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NATIONAL SOCIAL AND BEHAVIOUR CHANGE COMMUNICATION STRATEGY FOR

INTEGRATED EARLY CHILDHOOD DEVELOPMENT, NUTRITION AND WASH (2018-2024)

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LIST OF ACRONYMS 4

FOREWORD 5

ACKNOWLEDGMENT 7

1. Introduction 9

2. National integrated SBCC Strategy 11

3. Overview of relevant policies and key literature 13

4. Situational analysis and problem statement 17

5. Priority behaviors to address 26

6. National SBCC Strategy communication framework 31

7. National SBCC Strategy audience analysis 35

8. National SBCC Strategy communication objectives 37

9. Analysis of relevant communication channels 39

10. National SBCC Strategy implementation arrangements 44

11. Monitoring and evaluation framework 47

12. Conclusion 49

13. Annexes 51

Contents

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ANC :Antenatal CareCHW :Community Health WorkersCRS :Catholic Relief ServicesDHS :Demographic and Health SurveyDPEM :DistrictPlantoEliminateMalnutritionECD :Early Childhood DevelopmentEICV 4 :IntegratedHouseholdLivingConditionSurveyFAO :FoodandAgricultureOrganisationHMIS :HealthManagementandInformationSystemHSSP :Health Sector Strategic PlanHSWG :Health Sector Working GroupsICT :InformationandCommunicationTechnologyIEC :Information,EducationandCommunicationINWA :IntegratedNutritionandWASHActivityIYCF :Infant Young Children FeedingJDAF :JointActionDevelopmentForumKAP :Knowledge,AttitudesandPracticesMCH :Maternal and Child HealthMIGEPROF :MinistryofGenderandFamilyPromotionMINAGRI :Ministry of Agriculture and Animal Resources MINALOC :Ministry of Local GovernmentMINEDUC :MinistryofEducationMININFRA :Ministry of InfrastructureMIYCN :Maternal,InfantandYoungChildNutritionMOH : Ministry of HealthNCC :NationalCommissionforChildrenNECDP :NationalEarlyChildhoodDevelopmentProgramNST1 :NationalStrategyforTranformationNTWG :NutritionTechnicalWorkingGroupNWC :NationalWomen’sCouncilPNC :Post Natal Care PSF :PrivateSectorFederationRBC :Rwanda Biomedical Center RHCC :RwandaHealthCommunicationCenterSBCC :SocialandBehaviorChangeCommunicationUNICEF :UnitedNationsChildren’sFundUSAID :UnitedStatesAgencyforInternationalDevelopmentWASH :Water,SanitationandHygieneWFP :World Food ProgrammeWHO :WorldHealthOrganisation

LIST OF ACRONYMS

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The National SBCC Strategy will build on the integration of Early Children Development,Nutrition and WASH sectors which provides opportunities of benefiting from integratedECD,nutritionandWASHsocialbehavior and communication servicesaimingat improvingknowledge,attitudeandpracticesatcommunityandhouseholdlevels.

Early Childhood Development (ECD) refers to a comprehensive approach to policies and programmes for children from 0 to 6 years of age, their parents and caregivers. Lifetimebehaviorpatternsareformedduringthisperiodwhenbraindevelopmentismostactive.Assuch,whathappensordoesnothappenduringtheseearlyyearsofachild’slife,influencestheirgrowthanddevelopmentoutcomesaswellasopportunitiesinadulthood.Aschildrenacquiretheabilitytospeak,learnandreasoninearlyyears,cornerstonesarelaidandlateraffecttheirorientationtodevelopmentandthrivinginlife.Investmentintheearlyyearsofachildisthereforecriticalforbothsurvival,growthanddevelopmentofthechild,communityandnationalduetothepredictablegainsandproductivityinadulthood.

ConsideringthevalueofECD,theGovernmentofRwandadevelopedacomprehensiveECDPolicy (2016), Food andNutrition Policy (2013-2018) and other child development relatedpolicies,offeringgovernmentorientationoninterventionstosupportchildren’sfullphysical,cognitive, language,social,emotionalandpsychologicaldevelopment.Thepolicy isalignedwithrenewedgovernmentcommitmentsundertheEDPRSII(2013-18),theNationalStrategyforTransformation(NST)2017-2023,andtherevisedVision2020targets.

TheGovernmentofRwandaisalsocommittedtoimprovingthehealthofallRwandansandhas shown these commitments through several policies and strategies,whichhavegreatlyimproved the overall health sector and the health and well-being of the population. TheRwandangovernmenthasinvestedinthehealthandwell-beingofitspeoplethroughtheThirdandfourthHealthSectorStrategicPlan(2012–2018;2018-2024).Thisstrategyseekstoaddresskeydeterminantsrelatedtoearlychildrendevelopment,malnutritionandwater,sanitationandhygiene(WASH)mostlyrelatedtoknowledge,attitudeandpracticesatcommunityandindividual levels.

There aremany impediments within the health systems that prevent people from havingproductiveandhealthy lives.SocialandBehaviorChangeCommunication(SBCC)addresseskeybarrierspreventingpeoplefromadoptingimprovedhealthpractices.TheEarlyChildrenDevelopment, nutrition andWASH sectorswithin the health system can benefit positivelyfromanSBCCstrategy.ECD,NutritionandWASHhavemulti-sectoraldimensionsthatrequirecontributions from different disciplines including but not limited to agriculture, economicstrengthening,publichealth,gender,medicine,andsocialscience.ThetheoriesandmodelsfromthesedifferentdomainscanbeextractedtodevelopanddelivereffectivebehaviorchangecommunicationsparticularlyinthecontextofpromotingpositiveECD,nutritionalandWASH

Foreword

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relatedpracticesathouseholdandcommunity level inRwanda.ByaddressingkeybarriersrelatedtoECD,NutritionandWASHbypromotingCommunityandHouseholdintegratedbestpractices,thiswillensureoptimumhealthstatusofthepopulationofRwanda.

Thesechangesinbehaviorandhealthoutcomesarevitalforthewell-beingofchildren(0-6yearsofage)andpregnantandlactatingwomen.IntegratingECD,nutritionandWASHSBCChasthepotentialtodramaticallyimprovethehealthsectorthroughbetterECDnutritionandWASH-relatedoutcomes.ThisSBCCstrategytypifiestheGovernmentofRwanda’scommitmentto promote positive health and ECD, nutrition andWASH outcomes as stipulated inmanynationalframeworksincludingtheThirdandFourthHealthSectorStrategicPlan(2012-2018,2018-2014).ThisstrategyisdeemedhighlyrelevanttopromoteEarlyChildrenDevelopmentpractices, infightingmalnutrition inRwandawithspecialattentionbeinggiventoreducingstuntingamongchildrenunder5yearsofage.

Dr. Anita AsiimweCoordinator, National Early Childhood Development Program (NECDP)

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TheprocessofdevelopingtheNationalSBCCStrategyforIntegratedECD,NutritionandWASHwas led byMinistry of Health (MoH) in collaborationwithMinistry of Gender and FamilyPromotion(MIGEPROF)throughNationalEarlyChildhoodDevelopmentProgram(NECDP)andRwandaBiomedicalCenter/RwandaHealthCommunicationCenter(RBC/RHCC).

WearegratefultotheMinistryofLocalGovernment(MINALOC),theMinistryofAgricultureandAnimalResources(MINAGRI),MinistryofEducation(MINEDUC),MinistryofInfrastructure(MINIFRA)andothergovernmentinstitutionsnamelyLocalAdministrativeEntitiesDevelopmentAgency(LODA),NationalItoreroCommission(NIC)NationalCouncilofPersonswithDisabilities(NCDP),OfficeofGovernmentSpokesperson(OGS),andWaterSanitationcorporation(WASAC)fortheirusefulcontributionindevelopingthisSBCCstrategy.

TheIntegratedECD,NutritionandWASHstrategywassupportedbytwomajorprograms.TheIntegratedNutritionandWASHActivity(INWA)programlocallynamed“Gikuriro” is fundedby the United States Agency for International Development (USAID) in Rwanda and beingimplementedbyCatholicReliefServices(CRS)inconsortiumwithNetherlandsDevelopmentOrganization (SNV). The ECD programme led by UNICEF is funded by the Embassy of theNetherlands.CRSandUNICEF facilitated theprocessofdraftingandfinalizing thisNationalSBCC Strategy technical approach.

Therefore, we would like to recognize the generous technical and financial support fromUNICEF,theEmbassyoftheNetherlands,USAIDanditsimplementingpartnersCRSandSNV,andtheWorldBankthroughouttheprocessofdevelopingthisimportantNationalIntegratedSBCC Strategy.

Wearealsoextremelygrateful to the following institutions for theiractiveparticipation inthereviewandvalidationofthestrategythroughtheextendedHealthPromotion,Nutrition,WASH,andECDTechnicalWorkingGroups:AEE,CARITASRwanda,C4Development,DUHAMICADRI,FVA,FXBRwanda,GlobalCommunities/Twiyubake,KigaliHopeAssociation,MaternalChildHealth(MCH),RICH, ImbutoFoundation,SFHRwanda,URUNANADC,WFP,WHOandYWCA.

Acknowledgment

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1. INTRODUCTION 1.1TheoverviewofintegratedECD,nutritionand

WASHinthefightagainststunting

Scientificevidenceaffirmsthatthefirstthreeyearsofachild’slifearethemostimportantinthechild’sdevelopmentandgrowth(Lancet).Eightypercentofbraindevelopmentoccurswithinthefirst threeyears,making itaperiodofgreatestsensitivity toenvironmental influences.Anydeficienciesduringthistimeaffectsubsequentchilddevelopment,soinvestinginachild’slifeduringthiscriticalphaseensuresabetterlifeforthechildandthenation.Itiscurrentlyestimatedthat,worldwide,250millionchildrenundertheageoffivearefailingtomeettheirdevelopmentpotential.Arangeofriskfactorsleadtothislossofhumanpotential.Delayedcare-seekingforillness,malnutrition,lackofaccesstocleanwaterandsanitation,childabuseandneglect,alackofstimulationandlearningopportunitiesandmanyotherchallengesresultincompromisedchilddevelopment.Theleversforchangerestinlocalandcommunityeffortstoprovideaminimumpackageofsocialservicestoyoungchildrenandtheirfamilies,coupledwith national and global action. Recognizing the interconnectedness of poverty reduction,health,nutrition,education,agriculture,protection,WASH,genderequality,social inclusionand development should place children and families at the heart of the government vision for developmentandtheworkonSustainableDevelopmentGoals.

