Improving food and nutrition security in Rwanda (Story of Change)

This story illustrates how using evidence to create an advocacy case - and working as a coalition - can help reach high-level decision makers and influence change. In this case, the V4CP supports two Rwandan civil society organisations (CSOs) so that they develop an evidence-based argument for a multi-stakeholder approach to tackling malnutrition. It demonstrates that collaboration between research institutions and CSOs can be a powerful catalyst for change.

Tackling malnutrition

While Rwanda has met many of its development goals, stunting (low height-for-age) still affects as many as 37.9% of children under five years old. Stunting is the impaired growth and development that children experience as a result of malnutrition, repeated infection, and inadequate psychosocial stimulation. Stunting in early life - particularly in the first 1,000 days from conception until the age of two - has adverse functional consequences including poor cognition and educational performance, low adult wages, lost productivity and an increased risk of nutrition-related chronic diseases in adult life. This not only impacts families’ lives but also has far-reaching consequences for economic productivity and national development.

To tackle this, in 2010, the Ministry of Health started a programme to reduce all forms of malnutrition in children under the age of five, as well as in pregnant and lactating women. The country’s 30 district governments were asked to draw up a District Plan to Eliminate Malnutrition (DPEM). While this has led to great progress, stunting remains a challenge. There is an urgent need to identify the causes and to implement and scale-up evidence-based programmes and policies to address this.

In 2018, two CSOs in the V4CP - the Rwanda Development Organisation (RDO) and the Rwandan Civil Society Alliance for the Scaling Up Nutrition Movement (SUN CISA) – began working in close consultation with the National Early Childhood Development Programme (NECDP) to help fast track the Rwandan Government’s nutrition programme and support progress towards the United Nation’s Sustainable Development Goals (SDGs), particularly target 2.2, aiming to end all forms of malnutrition by 2030.

This is the story of how they did it.

The key to success

Everyone working to improve food and nutrition in Rwanda had felt optimistic when President Kagame initiated the DPEM yet, years on, there were coordination challenges because the underlying causes of malnutrition were diverse. One thing was clear: things were improving but far more needed be done.

Many opportunities for progressing the DPEM had fallen by the wayside because they had either been overlooked or not given priority when the plans and performance contracts had been developed by the district governments. This was partly because the roles and responsibilities for DPEM committee members were not clear so they did not know what was expected of them. It was also because tackling malnutrition was widely perceived as the responsibility of the health sector alone whereas, due to its multiple causes, solving it required a multi-stakeholder approach.

RDO and SUN CISA knew that the key to success lay in garnering the support of district leaders, yet convincing them would require both team work and solid evidence.

Strengthening capacity

Each of the V4CP CSOs had a specialism: RDO in tracking budget allocation and expenditures and advocating for budgetary increases on FNS and SUN CISA in advocating for improved service delivery on behalf of the most vulnerable in society.

Both of the CSOs knew they would benefit from improving their skills. The V4CP provided them with a training programme to build thematic knowledge and advocacy skills, as well as on-the-job advisory support and coaching in leadership and organisational sustainability. With this increased capacity, RDO and SUN CISA developed an advocacy strategy and implementation plan, with the support of SNV and IFPRI. The plan was based on three steps: to integrate activities from DPEM programmes into each district’s overall development plans and performance contracts; to strengthen the DPEM’s structure and management; and to secure a specific nutrition-related budget.

The power of evidence

To influence decision makers, the CSOs knew they must further contextualise and underpin their advocacy strategy with solid evidence, so they called upon IFPRI to research relevant government and publicly available data in the Eastern and Northern Provinces.

When analysed, the data not only showed where improvements were needed, but also demonstrated that the DPEM had great potential. It provided evidence that advocacy interventions by other CSOs in the Northern Province had made a significant impact on improving service delivery, taking measures and implementing best practices to address malnutrition and stunting issues. It also highlighted that, in the Eastern Province, practices and service delivery had improved in areas that had a higher FNS budget, such as in the Kirehe district where stunting figures had reduced. With IFPRI’s body of evidence, the CSOs could set their strategy in motion.

Inspiring high-level support

In July 2018, RDO and SUN CISA organised a series of workshops where they presented their advocacy case to stakeholders involved in FNS programmes in the Eastern and Northern Provinces, including representatives from the private sector. The events were a success. They inspired decision-makers and implementors to start working together and the evidence convinced them that a multi-stakeholder approach to tackling malnutrition was required.

At the official opening of the workshop in Northern Province, Governor Jean Marie Gatabazi called for assertive mass mobilisation for the elimination of malnutrition and reminded district officials that its eradiation should become part of the culture of all Rwandan families. He asked the CSOs to provide evidence for all his districts and to work with the district DPEM committee members in the formulation of a new, collaborative two year DPEM.

A monitoring and evaluation framework was developed and the Executive Secretary of the province was charged with tracking progress and reporting back to Governor Gatabazi every three months. A commitment was also made to include the new DPEM plans - as well as the mayors’ performance contracts - in the District Development Strategy, in order to increase accountability.

“The awareness campaign should be carried through coordination from those in charge of nutrition, social protection, health, gender, hygiene, agriculture and other development partners at the hospitals.” - Doctor Anita Asiimwe, Coordinator of the National Early Childhood Development programme, speaking at the workshop in Northern Province.

Scaling up progress

Inspired by this success, RDO and SUN CISA presented their successful collaboration in reviving provincial DPEM activities at a USAID event in Kigali later that month. On hearing the positive results, the NECDP invited them to spread their good work by facilitating the revision of the DPEM’s action plans across all districts in Rwanda.

Furthermore, experts from IFPRI set about collecting FNS budgetary data and, with support from RDO, developed Rwanda’s first ever Budget Allocation and Expenditure Analysis tool. This led to a dedicated FNS budget being approved for all DPEMs across the country. This will provide a basis for a budget gap analysis on FNS and contributes to accountability of the government at national and district level.

Collaboration for the future

This story demonstrates that collaboration between research institutions and CSOs can be a powerful catalyst for change. The evidence gathered by IFPRI improved the CSO’s engagement with decision makers. By combining it with the CSO’s first-hand experience of working in communities, the partnership created a compelling advocacy case that influenced policy agendas. In doing so, it helped Rwanda progress towards its SDG targets on malnutrition.

Today, RDO and SUN CISA continue to work with district mayors across Rwanda. With ongoing support from IFPRI, they are tracking government spending in order to ensure DPEM plans are adequately funded and are continually monitoring and evaluating progress.

Read more about how this story developed and how civil society inspired systemic reform.