For Rwanda’s Thousand Hills, A Thousand Solutions

Amidst the lush green hills of Nyabihu district, an enthusiastic crowd of over 5,000 Rwandans gathered on 17 May 2018 as Rwanda’s prime minister, Dr. Ngirente Edouard, launched a new multisectoral programme to reduce malnutrition and boost the country’s human capital.

In the spectacular misty mountains of rural Rwanda, stunting is a ‘silent killer,’ often largely invisible. Across the programme’s 13 target districts, over 40% of children under 5 are prevented from thriving and growing to their full potential. This costs Rwanda an estimated 11.5% of gross domestic product annually, mostly due to lower productivity of manual labour.


Concurrent with the programme launch, Rwandan families attended Maternal and Child Health Week activities by bringing their children to be weighed and measured. Health workers delivered essential micronutrient supplements to children while providing nutrition counselling and support to their parents.

The multi-sectoral ‘Three Projects, One programme’ approach responds to a call made in March 2017 by Rwanda’s President Paul Kagame. To translate Rwanda’s bold vision and make it a reality, experts from the Rwandan government worked with the World Bank, The Power of Nutrition, the Global Financing Facility (GFF), and the Global Agriculture and Food Security Programme (GAFSP) to fast-track a highly focused, cost-effective programme based on domestic and global successes and best practices.

With this comprehensive plan, Rwanda is taking a decisive step toward fulfilling its ambitious commitment to significantly reduce the rate of stunting in target regions to 32% by 2024, thus boosting the country’s economic growth and its ability to compete on the global market. The large-scale initiative tackles stunting from different angles by targeting several underlying causes of this complex and multifaceted issue, such as inadequate maternal, infant and young child nutrition and care practices, poor feeding practices, insufficient access to health services, lack of social protection, and food insecurity.

As a result of the programme, the poorest and most vulnerable families in 13 target districts will benefit from early childhood nutrition and stimulation during the crucial 1,000 first days of a child’s life when stunting can be prevented. Investing in early childhood improves children’s cognitive development, boosts educational attainment, and improves productivity into adulthood.

  • The first programme pillar, the Stunting Prevention and Reduction (SPAR) Project, aims to improve the delivery of high-impact nutrition and health interventions and support early childhood development through a community-based approach and intensive behavioural change communication to raise awareness of the early signs of undernutrition. Local health personnel are incentivised, while district officials are mobilized and held accountable for successful implementation through village and district-level multisectoral scorecards to support a convergent effort.
  • A second programme pillar is a convergent cash transfer system, delivered through the Local Administrative Entities Development Agency (LODA) as part of the Strengthening Social Protection Project. This project will incentivise pregnant and lactating women to attend health clinics for ante- and post-natal care and bring their children under two years for growth promotion, including height measurement and nutrition counselling. The national Civil Registration and Vital Statistics system will also be strengthened to identify children and track their progress more efficiently.
  • The third programme pillar is designed to increase agricultural productivity and improve food security and will add another layer to the multi-dimensional approach, which aims to maximise impact by combating stunting through a series of interventions.

Ahead of the programme launch, a two-day technical workshop brought together the Ministry of Health, the National Early Child Development Programme, Ministry of Local Government, district executives and officials, and development partners to promote strong cooperation toward one programme under a common goal at national and local levels.

In addition to IDA resources, the two projects benefit from innovative financing mechanisms that raised US$ 53 million in grants through The Power of Nutrition and the Global Financing Facility. The Power of Nutrition efforts to crowd-in private sector investment for health and nutrition are particularly in line with Rwanda’s vision to drive transformative nutrition outcomes for the most vulnerable children and women.

With this extensive, multi-layered plan, supported at the highest level, Rwanda is driving efforts to tackle stunting as never before. ‘Rwanda is poised to lead the way in reducing stunting, building human capital, and putting itself on a path to higher productivity and economic growth,’ World Bank Country Manager Yasser El-Gammal said.