EarlyChildhoodDevelopment(ECD)interventionsareameansofprovidingholisticcareandstimulationtochildrenduringtheirformativeyears.InRwanda,ECDisdefinedasarangeofchangesthroughwhichachildundergoesduringtheirearlyyearsoflifefromconceptiontosixyears,aswellassupportthatcaregiversneedtoprovidechildcare.ECDinterventionsdevelopsensory-motor,social-emotionalandcognitive-languageskillsforyoungchildren,whilebuildingthecapacityofparentsandothercaregiverstofulfiltheirparentingobligations.AccordingtoRwandaDemographicandHealthSurvey(DHS)2014-15,63percentofchildrenaged36-59months are developmentally on track in literacy-numeracy, physical, social-emotional, andlearningdomains.Thisindicatesthataboutonethirdofchildrenneedmorecareandsupportfordevelopment.Intermsofstunting,38percentofchildrenunderfiveyearsoldarestuntedcontributingtothedevelopmentaldelaysamongchildren.

The 2014 Knowledge, Attitude, Practice assessment on early nurturing of children report illustrated the many social and behaviour change determinants that contribute to theseissues.Whiletheprimarypointofcareandsupportoccuratthehousehold,itisrecognized

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thatparentsalonecannotprovideanoptimalenvironmentforchildren.InlinewiththeAfricanbeliefthat“ittakesavillagetoraiseachild”,communities,socialservicesandlocalleadersallplayimportantrolesinachild’slife.Thisiswherecommunicationplaysanimportantroleinachievingaconcertedeffortfrommulti-sectoralstakeholders.

ThisnationalSBCCstrategysetoutinthisdocumentisintendedtoguideECD,NutritionandWASHstakeholdersbyanalyzingthecurrentsituationandmakingconcreterecommendationson the targetaudience, keymessagesandcommunicationchannels. TheAnnexof thekeyinterventions, which will be updated annually, includes a summary of key interventionsin relevantfields (health, nutrition,WASH, early learning, parenting, childprotection). Thedocumentwillguidetheconcertedeffortsofthegovernment,policymakers,UN,civilsocietyorganizations(CSOs)andtheprivatesectortojoinhandsforthepromotionofIntegratedECD,NutritionandWASHservicesinRwanda,andfostersupportivesocialandbehaviorchangetogiveeverychildthebeststartinlife.

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2. NATIONAL INTEGRATED SBCC STRATEGY

2.1.Definition

SocialBehaviorChangeCommunication (SBCC)isabehavior-centeredapproachtofacilitatingindividuals,households,groups,andcommunitiesinadoptingandsustainingimprovedhealthandnutritionrelatedpractices.Itprovidesa“roadmap”forchangingbehaviorsandsocialnormsandidentifiesallthebehaviorsthatneedtobechangedtoattainpositivehealthandsocialimpacts.Itisamulti-leveltooloperatingthroughthreekeystrategicdimensions:aplanningcontinuum includingadvocacy, socialmobilizationandbehavior changecommunication forpromotingandsustaininghealthy,risk-reducingbehaviorsamongindividualsandcommunities.It achieves this objective by disseminating tailored health messages to specific audiencesthrough a variety of communication channels, based on evidence driven communicationobjectives.

2.2.NationalIntegratedSBCCGoal

Thegoalof thisNational IntegratedSBCCStrategywillcontributetostrengthen leadership,accountability,partnershipandcoordinationinthedeliveryofcommunicationinterventionsrelated to ECD, Nutrition andWASH at all levels. Such interventions will effectively buildcapacityamongparentsandfamilies,raiseawarenessamongcommunities,formsupportivesocialnorms,guidethelocalauthoritiesandstrengthentheprovisionofallsocialservicesthatsupportEarlyChildhoodDevelopmentandimprovingnutritionandWASHbestpractices.

Towardsthegoalofoptimalchilddevelopment,theinterventionswillensure:

● Parentshaveparentingskillsandengagewithchildrenwithloveandcare;

● Parentsandcommunitiesareequippedwithknowledgeandskillsonmaternalandchildhealth,ECD,nutritionandWASH;

● Parentsaresupportedbyenablingsocialnormstopracticepositivebehaviors,includingemphasisonmaleengagementinchildcarepractices;

● Centralgovernmentand localauthoritiesunderstandtheir rolesandresponsibilities inpromotingECD,NutritionandWASHinterventions

● Parentsusepositiveparentingtoguidechildrenandthecommunitytoparticipateinchildprotectionfromanyphysical,moralorpsychologicalharm;

● Families with young children increase demand for social services including health,

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nutrition,WASH,ECD,childprotectionandsocialprotection;

● Childrenwithdisabilitiesandspecialneedswillhaveequalaccesstothesesocialservicesand special care;

● KeyintegratedECD,nutritionandWASHmessages,appropriatecommunicationchannelsand tools to disseminate messages are harmonized, coordinated and implementedeffectively;

● Childrenhaveaccesstoearlystimulationandage-appropriatecommunicationchannels,tools and messages for school readiness;

● Monitoring framework is inplace forabetter followupof the implementationof theStrategy.

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3. OVERVIEW OF RELAVANT POLICIES AND KEY LITERATURES

This National SBCC Strategy will be based on the Rwanda National Policies to guide theimplementers at all levels with generalmissiontocoordinateandimplementallinterventionsthatsupportadequatedevelopmentforchildrenandeliminatestunting.Thefollowingpoliciesandstrategiesareofparticularimportance.

3.1.NationalECDPolicy:

The government elaborated the first ECD policy in September 2011 under theMinistry ofEducation(MINEDUC).In2014,theMinistryofGenderandFamilyPromotion(MIGEPROF)wasassignedtorevisetheECDpolicyandcoordinatepolicy implementation,given itsmandateof familypromotionand childprotection. Themission, goals andobjectivesof the revisedECDpolicyestablishthecountry’svisionforitsyoungestcitizens.Themissionemphasizesthedeliveryof credible interventions that caneffectively support children’sdevelopment fromconception to six yearsofage inRwanda.Themission is alignedwith theoverall visionofprovidingchildrenwith integrated interventionsthatenabletheirholisticdevelopmentandincreasetheirlearningopportunitieswhilealsoengagingthecommunity.

Thegeneralobjectiveofthepolicyemphasizesprinciplesofequity,accessandqualityofECDservices, and requires systems that are coordinated and provide sustainable services. Thespecificobjectivesare:(1)toincreasechildren’spreparednesstocopewithprimaryschool;(2)toenhancepositiveparentingandcommunityparticipationinchildprotection;(3)toreducemalnutritionandstuntedgrowthamongyoungchildren;(4)toreduceunder-fiveandmaternalmortalityrates;(5)todevelopchildren’sself-awareness,self-esteemandself-confidence;(6)toeliminatephysical,moralandpsychologicalabuseofyoungchildren;and(7)toenhanceequalaccessbychildrenwithspecialneedstoECDservices.TheECDpolicyissupportedbyastrategicimplementationplan,whichcomprisesfivekey areas of program investment and focus: (1) parenting education and support; (2) school readiness and transitions; (3) childprotection and family promotion; (4) health, nutrition and WASH; and (5) coordination,governance,resourcing,monitoringandevaluation.TheECDpolicywasofficiallyadoptedbythe Government of Rwanda in May 2016.

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3.2.FoodandNutritionPolicy(2013-2018)

TheNationalFoodandNutritionPolicydevelopedin2013buildsonseveralachievementsthathaveimprovedthestatusofnutritionandhouseholdfoodsecurityinRwanda.ThevisionoftheNationalFoodandNutritionpolicyistoensureservicesandpracticesthatbringoptimalhouseholdsecurityandnutritionforallRwandan.Thispolicyfocusesonthenationalresolvetosubstantiallyreducetheprevalenceofstuntinginchildrenundertwoyearsofage,andtoimprovehouseholdfoodsecurityparticularlyamongthemostvulnerablefamilies.Substantialreductionofacutemalnutritionhasoccurred inrecentyears,however,problemswithhighlevelsof chronicmalnutritionandmicronutrientdeficiency stillexist.Thepolicy recognizesthat,whenpregnantwomendonothaveappropriatenutritionalintakeduringpregnancy,andchildrendonotreceivethefoods,feedingandcarerequiredfornormalgrowthduringtheirfirsttwoyears’chronicmalnutritionoccurs.Thepolicyalsooutlineskeyeventsandinformationsources that influenced the dramatic rise of nutrition and household food security on thenationalagenda,notablyJointActionPlantoEliminateMalnutrition(JAPEM)atcentrallevelandDistrictPlanstoEliminateMalnutrition(DPEM)atlocallevel.

3.3.NationalHealthPromotionPolicy

TheNationalHealthPromotionPolicy(NHPP)wasdevelopedtopromotediseaseprevention,empower communities to translate health information into desired action, and encouragecommunityparticipationandownershipofhealthpromotionrelatedactivities.TheNationalHealthPromotionpolicyplays a very important role in influencingbehavior changeofourpopulationtherebyenhancingtheadoptionofpositivelifestylesbyindividuals,familiesandcommunitiestopromotetheirhealth.However,behaviorchange isacomplexprocessthatcouldtakealongtimetoberealizedeffectively.Therefore,itrequirestheprovisionofadequateresourcesonasustainedbasisand foranextendedperiodoftime inorder toachieve thedesired impact countrywide. TheHealth Promotion Policy has been developed taking intoconsiderationtheHSSPIII,vision2020,EDPRSIIandtheWHOrecommendationstomembercountriesontheneedforformalpoliciesonhealthpromotion.TheNHPPprovidesanoverallframeworkforhealthpromotiondevelopmentandpracticesinRwanda,ithighlightsthefactthatdeterminantsofhealthofthepopulationgobeyondhealthservicesandcallsformulti-sectorpartnershipapproachesasthewayforwardtoattainingeffectivehealthpromotion.

3.4.RwandaHealthSectorStrategicPlanIV(2018-2024)

This National SBCC Strategy is guided by HSSP IV priorities for health programwhich arecommunity education and awareness on dietary and complementary feeding practices;establishmentandusingECDasanentrypointinprovisionofhealthinterventions(specificallyearlychildhooddevelopment,nutritionandWASHservices);preventionandmanagementofmalnutrition(acuteandchronic)andimprovementofmulti-sectoralcollaboration.

