Undernutrition contributes to nearly half of all deaths in children under-five globally, with sub-Saharan Africa suffering disproportionately. Undernutrition results in suboptimal growth, and makes it difficult to resist infection and recover from common childhood illnesses, such as diarrhea and respiratory infections. Children who are undernourished often suffer from delayed cognitive development and long-term health issues such as diabetes and heart disease.

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Over the past decade, Rwanda has made significant strides in reducing child malnutrition. Acute malnutrition has dropped from 5% in 2005, to 2% in 2015, significantly reducing a form of malnutrition that puts children at an increased risk of dying. Stunting remains a concern in Rwanda with 38% of children under-five stunted. 

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We are working to eliminate child deaths due to severe acute malnutrition in the districts we support. Malnutrition is a cycle: an undernourished pregnant woman is more likely to delivery an underweight infant, who is at increased risk of becoming an undernourished child, and eventually a malnourished adolescent and adult. If that is an adolescent girl or a woman, the cycle of undernutrition continues into the next generation. The First 1,000 Days campaign initiated by the government in 2012 is aimed at ending this cycle by targeting a critical period of growth and development, where the risk of undernutrition is heightened. Particularly, pregnancy, lactation and the first 24 months of life are periods during the life cycle that are most vulnerable to the effects of undernutrition.

TRAINING AND MENTORSHIP AT HEALTH CENTERS

The Community Management of Acute Malnutrition (CMAM) has revolutionized the treatment of malnutrition in developing countries. Rather than admitting children to inpatient hospital units to treat malnutrition, children and their caregivers can now remain in their communities and households while receiving treatment. This leads to decreased risk of acquiring infections in the hospital, decreased economic losses when the caregiver can continue their daily activities, and decreased stigmatization of malnutrition. We train more than 90 health center providers annually on CMAM to improve the quality of care of malnutrition services.

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We have found success with our mentorship program to improve the quality of care in maternal and child health services. Our mentors accompany nutritionists and child health nurses at health centers to improve the treatment provided to children under-five who have acute malnutrition. By improving the quality of care, we are ensuring that children are admitted, treated and discharged from the malnutrition program according to best practices.