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Stakeholder & Action Mapping for Rwanda 2014/15Using the Scaling Up Nutrition Planning & Monitoring Tool
August 2015
Compressed version of the slide deck
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Disclaimer for the Stakeholder & Action Mapping
It is important to note what the Stakeholder & Action Mapping is, and what it is not.
The Rwanda Stakeholder & Action Mapping intends to help improve nutrition coordination and scale-up discussion by providing an indicative overview of who the key stakeholders in nutrition are, where they are working, and an estimate of how many they are reaching, on a chosen few Core Nutrition Actions.
However, the Stakeholder & Action Mapping is not research or exact science. Both the geographical and beneficiary coverage are estimates based only on the information provided by the organizations who have reported. The coverage is therefore not to be considered as exhaustive or exact. Moreover, it is voluntary to report, and not necessarily all stakeholders have been identified or have chosen to contribute.
Also, the Stakeholder & Action Mapping is only focusing on the chosen Core Nutrition Actions. Other organizations may be working on other nutrition actions that have not been included. Furthermore, the Stakeholder & Action Mapping is not assessing the quality or accuracy of the reported coverage.
The Stakeholder & Action Mapping only represents a snapshot of the situation in Rwanda. Partners, projects, programs and funding change continuously, and thus also the support and coverage will change. The coverage data is provided for 2014, i.e. the last full calendar year.
The Stakeholder & Action Mapping should thus only be interpreted as indicative and directional, and should not be used for other purposes, nor should estimated coverage under any circumstance be used or referred to as publicly approved or validated data.
IMPORTANT TO READ
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Executive Summary for the Stakeholder & Action Mapping
Chronic malnutrition (stunting) is still a major public health concern in Rwanda• Despite progress over the last decade, Rwanda is still in the high severity zone as defined by WHO• Progress in stunting reduction is consistent, but slow compared to targets set by the Government of Rwanda• On the positive side, the MDG targets for underweight reduction was achieved, and acute malnutrition
(wasting) is in low severity zones as defined by WHO
There are gaps both in geographical coverage and beneficiary coverage of the Core Nutrition Actions (CNAs)
• There are many partners supporting the fight against malnutrition in Rwanda, including ministries, donors, catalysts and field implementers. The scale and support varies across the different stakeholders
• The level of support and coverage of the CNAs also varies among different districts both in number of partners supporting the district, the number of CNAs implemented, and the coverage of beneficiaries for these CNAs
Further scale-up is needed to accelerate the reduction of stunting in Rwanda• Geographic coverage of the CNAs should be increased so that more CNAs are reaching all areas of Rwanda• Beneficiary coverage of the CNAs should be improved so that more CNAs are reaching a higher proportion of
their target groups• The quality of the coverage needs to be ensured, so that we are not only reaching more beneficiaries, but also
ensuring a level of quality that makes the interventions efficient and sustainable
All partners need to cooperate and contribute to further scale-up nutrition interventions in Rwanda• The findings in the Stakeholder & Action Mapping can help inform such scale-up discussions
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The Stakeholder & Action Mapping report is structured according to the following topics and key questions
Introduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working with nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are we working?• How many are we reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• What recommendations for planning and scale up can be made?
Appendix
1
2
34567
89
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Introduction to the Stakeholder & Action Mapping 2014/15
Objectives of Stakeholder & Action Mapping• To decide on the prioritized core nutrition actions (CNAs) in Rwanda
• To get a better overview of who is doing what and where in nutrition in Rwanda
• To be better able to identify gaps in coverage of target population and geographies of core nutrition actions
• Ultimately to help inform & improve planning of core nutrition actions, to scale up and eliminate malnutrition
Background for Stakeholder & Action Mapping• Request by the Social Cluster Ministries and the FNTWG to update the stakeholder mapping from 2012
• Redefining of previous mapping efforts to better understand the coverage of target populations and geographic areas of CNAs (using updated and improved SUNPMT tool)
What data is collected, and how?• The mapping exercise collects coverage data directly from key nutrition stakeholders
– Template input from stakeholders on which CNAs they are implementing or supporting and where
– Interview-based data collection for further details on CNAs (including beneficiary coverage)
• The data collected include the following: Organization and program contact details, actions / interventions being conducted, target group(s), delivery mechanisms, period of program operation, geographic regions of operation, number of beneficiaries reached
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What can the Stakeholder & Action Mapping help you with?
For Ministries
Get a better overview of who the partners are and what they do
Identify potential gaps in geographic coverage
Identify potential gaps in action coverage
Help planning & scale-up of nutrition actions
For Districts
See what partners are working with food & nutrition in your district
Get info on what actions are being conducted, and where
How many people are being reached by different actions, what needs to be scaled up
For UN & NGOs
Enhance coordination though better info on what organizations are working in the same districts and/or on the same actions
Identify what districts need further support
See what actions need to be scaled up, and where
For Donors
Identify what districts need further support
See what actions need more funds to scale up
Help identify what organizations can cover different actions and districts
Improve coordination among partners, and help inform planning and scale up of nutrition actions in Rwanda
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Updating the Rwanda Stakeholder Mapping, using an upgraded and more comprehensive M&E tool from REACH
2012: General overview of who does what and where within nutrition in Rwanda
2015: Map coverage of core nutrition actions to better inform nutrition planning and scale-up
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The 23 Core Nutrition Actions agreed to map in Rwanda (1/2)How do they link to the NFNSP, and who are the main target groups
Strategic Direction & Output1 1 2 3 4 5 6 7
Core Nutrition Actions (CNAs) Target group(s)
Promote optimal breastfeeding practices Promote optimal complementary feeding practicesProvide specialized nutritious products for complementary feeding (e.g. CSB)Provide Fe+FA supplementsProvide MNP supplements (Ongera)Provide Vit A supplementsProvide deworming tabletsProvide diarrhoea treatment (w/ ORS/ORS-zinc)Provide treatment of SAMProvide & support treatment of MAMConduct child growth monitoring / screeningPromote/Provide ANC visits (4+)
2.1&3 4.22.1&3 4.23.5
5.34.32.3
4.32.3
5.34.32.3
5.34.32.3
4.12.1 6.22.1&3 4.1 5.3
4.22.3
2.3
PLW & HHs w/ ch. u5PLW & Households
w/ children under 56-23 months & PLW
in Ubudehe 1 & 2Pregnant Women6-23 months6-59 months12-59 mths & 5-15 yrsu5 w/ severe diarrhoeau5 with SAMu5 with MAM6-59 monthsPregnant Women
4.12.1 6.2
6.2MIY
CN
Mic
ro-n
utr
ient
sM
anag
e di
seas
eM
AM
/SA
MM
NC
H
1. Refers to the Strategic Directions and Outputs of the National Food & Nutrition Strategic Plan (2013-18) Explanations: PLW = Pregnant and Lactating Women, HHs = Households, PW = Pregnant Women, LW = Lactating Women, SAM = Severe Acute Malnutrition, MAM = Moderate Acute Malnutrition, u5 = children under 5 years, ANC = Ante-Natal Care, MNP = Micronutrient Powders, CSB = Corn Soya Blend, ORS = Oral Rehydration Salts/Solution, Fe+FA = Iron & Folic Acid supplements
3.5
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Strategic Direction & Output1
The 23 Core Nutrition Actions agreed to map in Rwanda (2/2)How do they link to the NFNSP, and who are the main target groups
1 2 3 4 5 6 7Target group(s)
Provide materials and technology for small-scale horticulture (e.g. kitchen gardens)Promote food preservation and storageProvide animals for small-scale husbandryProvide input for production and consumption of bio-fortified crops (e.g. beans, sweet potato)Carry out nutrition education (e.g. cooking demonstrations)2 Carry out nutrition education at school (e.g. school gardens)Provide/Support improved water sourceProvide/Support improved sanitationPromote hygiene / hand washing Provide conditional social safety net actions (VUP)Provide school feeding (e.g. One Cup of Milk)
2.1&3 5.13.2
5.1
2.3 5.34.5
2.3 5.34.5
2.3 5.34.5
2.3 3.5
5.2
Households with children under 5
Farming householdsHouseholds Ub. 1&2Households with
children under 5Mothers / caregivers
(w/ children under 5)Schools
Households + schoolsHouseholds + schoolsPLW + schoolsHouseholds Ub. 1&2Primary school children
2.3 3.1
2.3 3.2
2.3 3.5
2.3 4.33.4
Food
& a
gric
ultu
reN
utrit
ion
educ
atio
nW
ASH
Soci
al
prot
.
Core Nutrition Actions (CNAs)
1. Refers to the Strategic Directions and Outputs of the National Food & Nutrition Strategic Plan (2013-18) 2. Should avoid overlap with "Promote optimal breastfeeding practices", "Promote optimal complementary feeding practices" and "Promote hygiene / hand washing"Explanations: Ub. 1&2 = Ubudehe 1 and 2 categories – the poorest households, VUP = Vision 2020 Umurenge Program – the social security programme of MINALOC
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Key messages on the nutrition situation in Rwanda
While there have been marked reductions in the prevalence of chronic malnutrition (stunting) over the last decade, stunting in Rwanda still remains in high severity zone as a major public health concern1
• Nearly 600,000 children under 5 (38%) are chronically malnourished• There is still a large gap to reach the targets set in the HSSP-3 and NFNSP (18% in 2018)• Very high1 stunting levels (>40%) persist in 1 of 3 of the country’s districts, and only 3 districts are below 30%• Further action and scale up is needed to address and accelerate the rate of reduction
Wasting (2.2%) is below the critical thresholds set by WHO (5%), but Severe Acute Malnutrition (0.6%) is still a public health concern1 (>0.1%)
• Underweight targets as set in the Millennium Development Targets were reached (target 14.5%, now 9% prevalence among under5s), but there is still a gap to the targets set in HSSP-3 and NFNSP (4% in 2018)
Anemia among children 6-59 months has decreased (down from 38.1% in 2010 to 36.5% in 2014/15), while anemia among women 15-49 years has increased (17.3% in 2010 to 19.2% in 2014/15)
• Both are still far from normal levels1 (<5%), and anemia thus needs to be further addressed
Several core indicators to reduce stunting are showing slow progress, such as Food Consumption Scores, Minimum Acceptable Diet and WASH indicators
• Indicates that further focus and scale up is needed
1. As defined by WHOSource: DHS 2014/15, DHS 2010, HSSP-3, NFNSP
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Situation Analysis Dashboard (National Level)What is the nutrition situation stakeholders need to address?