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3.5.NationalStrategyforTransformation(2017-2024)

NationalStrategyforTransformation(NST1)isbuiltonthreepillars:EconomicTransformation,SocialTransformation,andTransformativeGovernance.TheEconomicTransformationpillaraimstoaccelerateinclusiveeconomicgrowthanddevelopmentfoundedontheprivatesector,knowledgeandRwanda’snaturalresources.TheSocialTransformationpillaraimstodevelopRwandansintoacapableandskilledpeoplewithqualitystandardsoflivingandastableandsecuresociety.TheaimofTransformationGovernancepillaristoconsolidategoodgovernanceandjusticeasbuildingblocksforequitableandsustainablenationaldevelopment.TheNST1alsoembracestheSDGs,andAfricaUnionAgenda2063.

3.6.SanitationPolicy(2016)

Sanitationplaysavitalroleinpreventivehealthcareandqualityoflife.Forthatreason,theGovernment of Rwanda has made provision of sustainable sanitation services one of thepriorities of theNational Development Agenda and is establishing supportive policies andlegislation.TheMinistryofInfrastructurehasdevelopedtheNationalSanitationPolicytoensureproperimplementationofactivitiesinthesanitationsub-sector.ThePolicyoutlinesinitiativestoovercomechallengesandexploitexistingopportunitiesinanintegratedmannerandwilleffectivelycontributetowardsachievingthegoalsoftheNationalDevelopmentAgenda.TheGovernmentofRwandawillensureexpandedaccesstosafeandsustainablesanitationservicesthrough a number of means including: establishing District sanitation centers providing awide rangeof sanitation technologies; improvingoperationandmaintenanceof sanitationfacilities;andassistingDistrictsandtheCityofKigalitoplananddesignprojectstomitigateurbanstormwaterissues.TheGovernmentofRwandaisalsoencouragingactiveparticipationoflocalprivateserviceprovidersandoperatorsinthesanitationsub-sectorandwillensuretheprinciplesadvocatedbythispolicyareadheredtointhewholeprocessofsanitationservicesprovision. The Government further strongly recognizes the initiatives of the internationaland regional communities andwill continue to cooperate to achieve the 2030 SustainableDevelopment Goals.

3.7. Environmental Health Policy (2008)

AccordingtotheEnvironmentalHealthPolicy,themaincontributingfactorstoenvironmentalhealthrelateddiseasesinRwandaareinadequateandunsanitaryfacilitiesforexcretadisposal,poormanagementofliquidandsolidwastes,andinadequatepracticesofhandwashingwithsoap that leads to contaminationof foodandwater inboth rural andurbanareas. This ismainly due to a population, which lacks awareness, inadequate participatory hygieneeducation and environmental health promotion approaches in school and communities aswellasuncoordinateddeliveryofeffectiveenvironmentalhealthservices.Thenegativestateofenvironmentalhealthconditionsinfluencesthediseaseburdenwhich,inturn,contributestopoverty.Thechildren,theelderlyandtheimmuno-compromisedindividualsgetsickmorefrequentlyandmoreresourcesarespentoncurativeservicestorestoretheirstateofhealth,thus increasing poverty at household and community levels.

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3.8. Maternal, Neonatal and Child Health National Strategy (2013-2018)

The2013-2018Maternal,NeonatalandChildHealthNationalStrategy(MNCH)outlinestheroleofnutrition,particularlyduringpregnancy,lactating,andearlychildhoodtoeliminateallformsofmalnutrition ineveryRwandan family through implementationof the jointactionplan initiated for 2012 and strengthening of themulti-sectoral approach. It also highlightsthatmaternalundernutritionisoftenreflectedintheproportionofchildrenwithlowbirthweight(below2.5kilograms)andpregnantwomenareparticularlyvulnerabletoanemiadueto increased requirements for ironand folicacid.According toRDHS (2010),17percentofwomenaged15-49yearswerefoundtobeanemic,buttheoverallprevalenceofanemiahasdecreasedby8percentsinceRDHS2005.Maternalunderweightstatuscontributestopoormaternalhealthandbirthoutcomes.

3.9.DisabilityMainstreamingGuidelines(2014)

Rwanda has endorsed many legal instruments, 13 ministerial orders, Sector policy andstrategicplanstoconsiderthatalltypesofdisabilities,includingphysical,intellectual,visualandhearingimpairmentsareconsideredineveryareaoflife.Intermsofinternationallegalandpolicyframeworks,UNCRPDwasratifiedandEasternAfricanDisabilitypolicyendorsed.Domestication of these and political intent framed with: Rwandan constitution, law ondisability,Ministerialorders,EDPRSI,II,policyframeworksandMinistrysectorstrategicplans.IntheEDPRSIIdocument,disabilityisconsideredasacrosscuttingissuetotakeintoaccountinallpragmaticareas,anditismentionedthat“Rwandadoesnotintendtoleaveanyofitscitizensbehindinthedevelopment.Assuch,specificstepswillbetakentoensurethatpeoplewithdisabilities(PWDs)andotherdisadvantagedgroupsareabletocontributeactivelytothecounty’sdevelopmentandtobenefitfromit.”Theguidelinesconstituteasastepforwardforvariousactors,as itproposespracticalstepsofmainstreamingdisability invariousareasoflifemainlyineducationandhealthwithemphasisonearlychildhooddevelopment.(NationalCouncilofPersonswithDisabilities,Kigali,May2014).

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4. SITUATIONAL ANALYSIS AND PROBLEM STATEMENT

4.1.Stunting

Stunting is a complex form ofmalnutrition. Although therewas a remarkable progress inreducingstunting(from44percentin2010to38percentin2015accordingtoDHS),Rwandaaimstoreduceitto15%by2024.Stuntingisknowntocompromiseoptimalbraindevelopmentandhasadirectimpactonachild’sdevelopment.

Stuntingcanbecausedfirstbynutritionalfactors,includingmother’snutritionstatus(oftenresulting inchildrenbeingbornwitha low-birthweight), lackofappropriatebreastfeedingandpooryoung-childfeedingpractices.ThebreastfeedingrateishighinRwanda(99percentamongchildrenduringtheirfirstyearoflife),butonly56percentofchildrenaged6-8monthsreceivecomplementaryfoods.Thispartlyexplainsthehighrateofstuntingandofanemia(37percent)amongchildrenaged6-59months.Alongsidenutrition,hygieneiscriticalinpreventinginfectiousdiseasesthatexacerbatestunting.Stuntingislinkedtofrequentepisodesofdiarrheaamongchildrenunderfiveyears,whoseprevalenceisRwandais12percent.Childreninruralareasaremoreaffectedbydiarrhea (13percent in ruralareas, compared to10percent inurbanareas).Oncethechildgetsinfectiousdisease,itisimportanttoseekhealthcarebeforethechildhealthisfurtherundermined.However,theDHSshowsthatoutofthe19percentofchildrenwhohadfever,only62percentofparents/caregiverssoughtadviceortreatmentfromcommunity health workers or health providers.

Inthefollowingsection,furtherdetailsofthedatarelatedtoECD,health,nutritionandWASHwillbepresentedtounpackthedeterminantsofstunting.

4.2.Rwanda-EarlyChildrenDevelopment(ECD)figures

4.2.1 Child development

Overall,63percentofchildrenaged36-59monthsaredevelopmentallyontrackinliteracy-numeracy,physical, social-emotional,and learningdomains.Urbanchildrenaremore likelythan rural children to be developmentally on track (67 percent versus 62 percent). Beingdevelopmentallyontrackispositivelyassociatedwithmothers’education(59percentamongchildrenwhosemothers have no education compared to 69 percent among thosewhosemothershavereachedsecondaryeducationorhigher).Thereisalsoadisparityaccordingtofamily income-levelwith67-68percentof children founddevelopmentallyon trackamongtheuppertwowealthquintilesandonly59-63percentamongthelowestthreequintiles.Keyfactorshinderingthechilddevelopmentaredescribedbelow.4.2.2.Earlychildhoodeducationandorganizedcare

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AlthoughRwandahasahighrateofprimaryschoolattendance,veryfewchildrenbelowtheageofsixyearshaveanopportunityforearlylearning.Only13percentofchildrenaged36-59monthsattendanorganizedECDprogram;childrenlivinginurbanareasaremuchmorelikelytoattendthanchildrenlivinginruralareas(37percentand9percent,respectively).

Significantcorrelationsareobservedbymothers’educationandhouseholdwealthquintile.Only 4 percent of children whose mothers have no education attend an ECD program,comparedwith49percentofchildrenwhosemothershaveasecondaryeducationorhigher.TheKnowledge,AttitudeandPractices(KAP)surveylookedintothereasonsfornotbringingchildrentoorganizedcarefacilities.Forthemajoritywhodonottaketheirchildrentoorganizedchildcarecenters,themainreasonsprovidedareprotectionforthechildren,becauseparentsfeel they are too young tobeout of the family setting (16%), a preference for having thechildren at home (12%) or fear that children might get sick (5%). Some parents also felt that thechildcarecentersareexpensive(14%),whileothersdidnotknowwherethecenterswerelocated (14%).

The main problem hindering access to organized care is the supply issue - availability ofsafe andnurturing space for children.With the aimof increasing thequantity andqualityofservices,MIGEPROFismappingallECDinterventionsacrossthecountry.TheinformationgeneratedwillprovideaninsightonthescopeandreachofRwanda’sECDservicesandtheactors/stakeholdersinvolved.Itwillalsogiveinformationonthequalityofservicescurrentlyprovided and highlight any gaps in service-provision. The mapping will help to improveequitablescale-upofECDservices,startingfromareaswiththehighestneed.Youngchildrenspendthemajorityoftheirtimeathomesothehomeenvironmentmatters.Accesstobooksandotherlearning-playmaterialsisverylow:only1percentofchildrenhadoneormorechild-friendlybook,and30percentofchildrenhadaccesstoplaymaterials.

4.2.3.Childrenwithdisabilities

According toRwanda’s2012Census, therewere15,831childrenaged3-6withdisabilities.However, according to the 2014 Education Statistical Yearbook, only 1,387 children withdisabilitieswereattendingpre-primaryschool.Thismeansonly9percentofthesechildrenareattendingpre-primaryschool,whichissignificantlylowerthanthenationalaverageof13percent.Thisgapindicatesthatmanychildrenwithdisabilitiesarestayingathomewithoutaccesstoorganizedcare.Effortsarethereforeneededtosupportchildrenwithdisabilitiesandtheirfamiliesbyremovingphysicalandsocialbarrierswhileincreasinginnovativeandinclusivecare knowledge amongst parents and caregivers.

