Improving Early Childhood Nutrition in Rwanda

Early in the morning, Riberi Mukankusi, a community health worker in Rugera village of Nyabihu district in Rwanda, walks to Charlotte Mukajambo’s home to visit 2-year-old Efta. As Riberi enters the courtyard, Efta runs to greet her.  While his mother prepares breakfast, he plays ball with his elder brother, Emmanuel. Efta looks happy and healthy.

Riberi Mukankusi, a community health worker, visits Charlotte Mukajambo and her son Efta Iratabara at their home in Rugera village, Rwanda. 

Photo by Fred Hirwa/CRS

This is a welcome sight for Riberi. For the past few months, Efta’s health has been poor. At birth, Efta was a healthy 8.5 pounds, but as the months passed, his weight dropped, and his growth stalled. Unaware of how to meet her child’s nutritional needs, Charlotte would feed him “as best as I could,” she says, not knowing the serious consequences of malnutrition. As Efta approached his first birthday, he was getting sick often, losing weight gradually and becoming weak.

“I was feeling overwhelmed, worried about my son’s health and future well-being,” Charlotte says.

The U.S. Agency for International Development’s Gikuriro Kuri Bose project, implemented by a consortium led by Catholic Relief Services, trains community volunteers such as Riberi and equips them with the tools to monitor, screen and treat malnutrition for children under age 5.

Charlotte was invited by her neighbors to attend the monthly malnutrition screenings in her village. It was here that Efta’s malnutrition was confirmed. He was suffering from severe acute malnutrition, which required immediate medical intervention.

Charlotte Mukajambo holds her son Efta Iratabara at their home in Rugera village, Rwanda.

Photo by Fred Hirwa/CRS

Riberi referred Efta to the local health center to start a nutritional rehabilitation program. As Efta received treatment, Charlotte learned about the importance of balanced meals and received packaged milk and porridge to complement her son’s meals back home.

After a few days, Efta was discharged from the health center, and Riberi continued to visit the family at home, offering guidance to Charlotte on how to prepare nourishing meals for her child. To further enhance children’s nutrition, the project supported families with egg-laying hens, which Charlotte used to add eggs to Efta’s meals for additional protein and nutrients.

Now, Charlotte says, “I prepare meals with vegetables, small fish, and beans, and I ensure he gets an egg daily.”

The project also introduced Charlotte to the local village nutrition school, where she and other mothers learned how to prepare balanced meals using affordable, locally available foods. This hands-on education strengthened her confidence to continue caring for her son. The support extended to regular visits by Riberi, to continue tracking Efta’s growth, ensuring his full recovery.

Riberi Mukankusi, a community health worker, takes the mid-upper arm circumference measurement of Charlotte Mukajambo’s son Efta Iratabara at their home in Rugera village, Rwanda.

Photo by Fred Hirwa/CRS

Within two months, Efta began showing signs of improvement. By 18 months, he could walk properly, and interact with his older brother, Emmanuel. Efta also started attending an early childhood development center established as part of the project. At the center, he socializes and plays with other children, boosting his physical, social and cognitive skills.

Charlotte’s commitment to Efta’s recovery was further strengthened by joining a project savings group, where she learned to save and borrow, ultimately purchasing five more chickens to supplement her son’s nutrition.

“I am so grateful,” Charlotte says. “Today, Efta is healthy, plays with other children and speaks. I want him to grow up and help others.”

USAID’s Gikuriro Kuri Bose project, implemented by CRS-led consortium, has reached more than 2 million people across 10 districts in Rwanda. Through the support of more than 15,000 community volunteers, the project monitors the growth, nutrition and health of children, conducts monthly malnutrition screenings, and helps thousands of children recover from malnutrition. The program emphasizes the developmental importance of the first 1,000 days of a child’s life, strengthens the inclusion of children and adults with disabilities, and improves positive parenting and child development.

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