Iron deficiency
Underweight
Stunting
Care
Wasting
Food security
Underweight prevalence among children 0-59 mo. old
Stunting prevalence among children 0-59 mo. old
Anemia among women 15-49 yrs old (any anemia)
Indicator Status
SAM prevalence among children 0-59 mo. old
GAM prevalence among children 0-59 mo. old
Population living under national poverty linePopulation living in extreme poverty (national line)
Total fertility ratePercentage with unmet need for family planning
Gender
Poverty
Nu
trit
ion
al
imp
act
37.9%
2.2%
0.6%
9.3%
19.2%
Un
der
lyin
g
ca
use
s
Households with poor & borderline food cons. scoreGlobal Hunger Index rating
21.1%15.6
Population
Children 6-23 mo. old with min acceptable diet (MAD) 17.8%
Education
Bas
icca
use
s
Teenage pregnancy: women 15-19 with a live birthWomen who participate in major household decisionsGlobal Gender Gap ranking
44.9%24.1%
5.5%Xx.x%7 / 142
4.218.9%
Females that completed primary school or higher Literacy rate 15 years or more - Women
Xx.x%64.7%
44.2% (2010)
2.8% (2010)
0.8% (2010)
11.4% (2010)
17.3% (2010)
21.5% (2009)24.1 (2005)
16.8% (2010)
56.7% (2005/06)35.8% (2005/06)
4.7% (2010)58.7% (2010)N/A
4.6 (2010)18.9% (2010)
30.1% (2010)60.1% (2005/06)
Severity
N/A
N/A
N/AN/A
N/AN/AN/A
N/AN/A
N/AN/A
SourceDHS
DHS
DHS
DHS
DHS
DHS
EICVEICV
DHSDHSGGGI
DHSDHS
DHSEICV
CFSVAGHI
Year2014/15
2014/15
2014/15
2014/15
2014/15
Health & Sanitation
Under 5 mortality rate (deaths per 1,000 live births)Low birthweight prevalence (<2,500g)Women 15-49yrs with problems accessing health care Household access to improved water source Household access to improved sanitation facilities
50X.x%Xx.x%74.2%74.5%
76 (2010)6.2% (2010)61.4% (2010)70.2% (2005/06)58.5% (2005/06)
N/AN/A
N/A
DHSDHSDHSEICVEICV
2014/152014/152014/152010/112010/11
2014/15
2010/112010/11
2014/152014/152014
2014/152014/15
2014/152010/11
20122014
Infants 0–5 mo. exclusively breastfed Timely initiation of solid or semi-solid foods (6-8 mo)
87.3%55.8%
84.9% (2010)62.1% (2010)
N/AN/A
DHSDHS
2014/152014/15
Anemia among children 6-59 mo. old (any anemia) 36.5% 38.1% (2010)DHS 2014/15
Trend
Low
Medium
High
Severity:Improvement (blue arrow)
No change (yellow arrow)Worsening (red arrow)
Trend:
Households with handwashing facility, soap & water Xx.x% 2.1% (2010)N/ADHS 2014/15
Vit A deficiency Vitamin A deficiency among children 0-59 mo. old N/A 6.4% (1996)N/A N/A
Iodine deficiency Iodine deficiency among children 6-12 years old N/A N/AN/AN/A N/A
Note: Missing information to be updated as soon as the full Rwanda DHS 2014/15 is released
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Significant reductions in stunting, wasting and underweightStunting remains a public health concern, while wasting & underweight are below critical thresholds
Stunting Wasting UnderweightPrevalence among children under 5
2005 2010
DHS
20001992 2014/15
WHOseveritythreshold
20051992 2010
WHOseverity threshold
2014/152000
DHS
Prevalence among children under 5
2000 2005 20101992 2014/15
WHOseverity threshold
DHS
Prevalence among children under 5
Note: Prevalence for 1992. 2000 and 2005 have been recalculated using 2006 WHO growth standardsSource: Rwanda DHS, WHO classification of malnutrition severity
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While MDG target is achieved, only wasting seems to be on track to meet 2018 targets set in the HSSP III and the NFNSP
Stunting Wasting UnderweightPrevalence among children under 5
2005 2010
DHS
20001992 2014/15
2018TargetHSSP318%
20051992 2010
2018TargetHSSP32%
2014/152000
DHS
Prevalence among children under 5
2000 2005 20101992 2014/15
2018TargetHSSP34%
DHS
Prevalence among children under 5
Note: Prevalence for 1992. 2000 and 2005 have been recalculated using 2006 WHO growth standards. HSSP3 = Health Sector Strategic Plan 3 from 2013-2018Source: Rwanda DHS, WHO classification of malnutrition severity
Backup
MDG target14.5%
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There are still nearly 600,000 stunted children in Rwanda
Population of selected target groups Number of malnourished children
Note: Census data from 2012 adjusted using the Census' medium growth estimates to get 2014 estimatesSource: Rwanda DHS 2014/15, Rwanda National Census 2012
6,000
10,000
4,000
2,000
12,000
8,000
0
641
9,127
10,997
2,536
1,554
Rural population
33014%
83%
6%
Pregnant Women
Children under 2
Households
3%
Children under 5
Population in '000s
Total population
700
600
0
400
500
200
300
100
Malnourished children under 5 years old in '000s
38%
34
UnderweightWasting
144
Stunting
9%2%
589
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Stunting increases drastically from a child is 6 to 24 months oldNutritional status of children by age from DHS 2014-15
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Minimum Acceptable Diet (MAD) rates among children 6-23 months are still very low, and progress is slow
Backup
1. Given the standard deviations and confidence interval, this is not a statistical significant improvementNote: Minimum Acceptable Diet is a composite indicator building on both Minimum Meal Frequency and Minimum Diet DiversitySource: Rwanda DHS 2010 and 2014/15
18-23 months Total
+1.0
% of children 6-23 months with Minimum Acceptable Diet
9-11 months 12-17 months6-8 months
Age groups
DHS 2010
DHS 2014/15
Only 1%-point improvement over 5 years1
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Anemia rates are still high, and reduction is slow for anemia among children, while anemia among women is increasing
Two provinces with increased anemia among children 6-59 months
Anemia among women is increasing – only Kigali and East with reduction
+1.8
-3.5
+3.0
-7.5
-3.9
Anemia prevalence among children 6-59 months
West
-1.6
Kigali City
South North EastRwanda
DHS 2014/15
DHS 2010
Province
North
+3.8
EastSouth West
+1.9
-1.0
Kigali City
-3.2
+5.5
+2.6
Rwanda
Anemia prevalence among women 15-49 years
Backup
Source: Rwanda DHS 2010, Rwanda DHS 2014/15
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Food security as measured with acceptable Food Consumption Score is improving, but slowly
Backup
-0.4%
3.8%
% of population
+0.4%
Acceptable FCS Poor FCSBorderline FCS
2012
2009
1. Given the standard deviations and confidence interval, this is not a statistical significant improvementNote: CFSVA/NS data from 2015 will be added when availableSource: Rwanda CFSVA/NS 2012
Only 0.4%-point improvement over 5 years1
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WASH related indicators are at a low level, and improvement is limited and behind targets
2017/18 Target
EDPRS2
WATSAN 2014
2010/11 EICV3
25%
Households with access to improved water source
Still large gap to reach targets for access to improved water
Less than half of households are using appropriate water
treatment methodsOnly 2% have a handwashing
facility with soap & water
Households using an appropriate water treatment method
N/A
DHS 2014/15DHS 2010
10%
Hand washing facility
No water
or soap
Households with place for washing hands
Soap only
0%
Water & soap
Water only
Backup
Note: DHS 2014/15 data will be added when availableSource: EICV3, WATSAN 2014, EDPRS2, DHS 2010
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Stunting levels are high throughout the country with nearly 1 of 3 districts exceeding the 'very high' severity threshold
1. Among children 0-59 monthsNote: Will be updated to DHS 2014/15 data when available. NB! Confidence intervals are rather large on a district levelSource: Rwanda National Nutrition Screening 2014, WHO classification of malnutrition severity
Prevalence of stunting among children under 5 years old
Nyagatare37%
Gatsibo37%
Kayonza33%
Karongi42% Bugesera
41%
Rusizi36%
Nyamasheke39%
Kirehe40%
Ngoma35%
Rwamagana33%
Nyaruguru38%
Nyamagabe40%
Rulindo34%
Gicumbi38%
Huye30%
Nyanza31%
Musanze33%
Burera38%
Gakenke38%
Ngororero48%
Nyabihu46%
Ruhango37%
Muhanga43%
Kamonyi39%
Gisagara36%
Rubavu48%
City of KigaliRutsiro
51%
City of KigaliKicukiro
28%
Gasabo32%
Nyarugenge26%
20% - 29%30% - 39%>40%
Stunting prevalence1 <20%
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Vast regional disparities in anemia levels, spanning nearly 30 point range (52.7% to 23.0%)
40% of the districts in Rwanda had anemia levels above (≥40%) in 2010 (12 out of 30 districts)
The urban district of Kicukiro is above (≥ 40%) , which shows that anemia is also a latent urban problem.
The most alarming districts with ≥ 45% of children with anemia are: Rusizi, Nyamagabe, Gatsibo, Ngoma, Kirehe, Gisagara and Nyamasheke
Anemia is a critical public health concern, with 40% of the districts in Rwanda with anemia levels above (≥ 40%)
Backup
Note: Will be updated to DHS 2014/15 data when available NB! Confidence intervals are rather large on a district levelSource: Rwanda DHS 2010, Rwanda Nutrition Situation Analysis
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Districts with different level of development on key indicatorsRanked by weighted development score (constructed composite index)
<30 30-40 >40Weighted development score:
Note: Weighted development score is a composite indicator that consists of stunting prevalence, poverty rates, food security scores, minimum acceptable diet, improved water & improved sanitation. The chosen weights are shown on top. All indicators are adjusted so that lower is better. Source: DHS 2010, EICV3 2010-11, CFSVA/NS 2012, National Screening 2014
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Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
Districts in South and West are the least developed
City of KigaliKicukiro
Gasabo
Nyarugenge
<30 30-40 >40Weighted development score:
Note: Weighted development score is a composite indicator that consists of stunting prevalence, poverty rates, food security scores, minimum acceptable diet, improved water & improved sanitation. The weighted development score is indicative only, and should not be used for other purposes. Source: DHS 2010, EICV3 2010-11, CFSVA/NS 2012, National Screening 2014 NB! Confidence intervals are rather large on a district level
Weighted development score per district
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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High-level approach for the Stakeholder & Action Mapping
Time estimate
Activities
Preparation
1-3 months2
• Introducing the tool & approach
• Discussing and deciding on the Core Nutrition Actions (CNAs1)
• Preparing templates & letters
Data collection
2-4 months3
Quantitative analysis
~1+ month
Datainterpretation
~1+ month
Mapping process
Note: The Stakeholder & Action Mapping can be conducted quicker than the timeline above now that it has already been conducted and the tool and templates have been developed and customized for Rwanda. Also, the timeline has been stretched due to multiple parallel priorities (one resource working ~30% on the Stakeholder & Action Mapping, not 100%)1. CNA = Core Nutrition Actions 2. Depending on time to get agreement and sign-off on CNAs and Rwanda specifics in tool 3. Depending on number of districts mapped, the number of participating organizations, the data availability and the time and resources committed to data collection
Dat
a di
ssem
inat
ion
Sta
keho
lder
dia
logu
e on
sca
ling
up n
utrit
ion
• Templates & letters sent out
• Templates filled in and returned by stakeholders
• Beneficiary coverage meetings set up and conducted
• Clean and quality check data
• Remove potential duplicates
• Add situation indicators (DHS)
• Analyze data and make analysis output
• Interpret coverage data with situation indicators
• Identify potential coverage gaps
• Make recommendations
• Compile report / presentation
Jan-Mar Apr-Jul Aug Sep
Iteration
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The preparation phase consisted of three main deliverablesCustomizing tool to country specifics must be conducted and agreed before starting data collection
Country specifics to customize tool
Rwanda nutrition stakeholder overview
External data input for population & indicatorsA B C
GeographyGeography of mapping exercise
A1
Core nutrition actionsE.g. exclusive breastfeeding,
biofortification, ...
