Although Rwanda has met or exceeded most of its development goals, chronic malnutrition, or stunting, remains a major challenge, a newly released World Bank report notes.
The recently released 12th edition of the Rwanda Economic Update, Tackling Stunting: An Unfinished Agenda, notes that while stunting rates have declined gradually since 2000 and reduced since 2010.
Stunting remains stubbornly high at 38% according to the 2014 and 2015 rate.
“Stunting impedes cognitive development, educational attainment, and lifetime earnings,” said Yasser El-Gammal, World Bank country director for Rwanda.
“It also deprives the economy of quality human capital that is critical to attaining Rwanda’s aspiration to become a middle-income country and sustain its economic gains.”
While stunting is widespread, the report notes that rates are highest among the poorest households and those living in rural areas, with modest improvements in stunting since 2005.
The average annual rate of reduction for 2005 to 2015 was 2% among the poorest wealth, in contrast to 5% in the richest.
Moreover, nearly 25% of children in the top two wealthiest also suffer stunting.
The report notes that UNICEF conceptual framework shows that causes include lack of adequate quantity and quality of food, frequent illnesses, poor maternal and child care practices, substandard access to health services and unhealthy environmental shocks for example drought, irregular rains, prolonged dry spells that affects their ability to access food.
Rwanda’s government has placed stunting high on its priority list, to be addressed under the Sustainable Development Goals.
Food security, nutrition and early childhood development are prioritized as foundational issues in the National Strategy for Transformation and Prosperity 2017 to 2024. The government has set a bold target for all districts to reach a 19% stunting rate by 2024, in line with the country’s 2018 to 2024 Health Strategic Plan.
A National Early Childhood Development Coordination Program was recently established under the leadership of Prime Minister Édouard Ngirente to ensure high-level coordination.
In partnership with the World Bank, the Power of Nutrition, the Global Financing Facility and the Global Agriculture and Food Security Program, a multi-sectoral stunting reduction program was developed. The program encompasses three projects in nutrition, social protection and agriculture totaling $184 million.
The Strengthening Social Protection Project will scale up the main components of the Vision 2020 Umurenge Program (VUP).
“This is one of the most ambitious stunting reduction programs that the World Bank has supported,” said Meera Shekar, World Bank global lead for nutrition.
To succeed in its ambitious plans to slash stunting rates, the Rwanda Economic Update makes several policy recommendations:
- Adopting a pro-poor approach, targeting the poorest children under two years of age during the critical 1,000-day window beyond which stunting is largely irreversible
- Mobilizing parents, mayors, and policymakers to strengthen ownership of the stunting reduction agenda
- Expanding domestic financing, better aligning resources to results, and improving tracking of all spending on stunting by all sectors
- Generating evidence about what works and how it can be scaled up