Additional Information

Field Value
Cover Image File <FileStorage: '' ('application/octet-stream')>
Summary ## Publication Information **Publisher:** Rwanda Biomedical Centre (RBC) & National Child Development Agency (NCDA) **Publishing Division:** Maternal, Child and Community Health Division **Publication Year:** 2023 **Campaign Period:** June 12-16, 2023 **Document Type:** Integrated Campaign Performance Report ## Executive Summary The June 2023 Maternal and Child Health Week represented a landmark achievement in Rwanda's integrated service delivery approach, successfully implementing comprehensive health interventions across all 30 districts under the powerful theme "No Stunting Ever." This nationwide campaign demonstrated exceptional organizational capacity and community engagement, achieving outstanding coverage rates while generating critical nutrition surveillance data. ## Key Performance Indicators ### Service Coverage Achievements - **Vitamin A Supplementation:** 95% coverage (1,598,762 of 1,688,902 targeted children aged 6-59 months) - **Deworming Coverage:** 96% for children 12-59 months (1,447,718 children), 100% for children 5-15 years, 85% for adults 16+ years - **Praziquantel Administration:** 83% coverage for children 5-15 years, 87% for adults in targeted cells - **Malnutrition Screening:** 94% MUAC screening, 93% weight-for-age, 80% height-for-age assessment - **Micronutrient Powder (Ongera):** 82% coverage (410,973 children aged 6-23 months) - **Immunization Catch-up:** 3,636 defaulters vaccinated across multiple antigens - **Family Planning Services:** 20,152 clients served with comprehensive contraceptive methods ### Critical Nutrition Status Findings - **Stunting Prevalence:** 25.2% among children aged 6-23 months (97,313 of 386,505 screened) - **Underweight Prevalence:** 6.8% (26,154 children affected) - **Wasting Prevalence:** 5.8% (22,375 children with acute malnutrition) - **Geographic Disparities:** Stunting ranges from 11.8% (Nyarugenge) to 35.1% (Rutsiro) ### Provincial Performance Analysis - **East Province:** 24.7% stunting, 6.3% underweight, 6.2% wasting - **Kigali City:** 20.9% stunting, 5.2% underweight, 6.0% wasting (best performing) - **North Province:** 28.1% stunting, 6.8% underweight, 4.7% wasting - **South Province:** 22.3% stunting, 7.2% underweight, 5.7% wasting - **West Province:** 28.3% stunting, 7.5% underweight, 6.0% wasting (highest burden) ## Implementation Excellence ### Multi-Sectoral Coordination - **Government Leadership:** MOH/RBC, MIGEPROF/NCDA, MINALOC collaboration - **Community Mobilization:** Village-level coordination through local authorities and Community Health Workers - **Partner Support:** WHO, UNICEF, USAID-Ingobyi, UNFPA, ENABEL, Caritas Rwanda, CRS, World Vision, World Bank-SPRP - **Education Sector Integration:** MINEDUC support for school-based deworming and vitamin A distribution ### Service Delivery Innovation - **Integrated Platform Approach:** Multiple interventions delivered simultaneously at community level - **Technology Integration:** RedCap data entry system for real-time nutrition surveillance - **Quality Assurance:** Standardized protocols for anthropometric measurements and intervention delivery - **Community Engagement:** Over 6.7 million people reached with health education messages ### Geographic Implementation - **National Launch:** Musanze District, Kinigi Sector, showcasing high-level government commitment - **District Ownership:** Local authority leadership ensuring community mobilization and service quality - **Outreach Optimization:** Health centers, schools, and community sites maximizing population access - **Rural-Urban Coverage:** Comprehensive reach across diverse geographic and demographic contexts ## Intervention-Specific Outcomes ### Vitamin A Supplementation Program - **Age-Specific Dosing:** 100,000 IU for 6-11 months, 200,000 IU for 12-59 months - **Distribution Channels:** Health facilities, outreach sites, nursery schools - **Coverage Excellence:** 95% achievement demonstrating strong logistical capacity - **Geographic Performance:** All districts achieved >89% coverage with 99% in top-performing areas ### Deworming Campaign Excellence - **Multi-Drug Approach:** Mebendazole/albendazole for soil-transmitted helminths, praziquantel for schistosomiasis - **Population Targeting:** Children 12+ months, school-aged children, adults in endemic areas - **Implementation Scale:** Over 5 million people reached across age groups - **Strategic Targeting:** Geographic focus on high-prevalence districts and endemic cells ### Nutrition Surveillance System - **Comprehensive Assessment:** Height-for-age (stunting), weight-for-height (wasting), weight-for-age (underweight), MUAC - **Data Quality:** Systematic measurement protocols with trained health workers - **Population Coverage:** 386,505 children aged 6-23 months assessed for growth indicators - **Evidence Generation:** District-level nutrition status data for targeted interventions ### Family Planning Integration - **Service Diversity:** Depo-provera, Implanon, IUD, Jadelle, oral contraceptives, permanent methods - **Access Expansion:** 20,152 clients served during campaign period - **Method Mix:** Comprehensive contraceptive options addressing diverse user preferences - **Integration Benefits:** Leveraging campaign platform for reproductive health service delivery ## Strategic Impact and Innovation ### Stunting Prevention Focus - **"No Stunting Ever" Campaign:** High-visibility advocacy for nutrition prioritization - **Multi-Sectoral Approach:** Addressing nutrition-sensitive and nutrition-specific interventions - **Evidence-Based Targeting:** Geographic and demographic targeting based on surveillance data - **Behavior Change Communication:** Comprehensive health education reaching millions ### Health System Strengthening - **Service Integration:** Demonstrating efficiency of comprehensive intervention packages - **Community Health Worker Capacity:** CHW involvement in service delivery and community mobilization - **Supply Chain Management:** Successful commodity forecasting, procurement, and distribution - **Quality Improvement:** Standardized protocols and supervision systems ### Data Systems Enhancement - **Real-Time Monitoring:** RedCap platform enabling immediate data entry and analysis - **Geographic Analysis:** District and provincial performance comparison - **Trend Analysis:** Comparison with previous campaigns and routine surveillance - **Decision Support:** Evidence generation for program planning and resource allocation ## Critical Challenges and Solutions ### Implementation Challenges - **Community Mobilization:** Variable participation requiring extended campaign periods in some districts - **Equipment Limitations:** Insufficient height boards and baby scales affecting measurement quality - **Human Resource Constraints:** Limited qualified staff for anthropometric measurements - **Coordination Gaps:** Need for strengthened hospital-district communication ### Quality Assurance Issues - **Measurement Standardization:** Ensuring consistent anthropometric assessment protocols - **Data Quality:** Training requirements for accurate data collection and entry - **Service Standards:** Maintaining quality across diverse implementation sites - **Follow-up Systems:** Guidelines needed for managing identified malnutrition cases ### Strategic Adaptations - **Resource Optimization:** Equipment redistribution and procurement planning - **Capacity Building:** Enhanced training for measurement techniques and data management - **Coordination Strengthening:** Improved communication between implementation levels - **Follow-up Integration:** Linking campaign findings with routine health services ## Strategic Recommendations ### Immediate Actions 1. **Equipment Procurement:** Ensure adequate height boards and scales for all implementation sites 2. **Case Management:** Develop systematic follow-up protocols for identified malnutrition cases 3. **Data Utilization:** Share individual-level data with districts for targeted interventions 4. **Quality Enhancement:** Strengthen training and supervision for anthropometric measurements ### Medium-Term Improvements 1. **Surveillance Integration:** Link campaign data with routine nutrition monitoring systems 2. **Geographic Targeting:** Focus interventions on highest-burden districts and communities 3. **Service Integration:** Strengthen linkages between campaign and routine service delivery 4. **Community Engagement:** Enhance mobilization strategies for improved participation ### Long-Term Strategic Development 1. **Nutrition System Strengthening:** Build comprehensive nutrition surveillance and response capacity 2. **Multi-Sectoral Coordination:** Institutionalize collaborative approaches for stunting reduction 3. **Evidence-Based Programming:** Use campaign data for strategic planning and resource allocation 4. **Innovation Integration:** Leverage technology and community platforms for service delivery optimization ## Global Health Significance This MCH Week campaign demonstrates Rwanda's leadership in integrated health service delivery, achieving exceptional coverage while generating critical nutrition surveillance data. The systematic approach to anthropometric screening, combined with high-impact interventions, provides a model for other countries seeking to accelerate progress toward nutrition and child health targets. The campaign's success in reaching over 1.5 million children with multiple interventions while maintaining high quality standards showcases the potential of well-coordinated, community-based health service delivery platforms for achieving universal health coverage and sustainable development goals. ## Citation Rwanda Biomedical Centre & National Child Development Agency. (2023). *Report of Maternal and Child Health Week "No Stunting Ever" June 12-16, 2023*. Kigali: Maternal, Child and Community Health Division, Rwanda Biomedical Centre.