A2
Delivery mechanismsE.g. health centers, radio, ...
A3
Target groupsE.g. pregnant & lactating women,
households, ...
A4
Combine / LinkRelevant target groups, del.
mech. & indicators per action
A6
Situation indicatorsE.g. wasting, anemia, ...
A5
Long-list of all stakeholders• Who they are, where they
work, what they work on• Contact details
Draft stakeholder profile for the key stakeholders:
B1
B2
Population data • Per district• Per target group
Data on situation indicators per district
• Wasting, stunting, etc.
C1
C2
For each year and geography mapped, what is the population size of
each target group?
For each year and geography mapped, what are the situation indicator
levels?
Preparationphase
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Population data was mainly collected from the 2012 Census
Preparationphase
C1
Target group
Population groups• Entire population• Children 6-23 months• Children 0-59 months (u5)• Children 6-59 months• Children 12-59 months• Children 5-15 years• Pregnant women (PW)• Lactating women (LW)
Households• Households• Households with children u5
(Mothers/Caregivers w/ ch. u5)• Farming households• Households Ubudehe 1&2
Schools• Schools• School children• Primary schools• Primary school children
Children with illness• Children u5 with SAM• Children u5 with MAM• Children u5 with severe diarrhea
Sources
Rwanda Population and Household Census, 2012, NISR
• Population by district• Population by single age and
sex• Population growth projections
(medium growth)
Rwanda Population and Household Census, 2012, NISR
• EICV 3, Thematic Report Agriculture, 2012, NISR
• MINALOC Ubudehe cat. 2014
Rwanda Education statistics, MINEDUC 2013/14
• School overview MINEDUC• Education statistics for 2013
DHS & National Screening data• MAM & SAM prevalence from
DHS 14/15 & Nat. Nutr. Scr.• Severe diarrhea from DHS
Methodology
Using population data by district, by single age and by sex
• Adjusting 2012 figures to 2014 figures by using medium growth projections in the Census
• PW in 2014 estimated by the number of children 0 to 1 year in 2015 (estimate)
• LW estimated by the number of children 0-23 months in 2014
Same as above, but with additional data• Dividing u5 with 1.5 (based on average
birth spacing) to get HHs with childr. U5• % farming households from EICV3• % of HHs in U1&2 from MINALOC data
Using Rwanda Education statistics• MINEDUC provided number of schools• Number of school children from statistics• Schools split by type of school• School children split by type of school
Multiplying prevalence by age group• Children u5 multiplied by prevalence of
MAM and SAM (from DHS14/15 & NNS)• U5 multiplied by severe diarrhea prev.
Note: Target group size in SUNPMT may not match with target group sizes used by other organizations if sources and way of estimating differs
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Data collection was conducted in two steps
Who is doing what and where Coverage for 23 core nutrition actions1 2
Mapping of nutrition stakeholders in Rwanda – who is doing what and whereObjective
Mapping beneficiary coverage for 23 selected core nutrition actions
What to map
Long-list of nutrition stakeholders and their contribution to the core nutrition actions
• Indicate which of the core nutrition actions are they working with
• Report their organization role and their partners for each of the actions
• Report what districts and sectors they are supporting for each of the actions
Map action coverage for the 23 core nutrition actions (CNAs)
• How many of the target groups are we covering for each action, in each district?
• Focus on mapping beneficiaries coverage• Also get information on project duration,
donors, implementing partners and delivery mechanism
Data collection method
Self-reporting by the stakeholders• Template was sent out, filled and returned• Acted as information input for step 2
Collect coverage data using SUNPMT tool• Interview based data collection• Careful preparation from stakeholders
Who to collect
data from
Template sent out to all known nutrition stakeholders in Rwanda
Selected stakeholders working with the core nutrition actions (informed by step 1)
Qualitative view Quantitative view
Data collection
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Some of the coverage data is provided directly by ministries
Data collection Backup
Data collection sourceCore nutrition actions
Promote optimal breastfeeding practices Promote optimal complementary feeding practicesProvide specialized nutritious products for complementary feedingProvide Fe+FA supplementsProvide MNP supplementsProvide Vit A supplementsProvide deworming tabletsProvide diarrhoea treatment (w/ ORS/ORS-zinc)Provide treatment of SAMSupport and provide treatment of MAMConduct child growth monitoring / screeningPromote/Provide ANC visits (4+)Provide materials and technology for small-scale horticulture (Kitchen gardens)Promote food preservation and storageProvide animals for small-scale husbandryProvide input for production and consumption of biofortified crops (e.g. beans, sweet potato)Carry out nutrition education (e.g. cooking demonstrations) Carry out nutrition education at school (school gardens)Provide/Support improved water sourceProvide/Support improved sanitationPromote hygiene / hand washing Provide conditional social safety net actions (VUP)Provide school feeding (One Cup of Milk)
MoH (and partners)MoH (and partners)Implementing PartnersMoHImplementing PartnersMoHMoHMoHMoHMoH (and partners)MoHMoHImplementing partners
MINAGRI (and partners)Implementing partnersMINAGRI (and partners)
Implementing partnersMINEDUCImplementing partnersImplementing partnersImplementing partnersMINALOCMINAGRI (and partners)
MIY
CN
Mic
ro-n
utr
ient
sD
i-se
ase
MA
M/
SAM
MC
HFo
od &
A
gric
ultu
reN
ut.
Edu.
WA
SHSo
c.
Sec.
Comments
Split in two target groupsSplit in two target groups
From campaign dataFrom campaign dataHealth facilities treatment dataHealth facilities treatment dataOther partners also supportingOther partners also supportingOther partners also doing promotingNo data available from MINAGRI
No data available from MINAGRI
Other partners also doing SILC
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How is the population coverage calculated by the tool?
To have consistent results, it is important to consistently map the actions at the same geographic level
Number of beneficiaries in the target group covered by the
action, in the selected geography
Population size of the target group, in the selected
geography
Interview database
Popula-tion
Two sources are used as input for thepopulation coverage calculation Concrete example
Provide vitamin A supplements to children6-59 months in Gasabo, in 2014
Sum of all beneficiaries covered per action where• Country = Rwanda• Province = Kigali City• District level = Gasabo• Action = Provide vitamin A supplements• Target group: Children 6-59 months• At least 1 month of 2014 is included in timeframe
Population size where• Country = Rwanda• Province = Kigali City• District = Gasabo• Target group: Children 6-59 months
Quantitative analysis
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Important limitations to note on Stakeholder & Action Mapping
Not all nutrition stakeholders have participated in the
mapping
Stakeholder & Action Mapping does not cover all organizations working with nutrition in Rwanda• Focus has been on capturing data from the largest stakeholders, not all stakeholders• We have sent requests to all known stakeholders, but there may be other organizations that we do not
yet know about that have not been reached out to• It is voluntary to provide input on the mapping, and some stakeholders have chosen not to participate
Not all stakeholders have good data or data
at all
Even for the stakeholders who have participated, there is sometimes limitation in data availability• Not all stakeholders have collected coverage data for their programs and projects (this is for example
a problem for some of the ministries, e.g. MIGEPROF)• Some have collected the data, but the data quality is not good enough• Some organizations are very large and are doing many programs and projects. There may then be
nutrition activities conducted that they have not reported
Missing input from most WASH
stakeholders
There has been limited participation from WASH stakeholders in the Stakeholder & Action Mapping• WASH is very important for stunting reduction, and three of the CNAs are related to WASH• However, WASH is coordinated in separate technical working groups, and have less interaction with
the Food & Nutrition Technical Working Groups than what would be ideal• The mapping request was therefore also shared with the WASH TWGs, but very few stakeholders
participated in the mapping, meaning that there are large gaps in the completeness of WASH actions
We do not know the quality of the
coverage or actions conducted
When providing data of the number of beneficiaries reached with different actions, we do not necessarily know the quality of these actions
• For example, if one partner have done one large meeting with 500 participants, the quality of the sensitization may not be as good as if one organization is following 500 beneficiaries individually
• Or for kitchen gardens, the quality and how functional the kitchen garden is may differ• Coverage is still counted equally, though the quality of the coverage may differ
Data interpretat.
