight.