DAP RWANDA

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DAP RWANDA

• Development Assistance Program
• A multisectoral approach to livelihood security
  in Rwanda.
• USAID funded.
• FY 2005- FY 2009.
• Overall goal improve livelihood security for
  700, 000 households in Rwanda
• Partners WV/R, ADRA and FHI

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Country overview

• Population 9 million
• Population density- 336 persons per square km
• 5 provinces, 30 districts.
• Each district made up of sectors, each sector
  made up of cells.
• DAP coverage- Northern province Gicumbi,
  Gakenke, Musanze Eastern province Bugesera
  Southern province Nyamagabe and Nyaruguru.

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Situational analysis

• Livelihood of rural Rwanda is largely dependent
  on subsistent farming (over 90)
• Causes of livelihood insecurity/malnutrition are
  numerous and often intricately related
• Mainly can be categorized into
• Factors leading to low agricultural productivity
• Land scarcity from high population density
  (average of 0.7 hectares per capita)
• Soil erosion from unfavourable topography,
  deforestation and poor land practices (Rwanda
  between 1,000 and 4500 meters, 50 reduction of
  forest areas post genocide)
• Poor climactic conditions erratic rainfalls
  leading to drought and flooding.
• Limited agricultural information, knowledge and
  skills (poor quality extension services)

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Situational analysis II

• Factors related to limited market and economic
  opportunities
• Limited market access poor rural roads network,
  lack of transportation and small size of local
  market.
• Lack of collective bargaining power and little
  influence on market forces. (smallholder farmers
  poorly organized)
• Lack of capital and access to credit limited
  financial management skills and unfavourable
  borrowing terms.
• Factors related to the depletion of human capital
  
• High OVC and HIV burden (Rwanda prevalence- 3)
  leads to workforce depletion and reduction of
  household earnings.
• Malnutrition and HIV/AID mutually aggravate one
  another and impact negatively on productivity.
  Productivity loses to malnutrition is
  approximately 10 of life time earnings (World
  Bank)

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Country health indicators
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DAP Objectives

• A multisectoral approach with interacting
  sectors.
• Increased household agricultural Production and
  Productivity through Improved farming systems,
  strengthen soil conservation practices,
  diversification of assets base.
• Increased Economic Opportunities in Rural Areas
  through improved market access and efficiency
• Improved health and nutrition for women, children
  and vulnerable groups and reduction of risk and
  impact of HIV/AIDS
• Improved governance through increased positive
  interaction among diverse groups of people.

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HIV Sector

• Objective reduce risk of and mitigate the impact
  of HIV/AIDS
• Dissemination of Behaviour change messages
• Health education for PLWHA on nutrition and
  hygiene
• Disseminating HIV prevention messages among
  farmers.
• HIV prevention education to womens group.
• Supplementary food ration for PLWHA
• Family ration consisting of (CSB, fortified
  bulgur and vegetable oil)
• PLWHA in need of food assistance surpass
  resources criteria used include ARV status,
  children, lactating mothers and BMIlt18.
• PLWHA kept on food ration for minimum of 6 months

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Nutrition and Health sector

• Objective improved nutritional status of
  targeted vulnerable groups
• Growth monitoring and selection of malnourished
  children for supplemental feeding.
• Provision of supplementary ration and vitamins
  for nutritional recuperation of target children.
• Training mothers/foster parents and nutrition and
  health workers on PD/Hearth model and Care group
  concept.
• Nutritional rehabilitation through the PD Hearth
  approach.
• Mothers care group to improve infant and young
  child feeding (FHI)
• Sensitive community on malaria prevention.
• Mothers provided with improved vegetable seeds
• Mothers trained in bio-intensive kitchen gardens

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Livelihood sector

• Improved farming systems
• Promote the use of improved varieties of key
  crops
• Promote best cultural practices
• Enhance crop diversification
• Strengthen research-extension-farmer linkages
• Strengthen soil conservation practices
• Control soil degradation on hillside (Land
  terracing through the FFW program)
• Train farmers in environmentally sound practices
• Promote tree panting and agro-forestry practices
• Promote the use of energy saving stove.
• Household food security enhanced through
  diversification of assets base.
• Promote bio-intensive market gardening
• Promote bio-intensive farming and small animal
  rearing.

