UNICEF and the government of Rwanda have invited a professor from the University of B.C. to expand a 12-month nutritional pilot study involving 1,100 children into a national program for nearly half a million toddlers aged six months to two years.
“I presented the results in June to the government of Rwanda and the implementing partners and we were able to show a significant improvement in hemoglobin and significant decrease in the prevalence of anemia in kids who received micro-nutrient powders,” said Judy McLean, an assistant professor in UBC’s faculty of land and food systems. “Now, Rwanda wants to scale up to most of the country. I just got the email this morning,” she said earlier this week.
Malnutrition among young people in the tiny central African nation of 11 million is widespread, especially anemia, which affects 70 per cent of Rwandan children, said McLean. The staple diet of rural Rwandans consists of potatoes and bananas, with few nutritious vegetables and little or no meat. Anemia in small children can permanently affect brain development, cognition and growth. The solution costs a little more than a penny per day, about $6.75 per child for the 18-month program. Community health workers provide nutritional counseling and training to parents, a program developed in the field during the past three years by McLean and a team of students from UBC’s International Nutrition Group.
With instruction, mothers mix a small sachet containing powered micro-nutrients — vitamins and minerals, especially iron — into their child’s food every second day. The sachets are manufactured in India for about 2.5 cents each. “The packet is about the size of an artificial sweetener,” she said. “They are fortifying their food at home because they don’t buy fortified foods, like we buy.”
Popular in the developed world, infant cereals, such as the well-known Canadian creation Pablum, are fortified with iron and a variety of vitamins. “These are the first foods we give our children. But poor, subsistence farmers don’t have access to these products,” she said.
About 40,000 Rwandan children in six districts have started the micro-nutrient program during the past year, including the children in the pilot study. McLean is returning to Rwanda in October to create a plan to scale up the program for all children in the target age group in 10 more districts, to a total of 250,000 children. “My goal is to reach all the kids in this age range in Rwanda,” she said. “That’s the age range when the prevalence of anemia is the highest and (the children) have the most to gain. We see the improvement, mothers see it, the kids are more active. We had a really positive response.”
Funding is being sought from the Dutch government for the expansion, while the government of Rwanda has signaled its intention to incorporate the program into its universal health care system. It was an audience with then-Rwandan health minister Richard Sezibera three years ago that opened the door for McLean’s pilot project. “I had long had this idea in my head that this needed to happen in Rwanda, and I knew I had to get to the highest office possible,” said McLean. “(Sezibera) gave the approval and then (UNICEF) was able to support me.”
McLean has subsequently started similar initiatives in Cameroon, Sierra Leone, Zambia and Laos, and hopes to expand to countries across sub-Saharan Africa.