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.

David grew up in Kigali, Kanombe where he married his spouse. After bearing their three children, they moved to Nyagombe village in Kayonza where they bought a house in the community settlement and a 30*20 m land plot next to a marshland.

His wife left him 3 years ago. David explained that she seemed not have accepted to live in the countryside. Since then he had to care for his 3 children on his own.

In 2016, David enrolled into the USAID Twiyubake program. He attended the training on ECD and volunteered as a caregiver in the Twiyubake ECD center in Juru which is at an one hour walking distance from his village. “The walking distance was a challenge especially when the rain was falling, I had to carry the children from our village so that they could get there. My youngest daughter was attending the ECD center at that time when I was a caregiver. She went to primary 1 last January”, he explained.

In May 2017, YWCA established playgroups in villages with high numbers of children enrolled into the USAID Twiyubake program. Since then, David is volunteering as a caregiver at the Turereneza Nyabombi Gahini playgroup in his village. The village office offered a room for the playgroup. The children in the playgroup are coming from the three neighboring villages. The playgroup is operating from 8 am to 10 am from Monday to Friday and accommodating children from 3 to 4 and 4 to 5 years.

“After volunteering in the playgroup, I go home and cook for my three children, who are in primary 1, 2, and 3. They all received school materials from the program. A CMV visits me once a week to follow up on my household. He helped me to establish a balanced diet for the children. I am very grateful for the program as it helped me to love my children much more and to be aware on how to take good care of them”, he stated.

To initiate home based ECD facilities and playgroups in Kayonza district, USAID Twiyubake implementing partner in Kayonza district, Young Women’s Christian Association of Rwanda (YWCA), selected villages with many young children who either had to walk long distances to the community based ECD centers or who did not have an opportunity to be enrolled into them because of its high demand. The program also provided a three-day training on home based ECD to strengthen caregiver and community based volunteer (CBV) skills on basics of child development, day to day interactions with children to promote learning, establishing parenting groups and their active participation.

Dativa, a 39 years old mother, offered her living room to establish a home based ECD facility. “Dativa was already working as a caregiver since July 2016 at the Igihozo ECD center in Mwiri sector. She understood very well the ECD concept. She was the one who approached us and informed that she would like to provide the living room of her house in which 15 children could be hosted, especially because the parents in her village were asking her for it. Dativa had already gained the trust of the village residents as she used to sensitize in village meetings on child protection, against child labor and reminding parents to take good care of their children”, explained David Karemera, Field Officer at YWCA.

“Deep inside me, I always loved caring for children but I did not find an opportunity to practice it professionally. My parents passed away when I was 14 years old, since then I raised my younger siblings. The program trained me and promoted me from an ECD caregiver to a home based ECD CBV in May 2017. As a CBV, I manage all the activities around the home based ECD which YWCA equipped with basic materials”, explained Dativa.

Every day, two caregivers volunteer and assist the children at the Icyizere home based ECD at Rwazana village in Mwiri sector. The children come from 7-10.30 am. Children are grouped by age: 3-4 year and 5-6 years. The children usually start by a song which is followed by a prayer. At 9.30 am they go for a break on the grassland next to the house. At 10 am children go back to class and parents feed the children with porridge. The parenting committee is gathering each Sunday from 2-3 pm. They are a group of seven people. In the parenting group, parents acquire positive parenting skills and they schedule themselves to take turns in caring and providing porridge for the children and constructing handmade play materials to be used by the children in the facility.

Most of the parents cultivate on neighboring fields. It relieves them when the children are in the home based ECD facility. Almost all the parents of young children in the village asked Dativa if she could enroll their children in the home based ECD facility to allow them to pursue their income generating activities.

“My husband also became a caregiver and volunteers twice a week in the home based ECD program. He loves children the way I do and we both have a lot of satisfaction working in this service. We have five children and the youngest is in the home based ECD program. For now, we only have USAID Twiyubake program children who attend the home based ECD. I wish all children in our village could attend the home based ECD service. Our dream is to build another house next to this house, to have all children attend the service”, explained Dativa.

The saving group Urugero Rwiza, Abadahigwa, Ejo Heza, and Abanyarukundo of the sectors Nyakabanda in Nyrugenge district celebrated their saving group shared out of the first year on August 30, 2017.

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