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Inter-sectoral integration

• For for Work (FFW) land terracing increases land
  productivity in the long term but increases
  household food security in the short term.
• PLWHA included in FFW program reduces
  socio-economic impact of HIV/AIDS.
• PLWHA trained in non-labour intensive (context
  specific) farming methods kitchen gardens,
  planting in sacks sustains immediate gains from
  food supplementation programs.
• Farmers given HIV prevention education leads to
  long term productivity gains.
• Mothers of malnourished children given improved
  vegetable seeds and trained in bio-intensive
  kitchen gardens sustains nutrition
  rehabilitation programs.

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Integrated Nutrition / MCH / Food Security
Framework
Ag Marketing / Production
Nutrition / MCH
Value-chain approach
Clinic / Health Center
Community Health Promoters
Functions
Nutrition Rehab.
Rally Point
Link to markets, technologies, credit Training in
business skills, access to markets
credit Safety nets (food for work, etc.)
Retail
Associations, cooperatives, mothers groups
Positive deviant leaders
Health extension workers
Mothers Care Groups (15)
Wholesale
Growth Monitoring,Screening
Malnourished under 5s)
Under 5s Preg./Lac. PLWA OVCs
Households (10)

Assembly
Individuals
Entrepreneur start-up support
Families
Kitchen, community, health center gardens

• Kitchen gardens
• Small animals
• Fruit vegetables

Farmer field schools
Production
Multiplication of improved varieties
On farm trials, demonstrations
Hearth (moderately)
CTC (Severely)
Seed fairs, vouchers, etc.
Input Supply
gardens
Public Sector
Private Sector
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Key Achievements FY 07

• Trained 3473 farmers on bio-intensive gardening
  and 3153 on organic farming (FY 07 target for
  both was 2400)
• Trained 11, 895 beneficiaries on HIV prevention.
• Trained 16818 mothers on key health and nutrition
  lessons.
• 36 of targeted farmers adopting bio-intensive
  gardening (FY 07 target- 20)
• 40 of targeted farmers adopting organic farming
  practices. (FY 07 target 25)

• MCH Outcomes (Mid-term survey results)
• 91 of mothers adopting proper hand washing
  behaviour (baseline 19)
• Stunting rate reduced from 47.6 to 40
• Underweight (weight for age) reduced from 27.7
  to 22.
• Number of men and women 15-49 who can mention at
  least 2 ways of preventing HIV/AIDS- 95
  (baseline- )

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Achievements
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Outcomes 2 (FGDs)

• Nutrition knowledge and practices
• All mothers knew to exclusively breastfeed their
  infants for 6 months and then introduce
  complimentary foods, continue to offer breast
  milk on demand for up to 24 months
• Had or were breastfeeding their infants and some
  for up to 24 months
• Knew the importance of providing dense
  complementary foods using local foods and could
  identify local nutritious foods
• Knew to continue to feed their children during
  illnesses.

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Outcomes 3 (FGDs)

• Health knowledge and practice among mothers
• 97 participated in the growth monitoring program
• 84 received vitamin A
• 85 received deworming
• All had their children sleep under bed nets
• All had at least 4 prenatal visits and know the
  importance of skilled attendants for labour and
  delivery.
• All had their children fully immunized.
• All could state at least 3 ways that HIV is
  transmitted

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Outcomes 4

• My name is Nyirabashongore Amerberga of 37 years
  old. Im married with 2 kids. My husband died in
  2000, and after his death, I used to get sick
  without knowing the cause. After being trained, I
  was tested and found that Im positive in 2006
  and I decide to join association. Before getting
  food, I was having 30 CD4 (in September 2006). In
  March 2007 she had CD4153, and now she is having
  CD4 197.

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Key Challenges

• Applying criteria for including PLWHA into food
  supplementation programs in the midst of huge
  needs.
• Therapeutic feeding centres sometimes
  non-existent.
• Resource/budget constraints limiting income
  generating activities for PLWHA graduated from
  food supplementation programs.
• Removal of Rwanda from the list of high priority
  countries.
• Slow sales of monetization commodities and hence
  cash flow problems
• Integration of the DAP with other WVR programs.
• On-going AID Reforms and the need to make
  adjustments