Despite the government having made considerable progress in poverty reduction over the past decade, malnutrition remains its Achille’s heel with experts warning that the condition is likely to get worse if programmes targeted at the rural poor are not deepened.

According to the 2014-2015 demographic and health survey (DHS) released by the Ministry of Health, 38 per cent of children in Rwanda are stunted and 14 per cent severely stunted with the condition being at its peak among those aged between 18 and 23 months, at 49 per cent.

The condition affects rural children at 41 per cent more than those in the urban areas, at 24 per cent, with data further naming rural illiterates and poor as the groups severely battered by malnutrition.

A 2014 human development report released by the UNDP showed that northern Rwanda had the highest rates of stunting, exceeding 60 per cent, followed by rural areas bordering Lake Kivu at 51 per cent and along the Congo Nile Crest at 50 per cent.

“It’s true malnutrition is still an issue,” said Solange Hakiba Itulinde, the Permanent Secretary in the Ministry of Health.

“Our numbers are not good; we didn’t hit the Millennium Development Goals on fighting malnutrition. The focus now is to make sure that children get enough food to eat. There are also general programmes involving sensitising people on fighting malnutrition. At the community level, children with high malnutrition levels are being identified and taken care of.”

READ: Stunting in children is rising across region due to poor nutrition - report

Food insecurity and reduced household incomes, which has hit a big segment of the population, especially those in rural areas, is partly responsible for the high malnutrition levels.

Many of the country’s poor fall sick and are admitted in hospitals with malnutrition as one of the major causes of the illnesses. However, even when these people come to hospitals, they fail to get nutritional supplements because they cannot afford them yet some are expectant mothers.

In an interview with Gerald Luzindana, a complementary and nutritional therapist, to find out where the country gets it wrong in the fight against malnutrition, he said it is hard to address malnutrition without putting in consideration the genesis of the issue.

“Malnutrition defects start right from conception; you don’t wait for the child to be two years old to give him or her proper nutrients,” said Mr Luzindana. “We need to view malnutrition in a broader perspective.

“Interventions need to implemented at different stages. For instance, in the first three months of pregnancy, the mother needs strict nutrition intake because that’s the time the brain is developing. This should go on throughout pregnancy.”

He said all the stages of nutritional provision need to be followed, starting from pregnancy, lactation period, when the child is born and at home, at school and as an adult.

The high levels of malnutrition, particularly among mothers and children, have been reported to be brought about by lack of balanced diets within Rwandan households, which factor gets its roots from the poverty levels which are still high despite having reduced over the years.

The government has come up with a number of poverty alleviation and programmes to fight nutritional challenges. For instance, results of the national integrated policy on nutrition that is jointly implemented by the Ministries of Health and Agriculture have been dismal so far.

Local governments have also implemented programmes such as mobilising households to set up backyard vegetable and fruit gardens. Although this has had some traction in some places, the current malnutrition levels show that either there is a need for deepening the programme or going back to the drawing board to craft new programmes.

The One Cow Per Family programme, which was established to support the vulnerable and poor with nutritional supplements, is yet to bear tangible fruits as it has been riddled with scandals that have perhaps not made it able to meet its objectives.

According to the cost of hunger report in Rwanda, an estimated Rwf503.6 billion was lost in the year 2012 as a result of child under-nutrition, which is equivalent to 11.5 per cent of GDP.

The report further shows that 49.2 per cent of adults in Rwanda suffered from stunting as children, which represented more than three million people of working age who were not able to achieve their potential as a consequence of child under-nutrition.

It is also estimated that 922 million working hours were lost in 2012 due to absenteeism from the workforce as a result of nutrition-related mortalities, which represents Rwf309 billion, or 7.1 per cent of the country’s GDP.