Note: See also Disclaimer slide
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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37 food & nutrition stakeholders have provided mapping inputStakeholder profiles have been made for these organizations
Government
UN Agencies
Research / Academia2
NGOs
• Ministry of Agriculture and Animal Resources (MINAGRI)
• Ministry of Education (MINEDUC)• Ministry of Gender and Family
Promotion (MIGEPROF)• Ministry of Health (MoH)• Ministry of Local Government
(MINALOC)• Food & Agriculture Organization (FAO)• One UN REACH• International Fund for Agricultural
Development (IFAD)1 • United Nations Children's Fund
(UNICEF)• World Food Programme (WFP)• World Health Organization (WHO)• World Bank1
• Catholic University of Rwanda (CUR) • International Center for Tropical
Agriculture (CIAT)2 • University of British Columbia (UBC)
• The Access Project (AP)• Adventist Development and Relief
Agency (ADRA)• AVSI Foundation RWANDA (AVSI)• Caritas International Rwanda (Caritas)• Catholic Relief Services (CRS)• Clinton Health Access Initiative (CHAI)• Concern Worldwide Rwanda (CWR)• Cooperative for Assistance and Relief
Everywhere (CARE)• Family Health International 360
(FHI360)• Gardens for Health International (GHI)• Global Communities (GC)• Glocal Forum YaLa Africa (GFYA)• Heifer International Rwanda (HIR)• International Rescue Committee (IRC)• Partners In Health (PIH)• Peace Corps Rwanda (PCR)3 • Rwanda Nutrition Society (RNS)2 • Send a Cow Rwanda (SaCR)• Society for Family Health (SFH)• WaterAid Rwanda (WaterAid)• World Relief Rwanda (WRR)• World Vision Rwanda (WVR)
1. IFAD and the World Bank have provided input on some of their nutrition sensitive programs, but not directly on the core nutrition actions 2. CIAT and RNS have provided input on research support, but not directly on the core nutrition actions 3. Peace Corps is a new partner and the Peace Corps Volunteers will start working with food & nutrition from August 2015
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An additional 40+ food & nutrition stakeholders have been mentioned in the mapping by other partners
Government
Bi-/Multilateral
• Canadian Department of Foreign Affairs, Trade and Development (DFATD)
• Canadian Food Grain Bank (CFGB)• Embassy of the Kingdom of Netherlands
(EKN) / Government of Netherlands• European Union (EU)• Irish Aid (Irish DFAT)• Korea International Cooperation Agency
(KOICA)• Swiss Agency for Development and
Cooperation (SDC)• UK Department for International
Development (DFID) / UK AID• United States Agency for International
Development (USAID)
• Ministry of Disaster Management and Refugee Affairs (MIDIMAR)
• Rwanda Agricultural Board (RAB)• Rwanda Education Board (REB)• Rwanda Biomedical Center (RBC)• Local Administrative Entities
Development Agency (LODA)• National Women Council (NWC)• Districts• Health Facilities• Schools
NGOs & Foundations
Field implementers:• ADEPR• African Evangelist Enterprice (AEE)• Association for Humanitarian Peace (APH)• Association Rwandaise pour la Promotion
du Development Integre (ARDI)• Benishyaka Association• Caritas Kabgayi & Gikongoro• COFORWA (Compagnons Fontainiers du
Rwanda)• Farming cooperatives• DUHAMIC ADRI• Eglise Presbytérienne au Rwanda (EPR)• Mouvement de Lutte contre la Faim au
Monde (MLFM)• Rwanda Rural Rehabilitation Initiative
(RWARRI)• Save the Children Rwanda (StC)• SDA Iriba
Donor organizations:• CIFF – Children's Investment Fund Found.,
Global Giving, Oxfam, Gates Foundation, Keurig Green Mountain (KGM), Fondation d'Harcourt, CASASCHI, FONERWA, SUN Multi-Partner Trust Fund, Starbucks, African Development Bank (AfDB)
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Overview of large nutrition specific and sensitive programsKey programs being implemented in country – see more details in next slides
Nutrition specific programs
EKN/GoN Nutrition Program• Lead by UNICEF• 18 districts (all sectors)• 2014-17
One UN Joint Nutrition Program• Lead by WFP• 2 districts (all sectors)• 2013-16
CIFF Food & Nutrition Program• Lead by MoH & MINAGRI• 4 districts (all sectors)• 2015-18
USAID INWA Program• Lead to be decided• 8 districts (all sectors)• 2016-20
EU Nutrition Budget Support• Direct budget support to MoH,
MINAGRI and MINEDUC• 2013-16
Will in 2016 cover all 30 districts
Programs with food & nutrition component
USAID Gimbuka Program• Lead by Caritas• 9 districts (21 sectors)• 2012-15
USAID Ejo Heza Program• Lead by Global Communities• 8 districts (all sectors)• 2011-16
USAID Higa Ubeho Program• Lead by Global Communities• 10 districts (89 sectors)• 2009-15
USAID Twiyubake Program• Lead by Global Communities• 4 districts (all sectors)• 2015-20
Nutrition sensitive agriculture program
USAID Shisha Wumwa Program• Lead by Land O'Lakes• 2012-16
Land, Water, Hillside (LWH) program• Funded by WB, IDA, CIDA, US, ++• 2010-17
Rural Sector Support Program• Funded by World Bank• 2001-16
Post-harvest & Agribusiness Support Project
• Funded by IFAD• 2014-19
Rural Income through Exports• Funded by IFAD• 2011-18
Kirehe Watershed Mgmt Project• Funded by IFAD• 2009-16
A B C
A1
A2
A3
A4
A5
B1
B2
B3
B4
C1
C2
C3
C4
C5
C6
Note: Overview is not exhaustiveSource: Stakeholder interviews
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Nutrition specific programs will in 2016 cover all districtsBut from 2017, many districts will be without funding support unless funding is extended
Province District Organization Donor(s) Implementing partner 2014 2015 2016 2017 2018 2019 2020
Kigali CityNyarugenge USAID USAID TBD (INGO)Gasabo UNICEF GoN, USAID, IKEA WRR (from 2015)Kicukiro USAID USAID TBD (INGO)
South
Nyanza USAID USAID FXBGisagara UNICEF EKN CWR (ARDI)Nyaruguru UNICEF EKN CWR (ARDI)Huye CIFF CIFF MoH & MINAGRINyamagabe UNICEF EKN, SDC (One UN) WRR, WVRRuhango USAID USAID CaritasMuhanga UNICEF EKN CRS (Caritas Kabgayi)Kamonyi UNICEF EKN ADRA
West
Karongi UNICEF EKN CRS (EPR)Rutsiro UNICEF EKN, SDC (One UN) WRR, WVR, CaritasRubavu UNICEF GoN, USAID APNyabihu USAID USAID TBD (INGO)Ngororero CIFF CIFF MoH & MINAGRIRusizi UNICEF GoN WRR (from 2015)Nyamasheke UNICEF EKN, IKEA WVR
North
Rulindo CIFF CIFF MoH & MINAGRIGakenke UNICEF GoN, USAID, IKEA APMusanze UNICEF GoN, USAID APBurera UNICEF GoN Dir. district supportGicumbi UNICEF EKN, IKEA WVR
East
Rwamagana USAID USAID AEENyagatare CIFF CIFF MoH & MINAGRIGatsibo UNICEF EKN ADRAKayonza USAID USAID TBD (INGO)Kirehe UNICEF GoN Dir. district supportNgoma USAID USAID TBD (INGO)Bugesera UNICEF GoN, USAID AP
Note: Timeline showing approximate start and end dates with current funding Source: Stakeholder interviews
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Other partners and programs are also present in the districts
Province District Organization Donor(s) Implementing partn. Other stakeholders working in district1
Kigali CityNyarugenge USAID USAID TBD (INGO) GFYA (FAO, GG)
Gasabo UNICEF GoN, USAID, IKEA WRR (from 2015) GFH (GHI), GFYA (FAO, GG), SFH (USAID), WVR (WVI), GC (USAID/HU closed 2015, T from 2015)
Kicukiro USAID USAID TBD (INGO) GFYA (FAO, GG), SFH (USAID/EH), WVR (WVI)
South
Nyanza USAID USAID FXB SFH (USAID), GC (USAID/EH), AVSI (3x), SaCR (Oxfam,SaC,DFID GPAF)
Gisagara UNICEF EKN CWR (ARDI) SFH (USAID), GC (USAID/EH), CUR (CUL)
Nyaruguru UNICEF EKN CWR (ARDI) Caritas (USAID), SFH (USAID), GC (USAID/EH), WVR (WVI), SaCR (Oxfam,SaC,DFID GPAF)
Huye CIFF CIFF MoH & MINAGRICWR (IA cl.'15), SFH (USAID), GC (USAID/EH & T 2015), WVR (WVI), CUR (CUL), CRS (KGM-cl.2014)
Nyamagabe UNICEF EKN, SDC (One UN) WRR, WVR CWR (IA cl.'15), Caritas (USAID), One UN (SDC), WVR (SDC), GC (USAID/EH), CRS (KGM-cl.2014)
Ruhango USAID USAID Caritas Caritas (USAID), SFH (USAID), AVSI (3x), GC (USAID/HU closed 2015)
Muhanga UNICEF EKN CRS (Caritas Kabgayi) Caritas (USAID), SFH (USAID), GC (USAID/HU closed 2015)
Kamonyi UNICEF EKN ADRA CARE (USAID - closed Mar 2015), Caritas (USAID), SFH (USAID), AVSI (3x), GC (USAID/HU cl. 2015)
West
Karongi UNICEF EKN CRS (EPR) Caritas (USAID), SFH (USAID), GC (USAID/EH), WVR (WVI)
Rutsiro UNICEF EKN, SDC (One UN) WRR, WVR, Caritas Caritas (USAID), SFH (USAID), One UN (SDC, EKN), GC (USAID/EH), WVR (WVI, Koica)
Rubavu UNICEF GoN, USAID AP SFH (USAID), GC (USAID/HU closed 2015)
Nyabihu USAID USAID TBD (INGO) GC (USAID/HU closed 2015)
Ngororero CIFF CIFF MoH & MINAGRI Caritas (USAID), SFH (USAID), GC (USAID/EH)
Rusizi UNICEF GoN WRR (from 2015) FHI360 (USAID), SFH (USAID)
Nyamasheke UNICEF EKN, IKEA WVR SFH (USAID)
North
Rulindo CIFF CIFF MoH & MINAGRI SFH (USAID), WVR (WVI), SaCR (UKAID,Oxfam,Gates Fundation,SaC), GC (USAID/HU closed 2015)
Gakenke UNICEF GoN, USAID, IKEA AP SFH (USAID), WVR (WVI), GC (USAID/HU closed 2015)
Musanze UNICEF GoN, USAID AP GFH (GHI), SFH (USAID), GC (USAID/T - from 2015)
Burera UNICEF GoN Dir. district support PIH (PIH), GC (USAID/T - from end 2015)
Gicumbi UNICEF EKN, IKEA WVR SFH (USAID), AVSI (3x), GC (USAID/HU closed 2015)
East
Rwamagana USAID USAID AEE SFH (USAID), SaCR (Oxfam,SaC,FONERWA)
Nyagatare CIFF CIFF MoH & MINAGRI SFH (USAID), GC (USAID/HU closed 2015)
Gatsibo UNICEF EKN ADRA Caritas (USAID), AVSI (3x), WVR (WVI)
Kayonza USAID USAID TBD (INGO) ADRA (CFGB), SFH (USAID), WVR (WVI) PIH (PIH), SaCR (UKAID,Oxfam,Gates Fundation,SaC)
Kirehe UNICEF GoN Dir. district support SFH (USAID), PIH (PIH)
Ngoma USAID USAID TBD (INGO) IRC (EU), SFH (USAID)
Bugesera UNICEF GoN, USAID AP WaterAid (WaterAid UK), SFH (USAID), WVR (WVI), SaCR (UKAID,Oxfam,Gates Fundation,SaC)
