Rwandan public health is challenged with malnutrition, which causes childhood stunting among other public health challenges. As of 2021, approximately 32% of Rwandan children were stunted. As of 2021, only 30% of reproductive-aged Rwandan women met the minimum dietary diversity required for adequate nutrition. Child nutrition was also largely inadequate, with only 17% of children (6-23 months) meeting the minimum acceptable dietary diversity and meal frequency, eating less than 3 different food groups over only two meals on average each day. Even when supplementary foods are introduced, they are insufficient: over 60% of weaning children (aged 6 to 23 months) fail to meet the recommended daily intakes for iron, calcium, and zinc due to the low availability (both nutrient density and bioavailability) of these micronutrients in their supplementary food.
Interventions involving micronutrient powder (MNP) for inclusion in home-cooked foods have shown promising results. MNP have been distributed to all children (6-23 months) through Rwandan health centres and community health workers. Haemoglobin levels in anaemic children increased due to this intervention. After successfully trialled by UNICEF and the University of British Columbia, the Rwandan government implemented the programme across Uganda in 2021. Yet, this programme has experienced difficulties scaling up: only 6% of children in participating districts were consuming MNP. The main challenges were inadequate supply of MNP and consumer perceptions that it was only for ‘sick’ children.
By addressing these barriers to Rwanda’s current MNP programme, this project aims to alleviate malnutrition and childhood stunting through small tilapia powder (STP) consumption. Previous projects have successfully trialled MNP, but their scaling was limited due to international supply chain issues. This is the primary barrier that this project will address, by locally producing a whole-food based MNP from locally-farmed small tilapia. Because animal source food consumption is lacking among lower-income demographics in Rwanda, inclusion of STP could increase dietary diversity by an entire food group. Furthermore, because small tilapia are micronutrient dense, the inclusion of STP in diets will support adequate intake of a variety of nutrients. This builds on previous interventions which targeted anaemia only. Additionally, previous MNP intake was limited at the household level because mothers’ perception that the MNP was a medicine for sick children only. This project addresses this issue by supplying a whole food based supplement, based on a food item (fish) that is already known and accepted by the community.