4.2.4.Adultinvolvementinearlylearningandstimulation

Age-appropriate,responsivecareandstimulationsupportstherapidbraindevelopmentthatoccursinthefirstthreeyearsoflife.However,theRwandaDHSreportedthatonly49percentofyoungchildrenengagedwithanadulthouseholdmember infourormoreactivitiesthatpromotelearningandschoolreadinessduringthethreedaysbeforethesurvey.Amongthose

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children,only3percentengagedinfourormorelearningactivitieswiththeirbiologicalfathers,and12percentwiththeirmothers,indicatingverylowparentalengagement,especiallywithfathers.Parent-childinteractionincreaseswithincreasingwealthquintileandtheeducation-level of parents, especially mothers. The KAP Survey indicated that parents do not haveaccurateknowledgeofwhenchildrenstarthearing,seeingandlearning.Also,parentsdonotfullyunderstandwhatspecificformsofinteractionhelpinthedevelopmentoftheirchildrenatdifferentstagesofearlychildhood.

4.2.5. Role of Father

TheKAPsurveylookedintoattitudestowardsfatherhood.Theopinionsofcaregivers,inrelationtotheimportanceofthefather’sroleinthedevelopmentoftheirchild,wereinvestigatedindepth.Thefindingsshowthatthemostimportantroleofthefatherwithregardtochildrenaged0-2yearsisseenas‘showingloveandaffectiontothechildandplayingwithhim/her(92percent). This is closely followedby ‘providing forday-to-daynecessities’ (91percent).Forchildrenaged2-6years,however, themost importantroleof the father is foundtobe‘discipliningthechild’(91percent),closelyfollowedby‘providingthethingsthe child needs’ (89 percent). The breadwinning role is seen as being of central importance, and the roleof fathers is also particularly highlighted in relation to discipline. Key informant interviewswith fathers indicatedthatsocialnorms ingenderroleshaveanegative impactonfathers’participationinparenting. 4.2.6. Adequate care for young children to protect from harm

The Rwanda DHSmeasured the incidence of children under five left alone or with otherchildren.Childrenleftaloneareexposedtomanyrisksincludingaccidents,abuseandneglect.Thirty-fivepercentof childrenunderfive yearswere left aloneor left in the careof otherchildrenbelow10yearsduringtheweekprecedingtheinterview.Withregardstodiscipline,nearlyhalfofthoseinterviewedfortheKAPsurveyexpressedabeliefthatchildrenneedtobephysicallypunishedtogrowupwell.Ontheotherhand,50percentagreedwiththestatementthat ‘beating children may negatively affect self-confidence, including encouraging them to beat others’.Tounderstandtheseseeminglycontradictingviews,attitudestowardsdisciplinewereexploredinfocusgroupdiscussions.Parentsandcaregiversarenotinfavorofphysicalpunishmentand themajority showedpreference for talking tochildrenandadvising themontherightthingtodo.Thisopinionissharedbymaleandfemalecaregivers,aswellasbycommunityhealthworkers.AtthesametimetheKAPassessmentfindsthepracticeofphysicalmethodsofdiscipliningchildrentobecommon.Sixty-threepercentofcaregiversslaptheirchildrenaged4-6,forexample.Itisalsoevidentfromthefindingsthatpunishmentbecomesmoreabusiveaschildrengrow.

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4.3.AdultHealthandNutrition

4.3.1. Antenatal, Postnatal, and Delivery Care Services

Antenatal(ANC),postnatal(PNC),anddeliverycare(DC)servicesinRwandaarecloselylinkedtomaternal,child,andreproductivehealthoutcomes,whichmaketheserelevanttothiscurrentstrategy.Accordingtothe2015RDHS,99%ofwomenwithalivebirthsince2010receivedatleastoneantenatalcareservicefromaskilledhealthprovider,and44%ofwomenattendedthe recommended fourANCvisits during their pregnancy (RDHS2015). ThepercentageofwomenattendingfourANCvisitshasincreased9%since2010(35%).OtherkeyfindingsfromRDHS2014-2015include:91%oflivebirthssince2009-2010weredeliveredinahealthfacility;91%of livebirthswereassistedbyaskilledhealthprovider;and43%ofwomenwhogavebirthin2012or2013receivedapostnatalcarecheckupinthefirsttwodaysafterdelivery.ThestudyalsorevealedsomechallengesinANCandPNC,notablythatonly19%ofnewbornsin2012and2013receivedapostnatalcheckupwithinthefirsttwodaysafterbirth.Amongthesenewbornswhoreceivedpostnatalcheckups,nearlyallreceivedcarefromskilledpersonnel.Additionally,accesstohealthcarecontinuestobeabarrierformostRwandanwomen:59%reportedatleastoneprobleminaccessinghealthcare(RDHS2015).Themainbarriertoaccesswasfoundtobefinancial,althoughdistancetoahealthcarefacility,andsafety issueswerefrequentlycitedbywomenasseriousfactorsinthemaccessinghealthcare.Generally,thesebarriersareheightenedamongwomenlivinginruralareas.

4.3.2. Maternal Micronutrient Intake:

Adequatemicronutrient intake by pregnant women has important health implications forbothwomenandtheirchildren.Breastfeedingprovideschildrenwithcriticalmicronutrients,especiallyvitaminA.Ironsupplementationofwomenduringpregnancyprotectsthemotherandinfantfromanemia,whichisknowntoincreasetherisksofprematuredeliveryandlow-birthweight(Allen,2000).AnemiaprevalenceamongRwandanwomenisrelativelylow(19%)andincludesalmostnocasesofsevereanemia(DHS2015).Nevertheless,it isimportanttoensurepregnantwomenarereceivingmicronutrients,sothemothersandtheirchildrendonotbecomeanemic.Acommonapproachtoimprovingmicronutrientintakeamongmothersin Rwanda is to provide them with iron and folic acid supplements during pregnancy and vitaminA inthepostpartumperiod.RDHS2014-2015foundthat49%ofwomenwhogavebirthbetween2009-2010receivedvitaminAsupplements(RDHS2015).Approximately80%ofwomenreportedtakingironsupplementsduringpregnancy,althoughmostofthesecases(68%) took supplements for 60 days or less.

4.3.3. Overweight and underweight:

AccordingtoDHS2015,theproportionofoverweightwomenstandsat17%and4%ofwomenare considered to be obese. The proportion of overweight or obese women is positivelycorrelated towomen’s age, increasing from14%amongwomen age 15-19 to 26%among

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womenage30-39beforedecliningto23%amongwomenage40-49.Urbanwomenaretwiceaslikelytobeoverweightorobese(37%)asruralwomen(17%).6%ofmenareoverweightandlessthan1%areobese.Generally,obesityinwomenismorethanninetimeshigherthanmen. Overall 13% ofmen age 15-49 are underweight and about twice the percentage ofunderweight women (7%).

4.4.ChildHealthandNutrition

While overall nutrition outcomes in Rwanda have improved in the past decade, chronicmalnutritionamongchildrencontinuestobeapublichealthconcernthatwarrants furtherintervention.AccordingtoRDHS2015,theprevalenceofchronicmalnutrition(stunting)amongchildren under 5 has steadily improved – falling from a prevalence of 51% in 2005 to 44% in 2010,andto38%in2015(RDHS2015).StuntingisalsohigheramongruralhouseholdsandintheWesternProvince(45%)(RDHS2015).Acutemalnutrition(wasting)hasdeclinedfrom5%to 2%overthesameperiod,andtheproportionofchildrenunder5whoareunderweighthasdecreasedfrom18%in2005to9%in2014-15(RDHS2015).

These improvements may be partly attributable to Rwanda’s National Plan to Eliminate Malnutritionwhich,since2009,hasincludedactivenutritionscreeningofchildrenbycommunityhealthworkers(CHWs).Childrenwhoaredeterminedtobeatriskofacutemalnutritionarereferredtoahealthfacility forappropriatetreatmentusingtherapeuticmilks,ready-to-usetherapeutic food, anda corn-soyblend.Otherapproacheshavebeen initiated, includinganational infant and young child feeding program, community-based nutrition programs,behaviorchangecommunicationefforts includingmassmedia,andhome food fortificationusing micronutrient powders.

AlthoughmuchlesssignificantthanwastingorstuntinginRwanda,thenumbersofoverweightandobesechildrenisincreasingamongchildrenunder5yearsofage.Overall,8%ofchildrenunder5areoverweightorobese(weight-for-heightmorethan+2SD)(RDHS2015).Thereisasignificantdifferenceinprevalenceofbeingoverweight/obesebyareaofresidence:11%inurbanareasand7%inruralareas(RDHS2015).Thus,thereremainsaneedformoreintensiveandcomprehensiveinterventionsacrossmanysectors.

4.4.1. Initiation of Breastfeeding

TheWorldHealthOrganization(WHO)recommendstheprovisionofthemother’sbreastmilktoinfantswithinonehourofbirth(WHO,2016).Thefirstbreastmilkproducedbythemothercontainscolostrum,which ishighlynutritiousandhasantibodiesthatprotectthenewbornfromdiseases.Earlyinitiationofbreastfeedingalsofostersbondingbetweenthemotherandchild.InRwanda,81%ofchildrenarebreastfedwithinonehourofbirth,a10%increasefrom2010figures(RDHS2015).Ninety-six-percentofchildrenarebreastfedwithinonedayofbirth,andapproximately5%ofchildrenreceiveaprelacteal feed,which issomethingotherthanbreastmilkduringthefirstthreedaysoflife.

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4.4.2. Exclusive Breastfeeding and Complementary Feeding

Exclusivebreastfeedingduring thefirst sixmonths iswidelypracticed inRwanda–87%ofchildrenareexclusivelybreastfedfortheirfirst6monthsoflife(RDHS2015).However,thereisstillaneedtoconveytheimportanceofexclusivebreastfeedingfortheentirefirst6months:94%ofinfantsaged0-1monthwereexclusivelybreastfed,butthisfiguredropsto90%amongthoseaged2-3monthsand81%amongthoseaged4-5months(RDHS2015).After6months,breastmilkaloneisnolongersufficienttomaintainachild’soptimalgrowth.Forthisreason,UNICEFandWHOrecommend the introductionof solid food to infantsatapproximately6monthsofage(PAHO/WHO,2003).After6months,addingcomplementaryfoods,includingproteinandvegetables,toachild’sdietensuresthechildisreceivingallheorsheneedstogrow properly.