Backup
Note: Overview showing main catalysts and implementing leads only (with donor in parentheses), but not local implementing partners 1. NB! Overview is not exhaustive
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Program overview from 2016 – with implementing partners
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of KigaliKicukiroNyarugenge
USAIDCIFF
UNICEF
GasaboWRR'15
8 districts4 districts18 districts
WVR
WRR'15
CWR
CWR
WRR, WVR
CRS
WRR, WVR
AP
APDS
AP
CRSADRA
AP DS
ADRAWVR
FxB
TBD
TBDAEE
TBD
Caritas
TBD TBD
DS
DS
DS
DS
Note: DS = Direct Support, TBD = To Be DecidedSource: Stakeholder interviews
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USD 30+ million in nutrition specific funding on these programs alone
DonorTotal funding in USD
Years of funding
Funding per year in USD
EKN 17,720,000 3 5,906,667
GoN 6,550,000 4 1,637,500
USAID 1,800,000 3 600,000
IKEA 524,000 2 262,000
UNICEF RR 800,000 4 200,000
SDC 4,900,000 3 1,633,333
USAID 28,800,000 5 5,760,000
CIFF 16,450,000 4 4,112,500 Total nutrition program funding 77,544,000 20,112,000
EU (Budget support) 33,000,000 3 11,000,000 Total incl. EU budget support 110,544,000 31,112,000
Over USD 30 million in yearly funding for next year.. …or ~20 USD per child u51
Pregnant & Lactating Women
Target group USD per
year
USD per year
Children u5
Children u2
640'
970'
1,550'
Total #
1. Graph is showing total funding per year divided by total target group, so can not add together figures for Children u2, PLWs and Children u5Source: Stakeholder interviews, Rwanda National Census
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Overview of core nutrition action categories and roles (1/2)
DonorsCatalysts Field implementersAction categoryResponsible
Ministries
MIYCN
MoH
(MIDIMAR – refugee camps)
UNICEF, WHO, WFP, UNHCR, StC, CRS, IRC, CHAI
CWR, Caritas, GHI, FHI360, SFH, PIH, GC, ADRA, Care, WVR, WRR, CUR, EPR, DUHAMIC ADRI, ADEPR, AEE, BENISHYAKA, RWARRI
EKN, Irish Aid, SDC, USAID, GHI, PIH, EU, CFGB, WVI, IKEA, Koica, WRI, CUL, UNICEF
Micronutrient supplementation
MoH UNICEF, UBC, CRS
ADRA, AP, CWR, WVR, WRR, Caritas, EPR
EKN, Irish Aid, SDC, WVI, IKEA, UNICEF
Management of MAM/SAM
MoH
(MIDIMAR – refugee camps)
UNICEF, WHO,WFP, UNHCR
CWR, Caritas, GFYA, FHI360, PIH, ADRA, WVR, RWARRI
Irish Aid, USAID, FAO, GG, PIH, CFGB, WVI, Koica, EKN, UNICEF, IKEA, GoN
Disease Prevention / Management
MoH UNICEF, WHO
Several NGOs support campaigns, e.g. ADRA, CWR and WVR
UNICEF
Maternal, Neonatal &
Child Health
MoH UNICEF, WHO, CRS, GC, AP, IRC
Caritas, GHI, FHI360, SFH, PIH, ADRA, CARE, WRR, BENISHYAKA, RWARRI, EPR, WIF, DUHAMIC-ADRI, ADEPR + several supporting screening
USAID, GHI, PIH, EU, CFGB, MoH, UNICEF, GoN, EKN, WRI, SDC, IKEA
Note: For explanation on abbreviations, see the full list of stakeholders Source: Rwanda Stakeholder & Action Mapping 2014/15
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Overview of core nutrition action categories and roles (2/2)
DonorsCatalysts Field implementersAction categoryResponsible
Ministries
Food & Agriculture
MINAGRI FAO, UNICEF, RCA, CRS, CWR, IRC, GC, CIAT
EKN, Irish Aid, GHI, USAID, FAO, GG, KGM, PIH, EU, AVSI, FdH, CFGB, WVI, IKEA, Koica, WRI, SDC, Oxfam, SaC, DFID, UKAID, Gates, Fonerwa, IFAD, UNICEF,CASACHI,DFATD, ADB
Nutrition education
MoH, MINEDUC, MINAGRI
UNICEF, WHO, CRS, AP, IRC, GC, StC
CWR, Caritas, GHI, GFYA, FHI360, SFH, PIH, GC, AVSI, ADRA, CARE, WVR, WRR, SaCR, CUR, EPR, RNS, DUHAMIC ADRI, ADEPR, AEE, BENISHYAKA, RWARRI, WIF
EKN, Irish Aid, GG, USAID, GHI, FAO, KGM, SUN, PIH, EU, FdH, AVSI, CFGB, CASASHI, WVI, Koica, IKEA, WRI, UNICEF, SDC, Oxfam, SaC, DFID, UKAID, Gates, Fonerwa, CUL, ADB
WASH
MoH (hygiene) MININFRA (water & sanit.)MINEDUC (schools)
UNICEF, WHO, CRS, StC, WaterAid, AP, GC
EKN, WaterAid, Irish Aid, WVI, USAID, GHI, KGM, FdH, AVSI, CASASHI, CFGB, WRI, UNICEF, SDC, GoN, IKEA, Oxfam, SaC, Fonerwa, UKAID, Gates, DFID
Social Protection
MINALOC,
(MINAGRI & MINEDUC for school feeding)
UNICEF, WFP, CRS, RAB
CWR, EPR, Caritas, SDA Iriba EKN, Irish Aid, KGM, EU, DFID
WaterAid, CWR, Caritas, GHI, FHI360, SFH, GC, AVSI, ADRA, CARE, WRR, SaCR, WVR, EPR, COFORWA, ADEPR, DUHAMIC ADRI, AEE, MLFM, APH, RWARRI, WIF, SNV
Caritas, GHI, GFYA, FHI360, PIH, GC, AVSI, ADRA, CARE, WVR, WRR, SaCR, EPR, ARDI, KOAKAKA Local cooperatives, DUHAMIC ADRI, HIR, ADEPR, AEE, BENISHYAKA, RWARRI, ICYUZUZO, SINAPISI, WIF
Note: For explanation on abbreviations, see the full list of stakeholders Source: Rwanda Stakeholder & Action Mapping 2014/15
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Explanation of stakeholder roles
Responsible Ministries – Responsible Ministries are the Ministries that take a lead role in management of a core nutrition action. The majority of actions are under the Ministry of Health as they are nutrition-specific or health related, but several are also under MINAGRI (food & agriculture), MINEDUC (schools & school children), MININFRA (water & sanitation) and MINALOC (social security)
Field Implementers – Field implementers are the organisations implementing a core nutrition action. A number of international and local NGOs are field implementers, often through public infrastructure and resources such as health facilities, community health workers and schools
Catalysts – Catalysts give support and overview to the organisations carrying out the core nutrition action. They can also be technical leads for several other organizations. The catalysts are comprised of a number of UN agencies and international NGOs supporting the government or subcontracting to other organisations
Donors – Donors provide financial support to allow core nutrition actions to be carried out. Key donors include multilateral and bilateral organisations, trusts and foundations and also include the government itself
Backup
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Key messages on where the stakeholders are working
All districts have partners working on food & nutrition in their districts:• However, the number of partners supporting the districts varies widely (from 3 to 13 partners)
The number of Core Nutrition Actions supported by a partner varies substantially• Some partners are supporting up to 15 (of 23) different Core Nutrition Actions, while others are supporting only one Core
Nutrition Action• All Core Nutrition Actions are thus not conducted in all districts
There is large variation in the number of sectors that a partner is covering in a district• Some partners are covering all sectors in a given district, while others may only be supporting 1-2 sectors• Other partners are only supporting the central district level, e.g. central level coordination and capacity, not direct
implementation at the beneficiary level• Even though all sectors are covered, that does not necessarily mean that all Core Nutrition Actions are done in all sectors, that
all villages in each sector is supported, or that all beneficiaries are covered
The overview of what partners are working where is only a snapshot of the current situation• Some projects are being finalized, and others are starting up, so the situation is continuously changing
The geographical mapping builds on the qualitative reporting input provided by the stakeholders in the first phase of the mapping, and it will thus not necessarily be one to one with the quantitative mapping of beneficiary coverage
• This is e.g. because some districts where not supported in 2014, some CNAs were not carried out in 2014, some data is provided from central level, data may not be available, etc.
Source: Rwanda Stakeholder & Action Mapping 2014/15
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What catalysts & implementers are working in which districts?
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
GakenkeNyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of Kigali
Kicukiro
Gasabo
Nyarugenge
UNICEFCIATGFYA
GFYASFH1 WVR
UNICEFCIATGHIGCGFYASFH1 WVR
UNICEFPIHSFH1 HIR
UNICEFCIATSaCRSFH1 AP
UNICEFFAOCIATSaCRSFH1 AP2 WaterAidWVRHIR
GCSaCRWVR
UNICEFADRA2 AVSICARECaritasCIATGCSFH1 HIR
UNICEFCaritasCIATCRS2 GCSFH1
UNICEFWFPFAOCURCWR2 GCSFH1
CURCIATCWRCRSGCSFH1 WVR
UNICEFWFPFAOCaritasCWR2 GCSaCRSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasCIATCWRCRSGCSFH1 WRR4
WVR4
UNICEFFAOFHI 360SFH1 HIR
UNICEFFAOCIATGHIGCSFH1 AP2 HIR
UNICEFFAOGCSFH1 AP2
UNICEFFAOGCSFH1 APHIR
Note: The map shows all organizations that have provided mapping input, but it does not show whether they are using anyone asfield implementers in the different districts.
Color code explanations:Project end in 2015Mostly central district level support
1. SFH is mostly doing social marketing through local CBOs2. Implementing partner for UNICEF EKN/GoN program3. One UN Joint Nutrition Program (SDC funded)4. Implementing partner for One UN SDC program
Ngororero
CIATGCSFH1 HIR
ADRACIATPIHSaCRSFH1 WVRHIR
FAOCaritasGCSFH1 AP
UNICEFIRCSFH1 AP
UNICEFFAOAVSICaritasGCSFH1 HIR
UNICEFWFPFAOCaritasCIATCRS2 GCSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasGCSFH1 WRR4 WVR4
AVSIGCSaCRSFH1 AP
UNICEFCIATGCPIH
UNICEFFAOGCSFH1 AP2 WVR
UNICEFWFPAVSICIATGCSFH1 WVR2
UNICEFWFPFAOADRA2 AVSICaritasCIATWVRHIR
UNICEFFAOSFH1 WVR2 HIR
NB! Only shows stakeholders who have reported
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What catalysts & implementers are working in which districts?And how many Core Nutrition Actions (CNAs) are they conducting?
