The World Bank estimates that Rwanda requires at least $27.3m (approximately Rwf23billion) annually for the next 10 years to eradicate malnutrition in the country. In the organisation’s latest report on the country’s economic update, they estimated that the investment ought to go into averting cases of stunting – estimated at about 200,000 – as well as anemia in women. According to the latest statistics of 2014/2015, malnutrition was at about 38 per cent down from about 50 per cent in 2005. The intervention would enable the country bend the arc of history on stunting, attaining rates of reduction comparable to the best performing countries, the report’s authors noted. The funds, according to the bank, ought to be channeled towards complementary feeding education, prophylactic zinc supplementation, and the public provision of complementary foods would be the most effective in preventing stunting. Promotion of breastfeeding by counseling mothers was projected to increase the number of infants exclusively breastfed by 28,000, at a cost of $88 per child, with a total additional financing need of $2.5 million over 10 years. For preventing anemia in women, staple food fortification would be the most cost-effective for non-pregnant women, at a cost of US$10 for each case-year of anemia prevented, the World Bank simulation showed. Over 10 years, staple food fortification and iron and folic acid supplementation for non-pregnant women would prevent about 391,000 and 859,000 case-years of anemia in women, respectively, and require US$3.9 million and US$16.3 million. Among pregnant women, antenatal micronutrient supplementation would prevent 264,000 case-years of anemia, at a cost of US$37 per case-year prevented, or US$9.9 million over 10 years. Alternative interventions In the event of constrained resources that would make it difficult to raise the funds, the World Bank proposed two alternative packages; one costing $57m over 10 years while another a total of US$122 million over 10 years. The $57m package includes antenatal micronutrient supplementation, infant and young child nutrition counseling, intermittent presumptive treatment of malaria in pregnancy and treatment of severe acute malnutrition. The package would prevent more than 39,000 cases of stunting and avert 2,400 deaths in children under five years of age. The US$122 million would prevent 3,600 deaths and more than 75,000 cases of stunting among children. Dr Gandham Ramana of the World Bank noted that there is an urgent need to avert malnutrition due to the consequences it was having on the country and economy. Ramana said that among the biggest consequences was child mortality as well as repetition in primary school. He noted that children who are malnourished risk having lower cognitive ability as well as have a higher risk of non-communcable diseases. “Because cognitive and physical damage in early childhood is at this point largely irreversible, it is critical to ensure optimum nutrition during the 1,000-day period from pregnancy to a child’s second birthday” “Adults who were stunted in childhood have lower cognitive ability and fewer socio-emotional skills; they are also at higher risk of non-communicable diseases like cardiovascular problems. These problems translate into both lower productivity and lower wages, which ultimately affects economic growth,” he said. The government is taking on a multi-approaches to curb malnutrition including mobilizing support from the private sector, faith based organization, civil society and community members. Dr Anita Asiimwe, the National Early Childhood Development Program coordinator said that among interventions include raising awareness across the country on the importance of proper nutrition. This she noted was being done using decentralized models that have seen awareness reach even the remotest parts of the country. Dr Asiimwe also noted the increased registration of children had enabled the government collect statistics and keep records of children to ensure that cases of malnutrition were addressed and followed up. editorial@newtimes.co.rw