AccordingtoRDFS, thestuntingrate increasesaround6months,aftertheweaningperiod,andRwandaneedstosignificantlyimproveinthisarea.RDHS2015showsthatonly17%ofbreastfeeding children aged6-23months consumemeatorfish; 4%of children aged6-23monthsconsumeeggsinadditiontobreastfeeding;andonly1%ofchildreninthisagegroupconsumed cheese, yogurt, or other dairy products in the 24 hours preceding the survey.Overall,itwasfoundthat89%ofchildrenaged6-23monthsconsumedsolidorsemisolidfoodduringthedayornightprecedingthesurvey.Most“solidorsemisolidfood”referstofruit,vegetables,andlegumes.Furthermore,CFSVA2015indicatedthatforchildrenaged6to23months, themostcommonfood itemsconsumedbychildren in thisagegroupcomefromthefollowingfoodgroups:grains,rootsandtubers;vitaminArichfruitsandvegetables;andlegumesandnuts.About32percentofchildrenarereachingtheminimummealfrequency(For breastfed children, twice for 6–8-months old and three times for 9–23 months. For non-breastfed children, four times for 6– 23-months old)while29percentareobtainingminimumdietary diversity (four or more food items out of seven food groups).

4.4.3. Infant and Young Child Feeding Practices WHOandUNICEFrecommendthefollowinginfantandyoungchildfeedingpractices(IYCF):early initiationofbreastfeedingwithin1hourofbirth;exclusivebreastfeeding for thefirst6monthsoflife;andintroductionofnutritionally-adequateandsafecomplementary(solid)foodsat6months togetherwith continuedbreastfeedingup to2 yearsof ageorbeyond.Introducing solid and semisolid foods at 6 months is known as complementary feeding and is a time when a sharp increase in stunting and underweight is seen (RDHS 2015).Childrenwhocontinueexclusivebreastfeedinglongerthan6monthsandthosewhoarefedinadequate amounts of food or a lack of variety of foods are at the highest risk for developing malnutrition.ChallengesregardingIYCFpracticesinRwandashowthatonly18%ofchildrenaged 6-23months are currently fed in accordance to all 3 recommended practices (RDHS2015).TheMinimalAcceptableDiet(MAD),acompositeofbothMinimumMealFrequency

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andMinimal Dietary Diversity shows that overall, in children 6-23months, a gain of only1% improvement in this indicatorwas seen over a 5-year period of time from 2010-2015(RwandaStakeholder&ActionMapping2015).Adherencetoappropriate feedingpracticesarelinkedtoindicatorsofgeography—childreninurbanhouseholdsaremorelikelytobefedinaccordancewiththerecommendedIYCFpractices—andhouseholdincomeandeducationlevelarefactorsassociatedwithpracticingtheIYCFrecommendations.IYCFhasmademanypositivecontributionstowarddecreasingmalnutrition,anditneedstocontinuetoimprove,particularlyattimesofcomplementaryfeeding,whentheincreaseinratesofmalnutritioncanbeseen.

4.4.4. Diarrheal Disease and Treatment of Diarrhea

Diarrheal diseases constitute one of the main causes of death among young children indevelopingcountriesastheyareassociatedwithdehydrationandmalnutrition.Tocombattheeffectsofdehydration,WHOrecommendstheuseoforalrehydrationtherapy(ORT),whichincludesapreparedsolutionoforalrehydrationsalts(ORS)madefrompacketsorasolutionprepared at homeusing cleanwater, sugar, and salt (recommended homefluids, or RHF).According toRDHS2015, theprevalenceofdiarrhea is especiallyhighamongchildrenage12-23monthsand6-11months(22%and18%,respectively).Diarrheaprevalencevariesbyprovince,fromalowof8percentinCityofKigalitoahighof15percentinWest.RegardingtreatmentofDiarrhea,RDHS2015showedthat44percentofchildrenwithdiarrheaseektheadvice or treatment from a health facility or provider.

4.4.5. Feeding Practices during Diarrhea

Tominimizetheadverseconsequencesofdiarrheaforthechild’snutritionalstatus,mothersandcaregiversareencouragedtocontinuefeedingchildrennormallywhentheysufferfromdiarrhealillnessesandtoincreasethefluidsthatchildrenreceive.Thesepracticeshelpalsotoreducetheriskofdehydrationamongdiarrheicchildren.Accordingto(RDHS2015),only20percentofchildrenwithdiarrheaweregivenORTorincreasedfluidsandalsogiventhesame,more,orslightlylesstoeatthanusual.

4.4.6. Vaccinations and Micronutrient Intake

Accordingtothe2014/15DHS93%ofchildrenreceivedall8basicvaccinations,upfrom75%in2005.ThisincludesvaccineagainstRotavirus,whichisthemostcommoncauseofdiarrhealdisease among infants and young children.Inaddition,86%receivedavitaminAsupplement,80%receiveddewormingmedicationinthe6monthspriortothesurveyandalmost100%percent(99.7%)livedinahouseholdwithiodizedsalts.InaKAPsurveydonebyUNICEFin2012itwasfoundthat78%hadknowledgeaboutvaccinatingachildagainstapreventablediseaseand38%hadknowledgeaboutVitaminAsupplements.FromthisitwasinferredthatalthoughpeoplemaynotknowthefullimportanceofvaccinationsandVitaminAsupplementstheyvaccinatedtheirchildrenandgavethemVitaminAsupplements,anexampleofapositivehealthy social norm.

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4.5.Water,SanitationandHygiene(WASH)

4.5.1. Household Drinking Water

Currently,73%ofRwandanhouseholdshaveaccesstoan“improved”sourceofdrinkingwater(RDHS,2015),withprotectedsprings(32%)andpublictaps(27%)arethemostcommonsourcesof improved drinking water. The remaining (27%) households reported using unimprovedsourcesofwater,andonly10%ofhouseholdsinRwandahaverunningwaterintheirhome(RDH 2015). Fourteen percent of households reported using an unprotected spring as their primarywatersource.Bynothavingaccesstoorusingimprovedwatersources,householdsare at a higher risk of contracting diarrhea and other waterborne diseases compared topeopleusinganimprovedsourceortreatingtheirwaterbeforeconsumption.Further,thoseusingan improvedsourcemaystillbedrinkingcontaminatedwater,althoughdataonfecalcontaminationinwaterisunknownforruralareasinRwanda.Diarrhealdiseasesarelinkedtomalnutrition,especially inchildrenunder5yearsold. Ifahousehold isunabletosecurewater from an improved source, then treatment prior to consumption is recommended.Further,RDHS2015highlightedthatchildren inhouseholdswithsharedandnon-improvedtoiletfacilitiesaremorelikelytohavehaddiarrheathanthosewholiveinhouseholdswithimproved,notsharedtoilets.

There is anapparent associationbetweendiarrheaprevalenceandhouseholdwealth. Theprevalencevariesfromahighof15percentamongchildreninthelowestquintiletoalowof8percentamongchildreninthehighestquintile. InRwanda,44percentofhouseholdsuseanappropriatetreatmentmethodpriortodrinking,whiletheremaining56%do not take any measuretotreattheirwaterpriortodrinking(RDHS,2015p.21).Themostcommonmethodtotreatwaterpriortodrinkingisboiling(38%),followedbyaddingbleach/chlorinetountreatedwater(5%).Usingceramic/sandoranotherfiltertodistilluntreatedwaterwasalsoreportedasatreatmentmethodby4%oftheRDHSstudypopulation.Theissueofsecuringsafedrinkingwateralsoappearstobeinfluencedbygeography.Mosturbanhouseholds(91%)werefoundtohaveaccesstosafedrinkingwater,whileaccesstosafedrinkingwaterisconsiderablylessamong rural households (69%). It is not surprising then that Rwandans living in rural areas aremorelikelytodrinkuntreatedwater(60%)thantheirurbancounterparts(33%).Securingaccesstosafedrinkingwateriscriticaltoimprovingthehealthandwell-beingofallRwandans.

4.5.2. Household Sanitation Facilities and Practices

Asecuresanitationfacility(e.g.acoveredtoilet)inthehouseholdisvitaltoreducetheriskofexposuretodangerouspathogensanddiseases.Diarrhealdiseasesarethedeadliestandmostcommontypesofillnesswhicharecausedbyalackofadequatesanitationfacilities(Duncanet.al.,2010).Approximately10%oftheglobaldiseaseburdenhasbeenattributedtoalackofadequatesanitationfacilities,resultinginover2milliondeathsperyearglobally(Prüss-ÜstünAet.al.,2008).HouseholdaccesstoadequatesanitationfacilitiescontinuestobeanareainneedofimprovementinRwanda.RDHS2015foundthat54percentofhouseholdsnationally

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haveaccesstoanimproved,unsharedtoiletfacility.Fifty-sevenpercentofhouseholdsinruralareasreportedaccess,comparedto42%accessibilityinurbanareas(RDHS2015,p.21).

AlmostallhouseholdsinRwanda(99%)lacktoiletsthatflushtoapipedsewersystem.Twenty-sevenpercentofruralhouseholdsand11%ofurbanhouseholdsreportedusingapitlatrinewithoutaslaboran“openpit”(RDHS2015,p.22).Improvingaccesstoadequatesanitationfacilities is important intheefforttoreducetheimpactofdiarrhealdiseaseinthecountry.Promotionofroutinehandwashinginthehomeisrecommendedwidelybytheglobalhealthcommunity,asproperandroutinehandwashinghelpsdeterdeadlybacteria.Indeed,practicingrecommendedhandwashingreducestheriskofcontractingdiarrhealdiseases(UNICEF,2016).AccordingtoRDHS2015,thisisanotherareainneedofconsiderableimprovement:only12%ofhouseholdsnationallyhadaplaceforhandwashing.Amongthose,lessthanhalf(37%)hadwaterandsoapinthehouse.Surveyfindingsagainrevealanurban/ruraldisparityinaccesstosanitationfacilities–20%ofurbanhouseholdsdedicatedaspaceforhandwashing,comparedto 10% of households in rural areas. Pregnant women and children under 5 years old are especiallyvulnerabletosufferfromdiarrhealdiseases.

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5. PRIORITY BEHAVIOR TO ADDRESSBased on the data and findings above, the followingmeasures should be given priority incommunicationactivities.

5.1.Keynegativebehaviorsandbehaviorstopromote

Key negative behaviors /Barriers Behavior to promote

Early childhood education and organized care

Limited access to adequate programs and facilities that benefit early stimulation and learning

- Increase awareness of the government officials and local leaders on the importance of budgeting to increase the number of ECD centers and community based ECD that meets the minimum standard.

- Involve religious leaders, civil society organizations, community-based organizations, and private sector in scaling up the number of community-based ECD facilities.