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of Kigali
Kicukiro
Gasabo
Nyarugenge
CIATGCSFH1 HIR
UNICEFWFPFAOADRA2 AVSICaritasCIATWVRHIR
UNICEFCIATGFYA
GFYASFH1 WVR
UNICEFCIATGHIGCGFYASFH1 WVR
ADRACIATPIHSaCRSFH1 WVRHIR
UNICEFPIHSFH1 HIR
UNICEFCIATSaCRSFH1 AP
UNICEFIRCSFH1 AP
UNICEFWFPAVSICIATGCSFH1 WVR2
UNICEFFAOCIATSaCRSFH1 AP2 WaterAidWVRHIR
GCSaCRWVR
UNICEFADRA2 AVSICARECaritasCIATGCSFH1 HIR
UNICEFCaritasCIATCRS2 GCSFH1
UNICEFWFPFAOCURCWR2 GCSFH1
CURCIATCWRCRSGCSFH1 WVR
AVSIGCSaCRSFH1 AP
UNICEFWFPFAOCaritasCWR2 GCSaCRSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasCIATCWRCRSGCSFH1 WRR4 WVR4
UNICEFFAOFHI 360SFH1 HIR
UNICEFFAOSFH1 WVR2 HIR
UNICEFFAOAVSICaritasGCSFH1 HIR
UNICEFWFPFAOCaritasCIATCRS2 GCSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasGCSFH1 WRR4 WVR4
UNICEFFAOGCSFH1 AP2 WVR
UNICEFCIATGCPIH
FAOCaritasGCSFH1 AP
UNICEFFAOCIATGHIGCSFH1 AP2 HIR
UNICEFFAOGCSFH1 AP2
UNICEFFAOGCSFH1 APHIR
Color code explanations:Project end in 2015Mostly central district level support
Note: The map shows all organizations that have provided mapping input, but it does not show whether they are using anyone asfield implementers in the different districts.
1. SFH is mostly doing social marketing through local CBOs2. Implementing partner for UNICEF EKN/GoN program3. One UN Joint Nutrition Program (SDC funded)4. Implementing partner for One UN SDC program
CNAs covered:1 CNA2-4 CNAs5-9 CNAs10-15 CNAs16-23 CNAs
NB! Only shows stakeholders who have reported
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What catalysts & implementers are working in which districts?How many CNAs are they working on, and how many sectors are they covering?
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of Kigali
Kicukiro
Gasabo
Nyarugenge
Color code explanations:Project end in 2015Mostly central district level support
% of sectors covered:
0-25% of sectors
26-50% of sectors
51-75% of sectors
76-99% of sectors
100% of sectors
Note: The map shows all organizations that have provided mapping input, but it does not show whether they are using anyone asfield implementers in the different districts.
UNICEFCIATGFYA
GFYASFH1 WVR
UNICEFCIATGHIGCGFYASFH1 WVR
ADRACIATPIHSaCRSFH1 WVRHIR
UNICEFPIHSFH1 HIR
UNICEFIRCSFH1 AP
UNICEFFAOCIATSaCRSFH1 AP2 WaterAidWVRHIR
GCSaCRWVR
UNICEFADRA2 AVSICARECaritasCIATGCSFH1 HIR
UNICEFCaritasCIATCRS2 GCSFH1
UNICEFWFPFAOCURCWR2 GCSFH1
CURCIATCWRCRSGCSFH1 WVR
AVSIGCSaCRSFH1 AP
UNICEFWFPFAOCaritasCWR2 GCSaCRSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasCIATCWRCRSGCSFH1 WRR4 WVR4
UNICEFFAOFHI 360SFH1 HIR
UNICEFFAOSFH1 WVR2 HIR
UNICEFFAOAVSICaritasGCSFH1 HIR
UNICEFWFPFAOCaritasCIATCRS2 GCSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasGCSFH1 WRR4 WVR4
FAOCaritasGCSFH1 AP
UNICEFFAOGCSFH1 AP2
UNICEFFAOGCSFH1 APHIR
1. SFH is mostly doing social marketing through local CBOs2. Implementing partner for UNICEF EKN/GoN program3. One UN Joint Nutrition Program (SDC funded)4. Implementing partner for One UN SDC program
CNAs covered:1 CNA2-4 CNAs5-9 CNAs10-15 CNAs16-23 CNAs
CIATGCSFH1 HIR
UNICEFCIATSaCRSFH1 AP
UNICEFFAOCIATGHIGCSFH1 AP2 HIR
UNICEFCIATGCPIH
UNICEFFAOGCSFH1 AP2 WVR
UNICEFWFPAVSICIATGCSFH1 WVR2
UNICEFWFPFAOADRA2 AVSICaritasCIATWVRHIR
NB! Only shows stakeholders who have reported
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What catalysts & implementers are working in which districts?How many CNAs are they working on, and what districts does not have support in all sectors?
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of Kigali
Kicukiro
Gasabo
Nyarugenge
CIATGCSFH1 HIR
UNICEFCIATGFYA
GFYASFH1 WVR
UNICEFCIATGHIGCGFYASFH1 WVR
ADRACIATPIHSaCRSFH1 WVRHIR
UNICEFPIHSFH1 HIR
UNICEFCIATSaCRSFH1 AP
UNICEFIRCSFH1 AP
UNICEFFAOCIATSaCRSFH1 AP2 WaterAidWVRHIR
GCSaCRWVR
UNICEFADRA2 AVSICARECaritasCIATGCSFH1 HIR
UNICEFCaritasCIATCRS2 GCSFH1
UNICEFWFPFAOCURCWR2 GCSFH1
CURCIATCWRCRSGCSFH1 WVR
AVSIGCSaCRSFH1 AP
UNICEFWFPFAOCaritasCWR2 GCSaCRSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasCIATCWRCRSGCSFH1 WRR4 WVR4
UNICEFFAOFHI 360SFH1 HIR
UNICEFFAOSFH1 WVR2 HIR
UNICEFFAOAVSICaritasGCSFH1 HIR
UNICEFWFPFAOCaritasCIATCRS2 GCSFH1 WVR
One UN3 UNICEF3 WFP3 WHO3 FAO3 CaritasGCSFH1 WRR4 WVR4
FAOCaritasGCSFH1 AP
UNICEFFAOGCSFH1 AP2
UNICEFFAOGCSFH1 APHIR
Color code explanations:Project end in 2015Mostly central district level support
Note: The map shows all organizations that have provided mapping input, but it does not show whether they are using anyone asfield implementers in the different districts.
1. SFH is mostly doing social marketing through local CBOs2. Implementing partner for UNICEF EKN/GoN program3. One UN Joint Nutrition Program (SDC funded)4. Implementing partner for One UN SDC program
CNAs covered:1 CNA2-4 CNAs5-9 CNAs10-15 CNAs16-23 CNAs
% of sectors covered:
0-25% of sectors
26-50% of sectors
51-75% of sectors
76-99% of sectors
100% of sectors
Backup
UNICEFFAOCIATGHIGCSFH1 AP2 HIR
UNICEFCIATGCPIH
UNICEFFAOGCSFH1 AP2 WVR
UNICEFWFPAVSICIATGCSFH1 WVR2
UNICEFWFPFAOADRA2 AVSICaritasCIATWVRHIR
NB! Only shows stakeholders who have reported
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What other implementing partners have they reported?
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
GakenkeNyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of Kigali
Kicukiro
Gasabo
Nyarugenge
SFH1: LCBOs
UNICEF:WRR'15
GC:ICYUZUZOSINAPISICRS
SFH1:LCBOs
SFH1:LCBOs
SFH1:LCBOs
UNICEF:AP2
WaterAid:COFORWA
SFH1:LCBOs
GC:DUHAMIC-ADRIWIFCRS
UNICEF:ADRA2:RWARIAVSI:MLFMGC:DUHAMIC-ADRI,EPR, CRSSFH1:LCBOs
UNICEF:CRS2 CaritasGC:DUHAMIC-ADRI, CRSSFH1:LCBOs
UNICEF:CWR2:ARDIGC:DUHAMIC-ADRIAEEADEPRStCSFH1:LCBOs
CWR:ARDISDA IRIBACRS:CaritasGC:DUHAMIC-ADRI. AEEADEPR,StCSFH1:LCBOs
UNICEF:CWR2 ARDISDA IribaGC:DUHAMIC-ADRI. ADEPR, StCSFH1:LCBOs
One UN3 WRR4
WVR4 CWR:ARDISDA IribaCRS:CaritasGC:DUHAMIC-ADRI. AEEADEPR,StCSFH1:LCBOs
UNICEF:WRR'15
FHI 360:Local Coops
SFH1:LCBOs
UNICEF:AP2 SNV
GC:ADEPRCRS
SFH1;LCBOs
UNICEF:AP2
GC:ADEPRCRS
SFH1:LCBOs
UNICEF:SNV
GC:ADEPRCRS
SFH1:LCBOs
Note: The map shows all organizations that have provided mapping input, but it does not show whether they are using anyone asfield implementers in the different districts.
Color code explanations:Catalyst / LeadProject end in 2015
1. SFH is mostly doing social marketing through local CBOs2. Implementing partner for UNICEF EKN/GoN program3. One UN Joint Nutrition Program (SDC funded)4. Implementing partner for One UN SDC program
Ngororero
GC:EPR
SFH1:LCBOs
ADRA:RWARRI
SFH1:LCBOs
GC:CaritasADEPRStC
SFH1:LCBOs
IRC:BENISHYAKA
SFH1:LCBOs
AVSI:MLFM
GC:DUHAMIC-ADRI, CRS
SFH1:LCBOs
UNICEF:CRS2 EPR
GC:CaritasADEPRStC
SFH1:LCBOs
One UN3:WRR4 Caritas'15WVR4 '15
GC:CaritasADEPRStC
SFH1:LCBOs
AVSI:MLFM
GC:DUHAMIC-ADRIADEPR, StC
SFH1:LCBOs
UNICEF:SNV
UNICEF:AP2
GC:ADEPRWIF, CRS
SFH1:LCBOs
UNICEF:WVR2
AVSI:MLFM, APH
GC:ADEPR, CRS
SFH1:LCBOs
UNICEF:ADRA2 RWARRI
AVSI:MLFM
UNICEF:WVR2
SFH1:LCBOs
Shows stakeholders who have reported to work with other implementing partners
Backup
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Where are the ministries working?And how many Core Nutrition Actions (CNAs) are they conducting?
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
City of Kigali
Kicukiro
Gasabo
Nyarugenge
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
MoHMINAGRIMINALOCMINEDUCMIGEPROF
CNAs covered:1 CNA2-4 CNAs5-9 CNAs10-15 CNAs16-23 CNAs
MoHMINAGRIMINALOCMINEDUCMIGEPROF
Backup
Note: The ministries are often working through their implementing agencies, such as RBC, REB, RAB, NWC and LODA, and through the public infrastructure (health facilities, schools, etc.)
