Chronic malnutrition undermines Rwanda’s potential for development.
Despite considerable effort in recent years, malnutrition remains a significant public health problem in Rwanda, contributing to about 50% of infant and child morbidity and mortality. According to the 2005 Rwanda Demographic and Health Survey (RDHS, 2005), chronic malnutrition (stunting) affects 45% of children under 5 years of age, constraining good health and delaying normal growth. This figure rises to 52% if adjusted according to the 2006 WHO Reference Growth Standards. Although the incidence of malnutrition is higher in rural areas, Kigali City incidence rates are still as high as 29%. Children with low weight for age or are underweight account for 22% of children under 5 years old, and acute protein energy malnutrition (wasting), which is associated with a high death rate, affects 4% of these children.
Among adults, the 2005 RDHS showed that 9.8% of women between 15 and 49 years old were malnourished (BMI <18.5). Although the prevalence of underweight decreased from 29% in 1992 to 22% in 2005, stunting or chronic malnutrition increased slightly during the same period (42% and 45%). Micronutrient malnutrition is also an important public health problem. Anemia affects 56% of children under five years of age and fully one third of women of reproductive age.
Data from 2005 indicate that at least 3% of the Rwandan population is infected with HIV. HIV decreases capacity to access appropriate, quality nutrition (FAO 2001). Children from these families are more likely to be exposed to malnutrition than general population. The 2005 Rwanda Demographic and Health Study showed that stunting (59%), underweight (29 %) and wasting (8%) among the HIV infected population were consistently above the rates for the general population.
Acute malnutrition leads to a spiral of more common, and more serious, infections that increase both mortality and morbidity among children. Many long-term consequences of stunting cannot be fully reversed even in adulthood.
Chronic malnutrition stunts physical and intellectual development in young children, causing irreversible harm that may follow them through life. HIV exacerbates this problem among rural farmers by increasing the nutritional needs of a population that already struggles with minimal resources and marginal land.
The Ministry of Health concludes that these problems require urgent and sustained actions ranging from a system that provides effective immediate response for acute malnourishment cases and long-term actions to prevent this condition as well as stunting through improved nutrition and food security.