- Engage media to promote educational programs for young children and parents.1

Adult involvement in early learning and stimulation

- Insufficient awareness around ECD, particularly among parents and caregivers.

- Parent and caregivers lacks knowledge on child development and age-appropriate methods of stimulation to help child development.

- Misunderstanding that children’s growth between 0-6 years is mainly about the physical development. There is limited understanding of “brain development” in Rwandan context that makes children smarter.2

- Limited male engagement. Conventional gender role is translated into the social norm against fathers’ involvement in child care practices.

- Poor couple communication in household decision-making, which involves cultural and social, gender norms and misconceptions

- Increase awareness among parents and community about the benefit of ECD, including importance of early stimulation and brain development.

- Educate parents on age-appropriate stimulation according to the stages of child development. This includes promoting low-cost home activities such as storytelling, singing and playing with household objects.

- Encourage private sector, local cooperatives and community members to produce affordable toys for children.

- Promote communication between the couples in the household decision-making. Promote gender equality in the child care practices. Knowledge and practice should be shared by both fathers and mothers.

- Promote the nurturing role of fathers, which would require social change for the community to embrace equal participation of both mothers and fathers in childcare.

1. A first attempt has been spearheaded by MIGEPROF and the Rwanda Broadcasting Agency with UNICEF support in the form of a week-ly show called Itetero, which brings age-appropriate stimulation to children and educates parents on parenting skills.

2. Qualitative findings from a field survey confirmed during the ECD technical working group.

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Adequate care for young children to protect from harm

- Insufficient awareness about the risk of leaving child home alone or in the care of another child.

- Lack of alternative service/care when parents need to go to work and leave the child.

- Corporal punishment is common.

- Raise awareness among parents on the importance of child safety and protection from harm.

- Promote services such as mobile crèche and community-based solutions such as community-based ECD and home-based ECD to provide alternative child care.

- Promote positive parenting skills and address the social norms around corporal punishment.

- Children with disabilities and children with special needs (including those with HIV) face stigma and discrimination and experience social exclusion.

- Raise awareness in the community about disabilities and social inclusion (psychological and social barrier).

- Promote removal of physical barriers to increase access to social services and social activities.

- Promote disability mainstreaming in every activity.

- Advocate for the inclusion of early detection of disabilities as part of pediatric check-up.

Stunting

Adult nutrition

- Women of reproductive age, including pregnant and lactating women and adolescent girls, are not getting minimum meal frequency and dietary diversity.

- There is misconception about food taboos (e.g. girls and pregnant women should not eat eggs, vegetables are for poor people).

- Increased consumption of energy-dense foods high in saturated fats and sugars, and reduced physical activity which cause overweight and obesity.

- Increase awareness that women of reproductive age, particularly pregnant and lactating women should eat meals four times each day that contain foods from at least four food groups out of seven food groups (demand).

- Address taboos related to food and promote correct knowledge.

- Address food insecurity and rising price of nutritious food (access and resilience).

- Promote reduced consumption of energy-dense food high in saturated fats and sugars, and increase physical activities among those who are obese.

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Infant and Young Child Nutrition

- Poor infant and young child feeding practices. Minimum dietary diversity and frequency is not met, adequate amount of food and consistency are not met, and responsive feeding is not practiced;

- Non-exclusive breastfeeding (giving water with sugar to the newly born baby and water or other liquids/foods to infants under six months.)

- Delayed initiation and diluted complementary feeding to young children starting from 6 months.

- Poor hygiene and sanitation practices such as poor handwashing practices at critical times; feeding the child without washing hands with soap; drinking unsafe water and storage; not using an improved latrine and poor disposal of children’s feces; unclean household environment.

- Poor food safety practices, such as not washing food before eating, which causes infection from a foodborne illness.

- Not continuing feeding during diarrheal disease among young children.

- Limited capacity of getting food among poor families

- Issue of pregnancy and birth spacing which as one of the causes of children malnutrition

- Promote good infant and young child feeding practices with a focus on quality of food as opposed to only the quantity of food; address resource allocation and prioritize nutritious food for children.

- Promote optimal breastfeeding and early initiation of breastfeeding (within 30 min after delivery) and emphasis on colostrum.

- Encourage adequate and timely complementary feeding to young children between 6 and 23 months.

- Educate about minimum meal frequency3; Minimum dietary diversity4; adequate amount of food and consistency, active/responsive feeding, exclusive breastfeeding (not giving any other foods or liquids to infants besides breastmilk in the first 6 months of life).

- Promote hand-washing with soap and water at four critical times5; always treating water prior to drinking, use an improved latrine and properly dispose children’s feces.

- Promote continued feeding and Oral Rehydration Treatment (ORT) during diarrheal disease among young children.

- Advocate for construction and maintenance of latrines which can be cleaned.

- Advocate for poor families to have income generated activities

- Promote family planning among Rwandan families

- Lack of appropriate knowledge on responsive child feeding

- Not feeding children who are sick

- Raise awareness to parents and caregivers to responsive child feeding practices

- Education on feeding children even when they are sick

3. Minimum meal frequency for breastfed children: twice for 6–8 months old and three times for 9–23 months; For non-breastfed children: four times for 6–23 months old.

4. Minimum dietary diversity means consumption of four or more food items out of seven food groups.

5. Critical times of handwashing are: after defecating; after cleaning a child who has defecated; before preparing meals/touching food; before eating; before feeding a child.

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Health Seeking behavior

- Poor attendance of growth monitoring and promotion sessions.

- Mothers and caregivers of children under 5 are not properly giving micronutrient powders to their children.

- Poor completion of full ANC/PNC visits.

- Delayed health seeking behaviors when the child is ill.

- Promote regular attendance to the monthly growth monitoring and promotion sessions to assess the growth of the child.

- Educate mothers and caregivers of children under 5 about the importance of complying with the instruction on how to give micronutrient powders to eligible children.

- Promote full attendance at ANC/PNC.

- Promote early care seeking in case of diarrhea, fever and respiratory infection from a health facility.

5.2.Priorityareasforcommunication

• Infant and young child feeding (IYCF):Minimummeal frequency (i.e. for breastfedchildren:twicefor6–8monthsoldandthreetimesfor9–23months;Fornon-breastfedchildren:fourtimesfor6–23monthsold);Minimumdietarydiversity(consumptionof four or more food items out of seven food groups); adequate amount of food and consistency,active/responsivefeeding.Emphasisshouldbeputontimelyintroductionofnutritiousandfrequentcomplementaryfeedingatsixmonthsofagewithoutdelay.

• Effortsareneededtopreventsicknessbypromotinghandwashingwithsoap (afterdefecating;aftercleaningachildwhohasdefecated;beforepreparingmeals/touchingfood;beforeeating;beforefeedingachild),cleanhomeenvironment(constructandmaintainlatrineswhichcanbecleanedandcovertheholetoreducetheincidenceofdiarrhealdiseasestransmittedviaflies),safehandlingandstorageoffoodandwater,andimmunization.

• Early care-seeking behaviorswhen a child is sick (diarrhea, fever, acute respiratoryinfection)andcontinuedfeedingwithORTduringdiarrhea.

• Adolescent girls, women of reproductive age, particularly pregnant and lactatingwomen,eatmealsfourtimeseachdaythatcontainfoodsfromatleastfourfooditemsoutofsevenfoodgroups.Whenpregnant,attendANCandPNCandtakeiron+folicacidsupplementation.

• Familycarepractices:monthlygrowthmonitoringtocheckwhetherthechildisgrowingwell;Ongera/shishakibondomicronutrientpowder.

• To ensure equity, communication efforts should ensure reaching parents with lowsocio-economic status and low levels of education, and children with disabilities/special needs.

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• Parentsshouldbetaughtabouttheimportanceofearlylearningandearlystimulationthatchildgrowthisnotonlyphysical,butalsobraindevelopment“togrowsmarter”.Parentaleducationshouldemphasizeresponsivecaregiving,includingadequatecareofchildren,methodofstimulationperdevelopmentstage,protectionandadequatenutrition.

• Accesstoactivitiesandprogramsthatbenefitearlystimulationand learningshouldbepromoted.Thisincludesi)promotinglow-costhomeactivitiessuchasstorytelling,singingandplayingwithhouseholdobjects.Theprivatesector,localcooperativesandcommunitymembersshouldbeencouragedtoproduceaffordabletoysforchildren;ii)promotingmediaprogramsforyoungchildrenandparents.AfirstattempthasbeenspearheadedbyMIGEPROFandtheRwandaBroadcastingAgency inaweeklyshowcalled Itetero, which brings age-appropriate stimulation to children and educatesparentsonparentingskills.Sucheffortsshouldbeamplified,andmoreeffortsshouldbemade to increase listenership; iii) promoting community-based ECD care,whichincludesexpandedpartnershipwiththereligiousnetworksothatECDservicescanbeofferedatchurchesandmosques.

• Maleengagementandhouseholddecisionmaking:There isaneed topromote thenurturingroleoffathersandcouplecommunicationforjointdecisionmaking,whichwouldrequiresocialchangeforthecommunitytoembraceequalparticipationofbothmothersandfathersinchildcare.Thisissueofgenderequalityislinkedtothewidergenderagendathataffectschildren–thatsharedresponsibilitybetweenparentswilllead tomutual respectandunderstanding, andmore cohesion in the family.Whenparents demonstrate gender equality at home, children will be liberated from thenarrowdefinitionoftraditionalgenderviewsandfeelmoreempoweredtoparticipateinsocietyandexploretheirfullpotential.

• The promotion of positive disciplining needs to be approached from social normperspective.Wheretheindividualpreferenceof“Idonotreallyenjoyhittingmychild”is over-ridden by the perceived social norm that it is parental responsibility to usephysicaldisciplinetomaintainthesocialorder,communicationeffortsshouldtakeatwo-trackapproach.Itisnecessarytofostersocialchangeinthecommunitywhileatthesametime informingparentsabout theharmfuleffectsof corporalpunishmentandteachingnon-violentdisciplineskillstopromoteindividualchange.

• Improveaccesstonutritiousfoodandmitigatetheimpactofclimatechangeonfoodinsecurity in terms of social protection measures while building resilience in thecommunities.

Whencreatingmessages topromotebehaviors like thosecitedabove,attentionshouldbegiventothespecificbarriers(forexample:genderdynamicssuchaslimitedaccesstoorcontroloverhouseholdresources;culturalnormsandsocialbeliefs,limitedskillsandknowledgeonhealth, etc.) that areholdingpeopleback fromadopting thepromotedbehavior. It is alsoimportanttoconsidertheneedsofchildrenwithdisabilitiesandchildrenwithspecialneeds.