NB! Only shows stakeholders who have reported
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Key messages on coverage of Core Nutrition Actions
Geographic coverage of Core Nutrition Actions (CNAs):• 14 of 23 CNAs are being conducted in all districts• 6 of 23 CNAs are conducted in 15-29 districts• 3 of 23 CNAs are conducted in less than 10 districts• South, West and North with the most support and highest coverage• Low coverage in Kigali City, but also because people here tend to be better off (high development score)
Beneficiary coverage• Only 5 CNAs have more than 75% of beneficiaries covered• 4 CNAs have between 50-75% coverage, 4 CNAs have between 25-50% coverage, and 4 CNAs have below
25% coverage• 6 CNAs are measured as additional %-points reached, ranging from 1 to 8 additional %-points reached
Action category coverage• Health categories in general have the highest coverage, though some CNAs are lagging behind also here
(e.g. diarrhoea treatment, 4+ ANC visits and SAM/MAM treatment)• Nutrition education, including promotion of breast feeding, complementary feeding, and promotion of
hygiene and hand washing have lower coverage than ideal, and should be increased• WASH has in general low coverage, but that may also be due to low participation rates from WASH partners• Delivery mechanism analysis could be one source of information to discuss how to best scale up CNAs
Source: Rwanda Stakeholder & Action Mapping 2014/15
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What % of the target group is covered nationally and how? (1/2)
Country relevant actions# of districts
covered Key delivery mechanisms
CHWs, HFs, Women/Mother groups, Mass campaigns, PD/H
CHWs, Health centers, UN agencies, NGOs
CHWs, Health centers, UN agencies
CHWs, Health centers, Mass campaigns
CHWs, Health centers, Hospitals
Health centers, Hospitals
CHWs, Health centers, PD/H, Women/Mother groups
CHWs, Health centers, NGOs
Target groups (TG)Pregnant & lactating womenHHs with children u5 (CBNP)
% of TG covered
Children 6-23 months
Children 6-59 months
Children 0-59 months with severe diarrhoea
Children 0-59 months with SAM
Children 0-59 months with MAM
Children 6-59 months
CHWs, HFs, Women/Mother groups, Mass campaigns, PD/H
20 / 30
23 / 30
4 / 30
7 / 301
30 / 30
30 / 30
30 / 30
30 / 30
Promote optimal breastfeeding practices
Provide spec. nutritious products for CF
Promote optimal compl. feeding practices
Provide Fe+FA supplements
Provide deworming tablets
Provide diarrhoea treatment (w/ ORS/zinc)
Provide MNP supplements (Ongera)
Provide treatment of SAM
Support and provide treatment of MAM
MIY
CN
Dis
ease
pr
ev./m
gmt
Mic
ronu
trie
nt
supp
lem
enta
tion
MA
M/S
AM
Provide Vitamin A supplements
CHWs, Health centers, Mass campaigns30 / 30
Conduct child growth monitoring / screening
Promote/Provide ANC visits (4+)
MC
H
CHWs, Health centers, HospitalsPregnant women30 / 30
CHWs, Health centers, HospitalsPregnant women30 / 30
Pregnant & lactating womenHHs with children u5 (CBNP)
6-23 months in Ubudehe 1&2PLW in Ubudehe 1&2
Children 12-59 monthsChildren 5-15 years
0-25% 26-50%
51-75%
76-100%
1 / 30
30 / 30
30 / 30
1. MNP program (Ongera) is being scaled up, and is in the 2nd half of 2015 in 18 districts
30 / 30
As reported in SUNPMT tool
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What % of the target group is covered nationally and how? (2/2)
Country relevant actions# of districts
covered Key delivery mechanisms
FFLS, Agriculture village promotors, Coops, RAB
FFLS, Agriculture village promotors, CHWs, Coops, NGOs
CHWs, Agriculture village promotors, FFLS, Mass campaigns, PD/H
Pre-schools, Primary schools, Secondary schools
Districts, UN agencies, NGOs, CHCs, Women/mother groups
CHWs, CHCs, FFLS, Community meetings, PD/H, Mass campaigns
VUP, Social services, FFLS, Community leaders
Primary schools
Target groups (TG)% of TG covered1
Smallholder farming households
Households in Ubudehe 1 & 2
Mothers / Caregivers
Schools
Households in Ubudehe 1 & 23
FFLS, Agriculture village promotors, CHWs, Coops, PD/H, NGOs30 / 30
27 / 30
28 / 30
29 / 30
30 / 30
30 / 30
15 / 30
Provide materials & techn. for small-scale horticulture
Provide animals for small-scale husbandry
Promote food preservation and storage
Provide input for production & cons. of biofortified crops
Provide/Support improved water source
Provide/Support improved sanitation
Carry out nutr. education (e.g. cooking demos)
Promote hygiene / hand washing
Provide conditional social safety net actions (VUP)
Food
& A
gric
ultu
reW
ASH
2 N
utrit
ion
educ
atio
n
Carry out nutr. education at school (e.g. school gardens)
Districts, UN agencies, NGOs, Community leaders
Provide school feeding (One Cup of Milk)
Soci
al
secu
rity
FFLS, Agriculture village promotors, CHWs, Coops, NGOsHousehold with children under 530 / 30
Household with children under 5
HouseholdsSchools
HouseholdsSchools
Pregnant & lactating womenSchools
Primary school childrenPrimary schools
+8%
+3%
+5%
+4%
+1% 0%
+1% +1%
0-25% 26-50%
51-75%
76-100%
9 / 30
21 / 30
28 / 305 / 30
1 / 30
4 / 30
1. Beneficiary coverage displayed as "+X%" represents the additional %-points of households reached over the last calendar year (2014).2. Have received limited input from WASH stakeholders (who have separate technical working groups), and actual geographic and beneficiary coverage is probably higher3. Not all Households in Ubudehe 1 & 2 are targets for the Vision Umurenge 2020 Program (aiming mostly for those without employment), so not necessarily aiming for 100% coverage here
As reported in SUNPMT tool
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What % of the target group is covered per province? (1/2)
Country relevant actionsTarget groups
(TG)PLW
HHs w/ children u5
Children 6-23 months
Children 6-59 months
Children 0-59 mths with severe diarrhoea
Children 0-59 months with SAM
Children 0-59 months with MAM
Children 6-59 months
Promote optimal breastfeeding practices
Provide spec. nutritious products for CF
Promote optimal compl. feeding practices
Provide Fe+FA supplements
Provide deworming tablets
Provide diarrhoea treatment (w/ ORS/zinc)
Provide MNP supplements (Ongera)
Provide treatment of SAM
Support and provide treatment of MAM
MIY
CN
Dis
ease
pr
ev./m
gmt
Mic
ronu
trie
nt
supp
lem
enta
tion
MA
M/S
AM
Provide Vitamin A supplements
Conduct child growth monitoring / screening
Promote/Provide ANC visits (4+)
MC
H
Pregnant women
Pregnant women
PLWHHs w/ children u5
6-23 months in U1&2PLW in U1&2
Children 12-59 mthsChildren 5-15 years
0-25% 26-50%
51-75%
76-100%
As reported in SUNPMT tool
Rwanda total Kigali City South West North East
1. MNP program (Ongera) is being scaled up, and is in the 2nd half of 2015 in 18 districts
3 actions are being implemented at scale across all
provinces
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What % of the target group is covered per province? (2/2)
Country relevant actionsTarget groups
(TG)
Smallholder farming households
Households in Ubudehe 1 & 2
Mothers / Caregivers
Schools
Households in Ubudehe 1 & 23
Provide materials & techn. for small-scale horticulture
Provide animals for small-scale husbandry
Promote food preservation & storage
Provide input for prod. & cons. of biofortified crops
Provide/Support improved water source
Provide/Support improved sanitation
Carry out nutr. educ. (e.g. cooking demos)
Promote hygiene / hand washing
Provide conditional social safety net actions (VUP)3
Food
& A
gric
ultu
reW
ASH
2 N
utrit
ion
educ
atio
n
Carry out nutr. educ. at school (school gardens)
Provide school feeding (One Cup of Milk)
Soci
al
secu
rity
Household with children under 5
Household with children under 5
HouseholdsSchools
HouseholdsSchools
PLWSchools
Pri. school childrenPrimary schools
1. Beneficiary coverage displayed as "+X%" represents the additional %-points of households reached over the last calendar year (2014).2. Have received limited input from WASH stakeholders (who have separate technical working groups), and actual geographic and beneficiary coverage is probably higher3. Not all Households in Ubudehe 1 & 2 are targets for the Vision Umurenge 2020 Program (aiming mostly for those without employment), so not necessarily aiming for 100% coverage here
As reported in SUNPMT tool
Rwanda total Kigali City South West North East
0-25% 26-50%
51-75%
76-100%
+8%1
+3%1
+5%1
+4%1
+1%1
+1%1
+2%1
+14%1
+7%1
+6%1
+7%1
+8%1
+5%1
+5%1
+2%1
+2%1
+1%1
+5%1
+7%1
+7%1
+1%1
+6%1
+2%1
+1%1 0%1
+1%1 +1%1
+1%1
+1%1 +3%1
+2%1
+1%1 +4%1
+1%1 0%1
+4%1
There is the strongest support for food & agriculture actions in
the South compared to other provinces
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What % of the target group is covered per district?
0-25% coverage
Additional %-points reached
25-50% coverage
50-75% coverage
75-100% coverage
100+% coverage
Backup As reported in SUNPMT tool
Source: Stakeholder & Action Mapping 2014/15
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Leverage mapping findings on delivery mechanisms to identify opportunities for both scale up and synergies of the CNAs
Scale up
Synergies
For the actions with few delivery mechanisms, is there potential to increase reach by extending delivery to other delivery mechanisms?
For delivery mechanisms that are less commonly used, is there potential to strengthen scale up through these delivery mechanisms?
Could some delivery mechanisms be in danger of becoming over utilized or exhausted? Is it possible to increase capacity of such delivery mechanisms?
