Translation of policy for reducing undernutrition from national to sub-national levels in Rwanda

Elyse Iruhiriye (), Deanna K. Olney (), Edward A. Frongillo (), Emmanuel Niyongira (), Simeon Nanama (), Eugene Rwibasira (), Paul Mbonyi () and Christine E. Blake ()
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Elyse Iruhiriye: Johns Hopkins Bloomberg School of Public Health
Deanna K. Olney: International Food Policy Research Institute
Edward A. Frongillo: University of South Carolina Arnold School of Public Health
Emmanuel Niyongira: SNV Rwanda
Simeon Nanama: UNICEF Regional Office for West and Central Africa
Eugene Rwibasira: Rwanda Development Organization
Paul Mbonyi: Rwanda Consumer’s Rights Protection Organization (ADECOR)
Christine E. Blake: University of South Carolina Arnold School of Public Health

Food Security: The Science, Sociology and Economics of Food Production and Access to Food, 2022, vol. 14, issue 4, No 10, 977-993

Abstract: Abstract Understanding how countries improve children’s nutrition can inform policies and contribute to further improvements. We examined the relationship between improvements in nutrition in Rwanda (1992–2017) and political commitment to- and policy coherence in- nutrition. We reviewed nutrition-relevant Rwandan policies and programs (2000–2018) and conducted 90 semi-structured interviews with national (n = 32), mid-level (n = 38), and community (n = 20) nutrition stakeholders and 40 community-level focus group discussions (FGDs). FGDs and sub-national interviews were conducted in ten purposefully selected districts, five each in which stunting decreased (reduced) and increased or stagnated (non-reduced) between the 2010 and 2014/15 Rwanda Demographic and Health Surveys. Analysis consisted of thematic analysis and the assessment of events, policy developments, and strategies that influenced nutrition in Rwanda, including operationalization of political commitment and policy coherence for nutrition. Political and institutional commitment to nutrition increased in Rwanda as evidenced by the adoption of a multisectoral nutrition policy that was reinforced with national and subnational horizontal coordination platforms. These platforms strengthened multisectoral strategies to address nutrition and supported operational and institutional commitment. The role of mid-level actors in nutrition governance increased as responsibilities for planning, implementing, and monitoring nutrition programs were increasingly delegated to sub-national administrative levels. Variations in policy implementation existed between reduced and non-reduced districts. Despite improvements, challenges remained in coordination, financial commitment, and capacity to address, monitor, and evaluate nutrition. Political commitment to- and policy coherence in- nutrition at the national level are important for improving nutrition, and when reinforced institutionally, can be translated to sub-national levels where implementation occurs.

Keywords: Political commitment; Coherence; Multisectoral nutrition; Stunting reduction; Rwanda (search for similar items in EconPapers)
Date: 2022
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DOI: 10.1007/s12571-022-01271-2

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