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6. NATIONAL SBCC STRATEGY COMMUNICATION FRAMEWORK

6.1.Vision

AllchildreninRwandagrowtotheirfullpotentialandcontributetothedevelopmentofthecountry as a result of appropriate childcare practices in the family, equal access to socialservicesandsupportivecommunity.

Guiding principles

• SocialchangeshouldbenurturedtomakeECD,NutritionandWASHservicesapartofnationalculture.Progressonchildren’sholisticdevelopmentwillrequirecollaborationamongmulti-sectoralstakeholders(genderandfamilypromotion,WASH,health,socialprotection,childprotectionandeducation)forequalaccesstoqualitysocialservices,and leveraging partnerships (government, CSOs, academia, the private sector, andcommunity and religious leaders) to create anenabling environment. CollaborationbetweenministrieswillbecoordinatedasstipulatedintheECDpolicy.

• Specialfocusshouldbeplacedonbuildingtheself-confidenceofparentsorcaregiversandchildren,especiallyfordisadvantagedpersons,suchaspersonswithadisability,parents with low educational background, the poorest households and people inremote areas. The approach will be guided by the identification of what works inRwanda,basedonscientificevidenceanddocumentedgoodpractice.

• It is necessary to invest in capacity-building of various actors at different levels –household,community,serviceprovidersandgovernment.

• The communication mix will be carefully designed to engage communities andindividualsthroughmedia,socialmobilizationandinterpersonalcommunication.

• While communication often targets parents, efforts will be made to communicatedirectly to young children to form positive attitudes and behavior by using age-appropriatemessagesthroughchild-friendlymethods.

6.2.Theoreticalframework

Individualchildcarepracticeisdeeplyconnectedtosocialnorms,includinggenderroles,andtheavailabilityofsocialservicesforyoungchildrenandtheirfamilies.ThissectiondescribesandrecommendsthreetheoreticalmodelstoallstakeholderstoimprovetheECD,nutritionandWASHbestpractices.

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The socio-ecological model:DevelopedbyBronfenbrenner,socio-ecologicalmodel looksatanindividual’sdevelopmentwithinthecontextofthesystemofrelationshipsthatformhisorherenvironment.Thetheorydefinescomplex‘layers’ofenvironment,eachhavinganeffectonanindividual’sdevelopment.Thistheoryemphasizesthat,toaffectanindividual’sattitudesandbehavior,itisnecessarytoaddressthecommunityandsocialsystemsthatinfluencetheirchoices.Behavior-changemessagingtoindividualsneedstobecoupledwithcommunicationinterventionstoaddressenablingsocialnormsoncarepractices.

Figure: Visual Depiction of Ecologic Model. Source – U.S. Center for Disease Control and Prevention

SBCC strategy Theory of Change based on the socio-ecological model

ChildrenofECDagespendthemajorityoftimeathomesotheirfamily’sabilitytocareforchildren is themost important factor. Theabilityof family canbeenhancedby supportivesocialnormsandforumsinthecommunity,aswellasaccesstoqualitysocialservices,whichinturn,needstobesupportedbythenationalandlocalauthorityallocatingadequateresources.TheTheoryofChangecanthereforebesummarizedasfollows:

• IfthepolicymakersmakeECD,NutritionandWASHrelatedfamily-friendlypolicies,andnationalandlocalauthoritiesallocateadequateresourcestosupportsocialservices,communityinitiativeandfamilieswithyoungchildren;and

• If the social services (ECD, health, nutrition, WASH, child protection and socialprotection)tofamilieswithyoungchildrenprovideequalaccessandquality;and

• IfthecommunitiesandotherpartnersunderstandtheimportanceofECD,Nutritionand WASH Services and hold supported social values and norms; and

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• IfthefamiliesunderstandtheirrolesandskillsforparentingandadoptECD,NutritionandWASHgoodpractices;and

• If the children receive age-appropriate communication and interaction with familymembers;

• Thenchildrenwillachieveoptimaldevelopment.

Community Health Club (CHC) Approach

TheCHCapproachisbasedonthefamiliarPHASTmethodologyandappealstoaninnateneedforhealthknowledge,whichisthenreinforcedbypeerpressuretoconformtocommunallyacceptedstandardsofhealthandhygiene,andtherebycreatinga“CultureofHealth.” TheCHCApproachaddressesawiderangeofpreventablediseaseswithinaholisticframeworkofdevelopmentthatunderstandshealthpromotionasanentrypointintoalong-termprocessoftransformationofsocialnormsandvaluesthatultimatelyleadstopovertyreductionoutcomes.

ThestrengthoftheCHCapproachisnotonlyitsabilitytoengenderhealthandhygienebehaviorchangebutitisalsoabletoquantifybehaviorchangeusingcommunitymonitoringtoolsasanintegral part of the process of change. Each CHC is charged with monitoring the changes within initsownvillagemembership(usuallyconsistingofbetween50and150households).

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Theseobservations,knownasa“householdinventory”areconductedonaregularbasisandthe information is then entered into an exercise book, thus enabling eachCHC to identifyexactlywhentheagreedbehaviorandlifestylechangeshavebeenmadeandhousetohousevisitsamongCHCmembersisreinforcedtostrengthentheselectedtargetpractice.

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7. NATIONAL SBCC AUDIENCE ANALYSIS

Although the audience is all Rwandan, there are a number of key priority audiences. Thissectionhighlightskeycharacteristicsofthekeyaudiences.

7.1. Primary Audience:

Adolescent girls, pregnant women, lactating mothers / caregivers of children from zero to 6 years with emphasis on children under 2 years:

Mothersarenotonlybeneficiaries,butalsohaveprimaryresponsibilityforday-to-daychildcare.Manymothersofsmallchildren,whetherurbanorrural,havelowlevelsofformaleducationand income, and limitedaccess tohealth informationand services.Attimesmothersmaybelievethattheyhavelittleabilitytochangepracticesordonothavethecommunitysupporttonegotiate improvedpracticeswiththeirhusbandsand/ormothers-in-law.Mothersoftenaccesshealthandnutritioninformationthroughtheirreligiouscommunities,theirhusbands,peers,mothers-in-law,professionalhealthworkersaswellastheCHWs.

Fathers:

Theywerealso identifiedamong theprimaryaudience, togetherwithmothersof childrenfrom0to6yearswithemphasisonchildrenunder2,astheyexerciseinfluenceonthemothers’practices.Womenoftenaskmenforadvice,permission,ormoneyforhealth-relatedmattersasmenhaveextensivefinancialpowersandareoftenthekeydecisionmakersonhealthissues.

Girls and Boys aged 12-18:

They are found in primary school aswell as at the lower secondary education level. Theyareimportantmembersofsocietyastheygetreadytofulfilltheirroleasgoodcitizensandasfutureparents.Itisimportanttoequipthemwithinformationonreproductive,maternalandchildhealthandnutritionaswellastheirresponsibilityasfutureparents.Iftargetedwithempoweringinterventions,adolescentgirlsandboyscanchangetheirbehaviorandprotecttheirownhealthandthatoftheireventualchildren,aswellasserveasmodelstoimprovedhealthybehaviorsamongtheothermembersoftheirhouseholds.

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7.2. Secondary Audience

Health care providers:

Healthcareproviders includingdistricthospitalandhealthcentersstaffwhoaretrained incharge of ECD, Nutrition andWASH activities. This National Integrated SBCC Strategy willenablethemtocoordinateandimplementECD,NutritionandWASHbehaviorcommunicationactivitieseffectivelyatcommunityandhousehold levelsaimingat improving the individualbehaviors.TheSBCCimplementationplanwillbeelaboratedandintegratedineachdistricthospitalandhealthcenteractivitiesplanandbemonitoredincollaborationwithDistrictSBCCTaskforceunderDPEM.

Community Volunteers:

CommunityvolunteersincludingCommunityHealthWorkers(CHWs),ECDCaregivers,Inshutiz’Umuryango (Friendsof theFamily),MamansLumières/Parents Lumières (ModelParents),Farmer Promoters (FP) and Field Agents (FA) are trained community facilitators and recognized bytheGovernmentofRwandathroughdifferentlineministriestosensitizethecommunityonECD,Nutrition,WASH,agricultureandeconomic-relatedactivities.Livingwithincommunities,thosefacilitatorswillactasbehaviorchangechampionstoeducateandchannel integratedECD,nutritionandWASHmessagewithinthecommunity.

Grandparents and parents-in-law:

Theseareolderfamilymembers,usuallylivingwithintheextendedfamily.Theyareinfluentialandasourceofinformationonmaternalandchildcarepractices,oftenbasedontheirownexperience.Youngparentsusuallyrefertotheirgrandparentsandparents-in-lawforadvice,which they trust and follow.

7.3.Tertiaryaudience:

Community leaders, religious leaders, youth leaders, youth club members, women’s group leaders and leaders of civil society organizations, opinions leaders and decision makers:

Thesegroups arehighly influential, respectedand trustedentities in the community. Theyrepresent an extremely important channel for providing information and motivatingadolescents and parents within their community. ThisNationalIntegratedECD,NutritionandWASH SBCC Strategy willbringtogetherthesedifferententities,workingatthecommunity-level in a strategic communication planning process to identify issues, raise awareness ofprimary and secondary audience and support other community behavior change activitiesaimedatimprovinghouseholdECD,nutritionandWASHbehaviors.

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8. COMMUNICATION OBJECTIVES Themainfocusofinterventionscanbesummarizedasfollowsaccordingtothetargetaudience:

Audience 1: Children

Output 1:Childrenhaveincreasedexposuretoearlystimulationbytheirfamilies,including accesstoage-appropriatemediaprograms,books,andplayandlearningmaterials.

Communication objective 1.1: Children receive age-appropriate communication (e.g.mediaprograms,books,playandlearningmaterials).

Communication objective 1.2:Childrenreceivepreventiveandcurativecareintermsofhealth,nutritionandWASHservicestoavoidrecurringinfections.

Communication objective 1.3: Children start eating nutrition-rich and balancedcomplementaryfoodfromsixmonthofage.

Audience 2: Parents with children 0-6 years old / adolescent girls and boys

Output 2: Parents provide responsive care to young children.

Communication objective 2.1: Parents understand the importance of ECD, especiallyresponsivecareofyoungchildren(talking,interacting,readingandplaying)

Communication objective 2.2:Bothfathersandmothersparticipateequallyinchildcareandstimulation.