Major use of channel (75-100% of implementors)
Substantial use of channel (50-75% of implementors)
Some use of channel (25-50% of implementors)
Low use of channel (0-25% of implementors)
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Key messages on gaps
Only a few Core Nutrition Actions (CNAs) have full coverage• Most CNAs needs to be further scaled up• There may need to be a discussion of priorities on what CNAs to scale up, and where• E.g. on cost of scaling up versus effect and how accurately the main target group is addressed (e.g. school
feeding vs actions focusing more directly on children under 5 or under 2)
There is not necessarily a clear link between the districts with the highest stunting rates and the corresponding action coverage per district
• There may need to be a discussion on what districts to prioritize first, e.g. by investing in more core nutrition actions and higher coverage
Most districts have a stunting prevalence and a corresponding action coverage where further scale up is needed
• Should discuss how to best ensure this, e.g. by securing that all districts have dedicated partners and proper funding (may improve already with the CIFF and USAID INWA programs)
Continued focus on stunting reduction is needed• Some key situation indicators are on a low level and showing slow progress, e.g. anemia, food consumption
score, minimum acceptable diet and WASH
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Only a few of the core nutrition actions have full coverage
Iron and folic acid supplements
Biofortified crops
Food storage & preservation
MNP supplements (Ongera)4
Small scale horticulture
(kitchen gardens)
Small scale animal husbandry
Improved water source2
Diarrhoea treatment
Vitamin A supplements
Hygiene and hand washing
Treatment of SAM
Child growth monitoring / screening
Deworming tablets
Social safety net actions (VUP)3
Optimal compl. feeding Nutrition education
at schools (school gardens)
Improved sanitation2 Treatment of MAM
ANC visits (4+)
Specialized nutritious food for
complementary feedingSchoold feeding (One Cup of Milk)
Nutrition education
Optimal breast feeding
+1%-points1
+1%-points1
+3%-points1
+4%-points1
+8%-points1
+5%-points1
Source: Stakeholder & Action Mapping Rwanda 2014/15
0-25% 26-50% 51-75% 76-100%
1. Beneficiary coverage displayed as "+X%-points" represents the additional %-points of households reached over the last calendar year (2014)2. Have received limited input from WASH stakeholders (who have separate technical working groups), and actual coverage is probably higher 3. Not all Households in Ubudehe 1 & 2 are targets for the Vision Umurenge 2020 Program, so not necessarily aiming for 100% coverage here 4. MNP program (Ongera) is being scaled up, and is in the 2nd half of 2015 in 18 districts
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Prevalence of stunting varies across districts, and not all the districts with high stunting have all core nutrition actions
Stunting strongly prevalent in most districts, especially in the West & South-East
All districts with 15 or more CNAs, but only one district with all 23 CNAs
1. NB! Confidence intervals are rather large on a district levelSource: Rwanda National Nutrition Screening 2014, Rwanda Stakeholder & Action Mapping 2014/15
10-1415-19
2320-22
# of Core Nutrition Actionsbeing conducted per district
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
20% - 29%30% - 39%>40%
Stunting prevalence among children 0-59 months 1
<20%
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Only one district have an action intensity where more than 75% of core nutrition actions reach at least 30% of target population
Stunting strongly prevalent in most districts, especially in the West & South-East
Only one district with more than 75% of actions reaching over 30% of target population
0% - 25%26% - 50%
76% - 100%51% - 75%
% of actions with at least 30%2 of target population covered
1. NB! Confidence intervals are rather large on a district level 2. 30% of target population covered or more than 1%-points additional beneficiaries covered (for Food & Agriculture and WASH infrastructure)Source: Rwanda National Nutrition Screening 2014, Rwanda Stakeholder & Action Mapping 2014/15
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
Nyagatare
Gatsibo
Kayonza
KarongiBugesera
Rusizi
Nyamasheke
KireheNgoma
Rwamagana
Nyaruguru
Nyamagabe
Rulindo
Gicumbi
Huye
Nyanza
MusanzeBurera
Gakenke
Ngororero
Nyabihu
Ruhango
MuhangaKamonyi
Gisagara
Rubavu
City of KigaliRutsiro
Nyamagabe is also the only district where
all 23 core nutrition actions are being
implemented
20% - 29%30% - 39%>40%
Stunting prevalence among children 0-59 months 1
<20%
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What actions are not being conducted and where?
Backup
1. MNP program (Ongera) is being scaled up, and is already now (2nd half 2015 in 18 districts)Source: Stakeholder & Action Mapping Rwanda 2014/15
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Monitor Maintain
Scale up Investigate
Many districts are not adequately addressed, and scale-up discussion in these districts may be necessary
60%
70%
40%
0%
30%
50%
30%
80%
40%
0%
50%
60%
Gatsibo
GicumbiNyagatare
Rwamagana Kayonza
Musanze
Ngororero
Nyamagabe
Kirehe
Ruhango Nyarugur
u
Muhanga
RubavuRutsiro
BugeseraNyabihu
Stunting prevalence1
% of actions with at least 30%2 of target population covered
GakenkeNyamashekeNgoma Rulind
o Rusizi
Burera
Huye
KarongiKamonyi
Gisagara
NyanzaKicukiro Gasabo
Nyarugenge
1. Among children 0-59 months old. NB! Confidence intervals are rather large on a district level2. 30% of target population covered or more than 1%-points additional beneficiaries covered (for Food & Agriculture and WASH infrastructure)Source: Stakeholder & Action Mapping Rwanda 2014/15, Rwanda National Nutrition screening 2014
WestNorth
South
East
Kigali City
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
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Summary of initial recommendations on planning and scale-up
Increase geographic
reach
Improveaction &
beneficiary coverage
Focus on stunting and on improving
core indicators
Main issues
Some districts have limited support, leaving gaps in geographic coverage
Some partners seem to be spread thinly (e.g. covering some sectors and villages here and there) instead of focusing their efforts
Initial recommendations
Secure that all districts have dedicated partners in fighting malnutrition
Encourage partners to focus efforts more geographically (cover all villages & sectors in an area) to simplify coordination & increase efficiency
Several CNAs are not present in all districts, and many are just done in some sectors and villages Beneficiary coverage is low for many of the CNAs – large parts of the target groups are not reached
Many core nutrition actions should be scaled up to cover more districts, sectors and villages
When core nutrition action is present in districts, coverage of the target groups needs to be improved
Stunting is still high, and rate of reduction is slow
Main indicators are lagging behind, like Minimum Acceptable Diet, Food Consumption Scores and WASH access
Continue focus on reducing chronic malnutrition, but accelerate scale-up
Complementary feeding practices, food diversity & availability, and water source, sanitation and hygiene needs to be further improved
A
B
C
✗ ✓
Source: Rwanda Stakeholder & Action Mapping 2014/15
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Increase geographic reach, but don't spread resources too thin
A
Large differences in district supportEven with many partners,
some are only covering a few sectors
Secure that all districts have dedicated partners in fighting malnutrition
Encourage partners to cover all villages and sectors in a district to simplify
coordination and increase efficiency
# of districts supported
Avg % of sectors
Number of partners per district
Averagepartners:6
Districts Each point represent an implementing partner
Source: Rwanda Stakeholder & Action Mapping 2014/15
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Improve action & beneficiary coverage
B
Some CNAs are only present in a few districts
Beneficiary coverage for many of the CNAs are too low
Scale up core nutrition actions to cover more districts, sectors and villages
(e.g. by piggybacking on other programs)
Improve CNA coverage of the target groups, while also focusing on the
quality of the action coverage
Provide specialized nutritious products for CF
Provide micronutrient suppl. (MNPs/Ongera)1
Provide/Support improved water source
Provide school feeding (One Cup of Milk)
Provide/Support improved sanitation
Promote food preservation and storage
Promote hygiene / hand washing
Provide animals for small-scale animal husbandry
Carry out nutrition education (e.g. cooking demos)
50%
0%
100%
Growth monitoring / screening
Iron and folic acid
Spec. products for CF (e.g. CSB)
Nutr. education (e.g. cooking demos)
School feeding (One Cup of Milk)
MNPs (Ongera)Diarrhoea treatment
(ORS/zinc)
Deworming tabletsVitamin A
supplements
Social safety net actions (VUP)
ANC visits (4+)Hygiene / hand washing
Nutr. educ. school (School gardens)
Small-scale horticulture (Kitchen gardens)
Improved sanitation
Food preservation & storage
Biofortified crops (beans, sweet potato)
Small-scale animal husbandry
Improved water source
Treatment of SAM
Optimal BF practicesOptimal CF practices
Treatment of MAM
# of districts per CNA:
Beneficiary coverage per CNA:
>75%50-75
%25-50%
<25%+%-pt
s
30 districts
<30 districts
Source: Rwanda Stakeholder & Action Mapping 2014/15
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Focus on stunting and main lagging indicators
C
Stunting progress is still too slow Main indicators showing limited progress
Continue focus on stunting reduction and the 1st 1000 days windows of opportunity,
but significant acceleration is needed
Complementary feeding practices, food diversity & availability,
and WASH should be further improved
Stunting prevalence1 among children under 5 years
-20
-7
-6
2018 target22005 2010 2014/15
Min. Acc. Diet1 +1.0
75.2%5
Anemia 6-59 mths1
Improved water
+0.4Acceptable FCS3
74.5%4
-1.6
+0.7
20102014/15
(2009)
(2012)
(2010/11)
Source: 1. Rwanda DHS 2010 & DHS 2014/15 2. HSSP-3 3. CFSVA/NS 2009 & 2012 4. EICV3 2010/11 5. WATSAN 2014
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Progress from 2010 to 2014/15 is far from sufficient to reach 2018 target
40%
60%
20%
30%
0%
50%
Rwanda stunting prevalence
18.0%
2018 target
51.0%
37.9%
24.5%
Year
18.0%
-15.0%
2014-15
33.0%
44.2%
2005
44.2%
2010
HSSP III target trajectory
2014/15-18 target trajectory
2005-10 actual
2005-10-14/15-18 trajectory
2010-14/15 actual
Immediate scale-up of nutrition interventions is needed to accelerate stunting reduction
Current trajectory leads to estimated 33% stunting
prevalence in 2018, a 15%-point gap from
the HSSP III target
Source: Rwanda DHS 2010 & DHS 2014/15, HSSP-3
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Rwanda is still far behind some of the best practice countries in stunting reduction
Rw
anda
BrazilG
ambia
Vietnam
Peru
Mauritania
Maharashtra
Countries
Average Annual Rate of Reduction1 in stunting (in %2)
Average:4% AARR
Africa
average
1. Average Annual Rate of Reduction (AARR) is calculated from the 4-6 best consecutive years of reduction for each country from 1995 – 2015. 2. In %, not %-pointsNote: Rwanda calculated from DHS 2010 to DHS 2014/15 Source: WHO/UNICEF/World Bank database
Backup
Other countries' success show that there is potential to further accelerate stunting reduction in Rwanda
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AgendaIntroduction, background and objectives of the Stakeholder & Action Mapping
Recap of the food and nutrition situation in Rwanda – highlights from the Nutrition Analysis• What is the food and nutrition situation nationally?• What is the food and nutrition situation per district?
Stakeholder & Action Mapping methodology and approach
Stakeholder & Action Mapping overview and analyses• Who are the main stakeholders working in nutrition in Rwanda?• What are the main programs?• What core nutrition actions are the stakeholders working on?• Where are they working?• How many are they reaching?
Implications of the findings from the Stakeholder & Action Mapping• Where and what are the gaps?• Main recommendations and findings for scaling up
Appendix
Recommended