Great Lakes Health Program in Rwanda_Phasing out

Background
The prevalence of chronic malnutrition (i.e. stunting) among children under five in Rwanda is very high; stunting rates across the country average 38% for children under five and exceed 50% for children aged between 20 to 30 months. Different national strategies and decentralised programs are in place to fight malnutrition and food insecurity in Rwanda. Childhood stunting is recognized as a national nutrition, food security and social protection problem in the Economic Development and Poverty Reduction Strategy (EDPRS 2), Health Sector Strategic Plan (HSSP III) and in this National Food and Nutrition Strategic Plan 2013-2018 (NFNSP). The Swiss Agency for Development and Cooperation (SDC) has provided support to the Rwandan health sector since 2002. Starting in 2013, the SDC funded the Great Lakes Health Programme in Burundi, the Democratic Republic of Congo and in Rwanda, which will be phased phasing out until the end of 2018. To this effect, a ‘Nutrition Action Research’ project is being established to build a local knowledge management system driven by the primary caregivers, the parents and Community Health Workers (CHWs).

Objectives
The aim of the Nutrition Action Research project is to generate evidence-based understanding of the causes of stunting among children up to 2 years old and to provide an array of good practises on how to prevent it.

Methods/Approaches
The proposed participatory action research (PAR) will use a horizontal learning approach to engage participants – in this case parents/caretakers and CHWs – to share their innate knowledge and best practice experience to create learning, and stimulate behavior change among peers around good nutrition for children under two. The ‘Most Significant Change’ methodology will be used to document best practices from the community.

Results
The combination of both interventions methodologies will provide evidence-based understanding of the causes of child stunting and of the array of good practices to prevent it, as perceived by the primary caregivers. Properly documented and disseminated, the results of the PAR will be a main ingredient in a comprehensive strategy for the prevention of chronic undernutrition.

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