On September 28, 2017, USAID CHAIN project partners visited USAID Twiyubake activities in Burera district. The team was composed of the USAID program management team, representatives of Rwanda Social Marketing Program (SFH), Turengere Abana (FXB), Orange Fleshed Sweet Potato Activity (CIP), Iron Rich Beans Activity (HarvestPlus), Twiyubake as the CHAIN focal point program in the district and a representative from the Rwanda Medical Center. CHAIN partners work with the same communities and coordinate their program resources. The overall objective of the visit was to assess their coordination and identify needs for a more effective collaboration.

 

The USAID CHAIN project is a strategic framework designed to address health and nutrition outcomes to reach a better quality of life of communities, decrease stunting and targeting children in the first 1,000 days from conception to age two. To achieve this mandate, CHAIN is optimizing achievements across its multisector nutrition strategy covering program areas of nutrition, agriculture, WASH, and HIV.

 

At the district office, the team discussed CHAIN interventions. In Burera district, USAID Twiyubake linked beneficiary farmers to HarvestPlus and CIP to promote production and consumption of high iron beans and orange fleshed sweet potatoes rich in vitamin A. HarvestPlus coordinated nutrition education in collaboration with community health committees and Twiyubake in turn provided technical support to HarvestPlus to train community health workers on nutrition value of high iron beans. The project partners also conducted a joint WASH campaign.

Faustin Ntaganda, Rwanda Biomedical Center Nutrition Technical Officer, Division of Maternal Child Community Health, explained that although severe malnutrition is managed in the community through monthly growth monitoring sessions, stunting is still an issue in Burera district. The DHS 2014-2015 reveals that 42.9% of children under 5 years are suffering from stunting. This is why tackling stunting is now integrated in the vaccination program at the health center, and through mobilization in the community to encourage parents to bring their children to the health center for the anthropometric index height for age measurement.

 

Silver Karumba, USAID Nutrition Specialist, added to Faustin Ntaganda’s explanation that Burera has a fertile soil thus people may wonder why stunting prevalence occur. The problem lays in the feeding practice in the community. Most children are fed with starches although protein consumption is key for small children, especially consumption of eggs.

 

Additional thoughts were given by the district’s Director of Agriculture and Livestock to share practical skills from farmer field schools and on small livestock rearing with the youth.

The journey continued to a growth monitoring and cooking demonstration session in Cyanika sector. Children aged 0 to 60 months are examined once a month by Community Health Workers, who monitor and track their weight, and mid-upper arm circumference (MUAC) to assess their nutritional status, and control their vaccination calendar.

 

“In this growth monitoring session in Rutingo village, we monitor 220 children under 5 years, as well as pregnant and lactating mothers. There is only one child from Congo who came to visit his aunt which showed a MUAC measurement in yellow classified as moderate malnutrition”, explained Clementine Twezirimana, Community Health Worker in charge & Hygiene at Cyanika health center.

The child will be transferred to the program’s positive deviant hearth group, a nutrition education program owned by the community which include cooking sessions for 14 consecutive days and evaluation of the child status.

Twiyubake equipped the village kitchen with pans, plates, cups and jerry cans. The village kitchen also received iron beans and orange fleshed sweet potatoes from HarvestPlus and CIP and volunteers trained by Twiyubake in partnership with HarvestPlus and CIP provide messages on balanced diet and best feeding practices against malnutrition.

 

While Jaqueline Mukamana, Community Health Worker at Cyanika sector, was leading a discussion on balanced diet with the participants, parents in the village kitchen prepared a meal composed of orange fleshed sweet potatoes, fortified beans, rice and greens which was then shared by the participants.

 

The visit continued to a saving group and farmer field school (FFS). Saving groups are the entry point of all households to the USAID Twiyubake program. Their purpose is to stabilize poor families and help them acquire purchasing power to feed and care for their children. The farmer field school enables households to spend less money for the food consumption and ensure a daily intake of micronutrients to improve their nutrition.

The Imbere Heze saving group and FFS group in Cyanika sector, Kagitega village, is a saving group composed of 27 members, 7 men and 20 women. The group reached a total of Rwf 987,700 after one year of saving at its annual share out and received additional incentives from the program of a match of 1.5 times the total amount saved equal to Rwf 777,000. The new share amounts to Rwf 500. Divine K. bought a sewing machine and Fulgence M. 3 piglets and community health insurances for his children. The group was sensitized on health promotion and WASH education messages. All members and their families went for HIV testing and counselling. Their children attend school. In addition, the group members appreciated the program’s mobilization of parents evening forums in villages and observed that since they formed their saving group, many other saving groups were duplicated in the region.

 

All members have a kitchen garden and practice bio-intensive agriculture techniques in the farmer field school and at home.

They produced 150 kg of orange fleshed sweet potatoes and 300 kg of iron fortified beans yielding a total of Rwf 250 000 which is saved on their bank account, explained Providence Niyibizi, president of the Imbere Heze FFS group while touring the group along the different kitchen garden models.

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