A Nutritional Landscaping Tool: A Case Study in Rwanda
Authors: Kompala Chytanya , Monterrosa Eva , Kraemer Klaus 
Published: November 2023

BackgroundDifferent forms of nutrition problems continue to burden most of the developing world in spite of recent public efforts to improve population nutrition. Understanding the nutritional landscape within a specific country is essential for any policy maker to respond with appropriate nutrition interventions. The distributions and determinants of different forms of malnutrition can be complex and poorly understood; in some cases, existing data and evidences bases are available but often not used adequately and in other cases, there are substantial gaps in the data. Therefore, it is imperative to identify the leverage points and the areas for improvement in order to plan future programs and policies. Policy makers need resources to help them understand these different factors in the nutritional landscape within a specific country and make informed programmatic decisions. We have developed a landscaping tool that can be used by policy makers to identify the current evidence base, gaps and leveraging point and tailor their programs accordingly within a specific country. Like many developing countries in this region, Rwanda is a nation that has continually faced malnutrition and health concerns, specifically among vulnerable populations (infants, young children, adolescent girls, and pregnant and lactating women). It serves as the ideal case study for the application of the landscaping tool we have developed.ObjectiveTo develop a landscaping tool that provides an assessment of existing nutrition data and current programs at a national level. The secondary objective is to apply this landscaping tool to the nutritional situation of Rwanda as a case study.MethodsSearches for key papers and country profiles were conducted using Pubmed; hand searches; and discussions with experts.ResultsPrevalence rates of indicators of malnutrition including stunting and anemia among children under five remain alarmingly high. There is a severe gap in knowledge about micronutrient status among this population, with the exception of iron status. Many ongoing intervention efforts to improve child nutrition have yielded minimal results.ConclusionIn spite of available interventions and new program implementation, Rwanda continues to suffer a larger burden from poor nutrition status including both growth faltering (primarily in the form of stunting) and presumably micronutrient deficiencies. Assessment of micronutrient status of this country is essential in order to design population specific interventions in an effort to reduce the burden of malnutrition and illness in Rwanda. Policy recommendations include the education of caregivers about infant and young children, the promotion of nutrient‐dense complementary food and targeting the most food insecure sub‐populations in future programs. This landscaping tool was able to frame to nutritional situation of Rwanda and indicate clear gaps in the data and ongoing programs. Using this analysis of Rwanda as a case study provides an example of the usefulness and applicability of this tool for policy makers for other countries in the future.