Communication objective 2.3:Parentspracticeappropriatehealth,nutritionandWASHpracticesforthemselvesandfortheirchildren.

Audience 3: Community

Output 3:CommunitiesadoptsupportivesocialnormsforECDandtakeownershipof ECD initiatives.

Communication objective 3.1:Communitiesunderstandthe importanceofECDand itspositiveimpactonthecommunity.

Communication objective 3.2: Communities demand basic social services for youngchildren(aminimumpackageofhealth,nutrition,WASH,childprotection,socialprotectionandECDservices), includingtheiraccessibility tochildrenwithdisabilities,andsupportcommunity-basedECDinitiatives.

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Communication objective 3.3:Communitiesembracefatherswhoparticipateincareofyoung children.

Communication objective 3.4: Communities discuss their own issues related to youngchildren and families in local forums.

Audience 4: Social service providers

Output 4: Service providers (health professionals, Community HealthWorkers, Inshutiz’Umuryango, socialprotection)provideadequate services toyoungchildrenand theirfamilies.

Communication objective 4.1: Frontlineworkers acquire interpersonal communicationskillstoensuresocialinclusionandtoworkwithparentsinthebestinterestsofthechild.

Communication objective 4.2: Frontline workers feel their work is important and valued bythecommunity.

Communication objective 4.3:Qualityserviceprovidersaremotivatedandremainintheirjobs.

Communication objective 4.4: There isanestablished linkageat the local levelamongdifferentareasofsocial serviceschildrenand familiescanbenefit fromreferralsacrosssectors.

Audience5:Localauthorities

Output 5:Localauthoritiesprovideadequate leadershiptoscaleupECDinitiativesand basicsocialservices.

Communication objective 5.1:LocalauthoritiesknowthekeyaspectsoftheECDpolicy,understandtheimportanceofECD,andtheirECD-relatedrolesandresponsibilities

Communication objective 5.2:ECDishighonthelocalagenda(atdistrict,sector,cellandvillagelevels,respectively)andisincludedindistrictplansandbudgets

Communication objective 5.3:Localauthoritiesandcommunityleaderssupportscale-upofECDandstrengthenthelinkagesbetweenECDandothersocialservices.

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9. ANALYSIS OF RELEVANT COMMUNICATION CHANNELS:

Mass media

TelevisionandothermediacanincreasehomeaccesstoECD,NutritionandWASHprogrammingaimedateitherchildrenorparents.Forexample,localversionsoftheeducationaltelevisionprogram Sesame Street reach children inover150 countries.Ameta-analysis representingmorethan10,000childrenfrom15countriesfoundsignificantbenefitsfromwatchingSesame Streetinliteracyandnumeracy,healthandsafety,andsocialreasoningandattitudestowardothers.TheRwandaDHS2014-2015showedthatradioisthemostwidespreadandfrequentlyusedcommunicationchannelinRwanda–morethanhalfthepopulation(55percent)ownaradio.Radioprogramsarealsolistenedtoviamobilephones,whichareownedby60percentofthepopulation.Onaverage,79percentofmenand62percentofwomenlistentoradioatleastonceaweek.Accesstotelevisionisstilllimited(10percent)but29percentofmenand16percentofwomensaytheywatchTVatleastonceaweek.This indicateshighlevelofcommunalTVviewing,whichwouldbeexpectedtorisesharplywiththecountry’srapidelectrification. Overseen by MIGEPROF, the Rwanda Broadcasting Agency launched its first home-grownchildren’sprogramcalledIteteroinOctober2015.Thisweekly30-minuteprogramisairedonRadioRwandatwiceaweekandaimstostimulateyoungchildrenaged0-6yearsandtoguidetheir familieson issues related toparenting. Itetero combinesdifferent creative segmentsincludingmusic, drama, storytelling and expert interviews reflecting the local context andculture.ThecontentisdevelopedbyagroupoftechnicalstakeholdersfromvarioussectorswhoformtheContentAdvisoryGroup(CAG)onECD.Thereisascopeforfurtherexpansionofchildren’smediaprogramsonbothradioandTV.

Community forums

Rwandahasseveralnationwideforumsthatareimportantatthecommunitylevel.

Umugoroba w’Ababyeyi (Parents’ evening) isavillagegatheringthatbringstogetherparents(bothmenandwomen).Youngwomenandmenwhodonothavechildrenaresometimesinvitedtojointhegathering,andchildrenmayoccasionallyparticipateiftherearesubjectsthatconcernthem.Accordingtoitsstrategydocument,Umugoroba w’Ababyeyi aims to provide a platformwhereparentscandiscussandaddresstheirsocio-economicconcernsforsustainabledevelopment. It has seen success stories in resolving family issues, improving health andnutrition, and reducing the poverty gap and violence in the family. Village Committees oftheNationalWomen’sCouncil(NWC)incollaborationwiththeVillageExecutiveCommitteesare responsible for overseeingUmugoroba w’Ababyeyi’s activities. The National Women’sCouncil highlights achievements of Umugoroba w’Ababyeyiinitsquarterlyreportsubmittedto MIGEPROF.

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National Children’s Forum

Thiswasestablishedtoprovidechildrenwithaplatformtoexpresstheiropinionsandbeheardonmattersconcerningtheirlife,familyandcountry.TheForumservesasthenationalvoiceforchildrenandachannelwherechildrencanexpresstheirviewsonnationalissuesandsuggesthowthesecanberesolvedbygovernmentswithchildren’sparticipation.These forumsarealso structures where children learn leadership and socialization skills from an early age.Children’sForumcommitteesareelectedbychildrenforthree-yearterms.Thecommitteesareformedatvillage,cell,sectoranddistrictlevel,andtheirresponsibilitiesincludeleadingregularChildren’sForummeetingsandprovidingviewsonthewelfareandrightsofchildren.Otherfunctionsincludetakingpartinthedecisionsthataffectchildren,denouncingproblemsaffecting children in the community and disseminating the resolutions of Annual NationalChildrenSummits.Establishedin2004,theannualNationalChildrenSummitbringstogetherchild delegates from all administrative sectors across the country. The Children’s Summitprovideschildrenwithaspecialopportunitytoexpresstheirviewsandwishesaboutbuildingthenation.Childrenalsoparticipateinunderstandingandproposingwhatisdoneorplannedforthemintermsofnationalpoliciesandprograms.Theydiscusstheirrights,thecountry’seconomicandsocialdevelopment,andtheirroleinsuchconcerns. Youth-friendly Centers

Healtheducationisprovidedtoyoungpeopleatyouthresourcecenters,whichofferyoungpeopletheopportunitytoparticipateinsports,culturaldance,andotherfunactivities.Thischannel offers an opportunity for discussion between boys, girls, and their parents abouthealthybehaviorsbasedoninformedchoices.ThisnationalintegratedstrategywillcollaboratewithNationalYouthCouncilandusethischanneltotargetyouthatcenterswithappropriatemessagesfocusingontheroleofyouthinimprovingECD,nutritionandWASHbehaviors.

Umuganda (Community work)

ThewordUmugandacanbetranslatedas‘comingtogetherincommonpurposetoachieveanoutcome’. In traditional Rwandan culture,members of the communitywould call upontheirfamily,friendsandneighborstohelpthemcompleteadifficulttask.AspartofeffortstoreconstructRwandaandnurtureasharednationalidentity,thegovernmentdrewontraditionalpracticestoenrichandadaptdevelopmentprogramstothecountry’sneedsandcontext.Theresultisasetofhome-grownsolutions−culturallyownedpracticestranslatedintosustainabledevelopmentprograms.OneofthesesolutionsisUmuganda.ModerndayUmugandacanbedescribedasacommunity-serviceday (umunsiw’umuganda).Onthe lastSaturdayofeachmonth,Rwandansaged18-65cometogetherforthreehoursinthemorningtodoavarietyofpublicworks.Thisoftenincludesinfrastructuredevelopmentandenvironmentalprotection.Participation inUmuganda is usually supervisedby amanagerorUmudugudu chairpersonwhooversees theeffectiveness andefficiencyof communityparticipation.While themainpurposeistoundertakecommunitywork,italsoservesasaforumforleadersateachlevelof government (fromvillageup to national level) to inform citizens about important news

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andannouncements.Communitymembersarealsoabletodiscussanyproblemstheyorthecommunityarefacingandproposejointsolutions.Thistimeisalsousedforevaluatingwhattheyhaveachievedandforplanningactivitiesforthefollowingmonth’sUmugandasession.

Growth Monitoring and Promotion session (GMP)

Growthmonitoringistheregularmeasurementofachild’ssizetomonitorhisgrowth.Itreferstoregularlyweighingachild(frombirththroughthefirsttwo,threeorfiveyearsoflife)andrecordingtheweightonagrowthchart.Becauseweighingandchartingalonecannotimprovegrowth,promotionalactivitiesarealsoneeded.TheseincludenutritioneducationandSBCCactionstoimprovechildgrowthandpreventallformsofmalnutrition.ThisactivitytakesplacemonthlyinallvillagesofRwandaandisledbyhealthserviceprovidersincludingCommunityvolunteers in collaboration with local leaders. This national strategy will use this channelto increaseawarenessandeducatemothers, caregiversandhusband/fathersofunderfivechildrenaroundECDservices,nutritionandWASHbestpractices.

Inshuti z’Umuryango (Friends of Families)

Enshrined inRwandan society is thebelief that childrenbelongnotonly to thebiologicalparentsbutalsototheextendedfamilyandcommunityatlarge.Thispromotesthepositivevalueof‘treatingeverychildasyourown’.Withthisinmind,twopersons(onemanandonewoman)wereselectedineveryvillagetopreventandrespondtoviolence,abuse,exploitation,neglect,abandonmentandotherchild-protection risks in their locality.This informal cadreestablishedin2015bytheNCCisanintegralpartofthechildprotectionsysteminRwandaandworkstogetherwithprofessionalsocialworkersandpsychologistsatdistrictlevel.Theirmain responsibilities are to conduct home visits, identify any cause for concern regardingchild protection,make referrals to professionals and other service-providers, and sensitizehouseholdsonpositiveparentingandchild-friendlypractices.Theyreporttolocalauthoritiesand professional socialworkers and psychologist in districts, andworkwith other sectors,including community health workers and ECD caregivers, to ensure children and familiesreceiveholisticservices.

Itorero (National Itorero Commission)

ThisisaRwandanciviceducationinstitutionwhichaimstoteachallRwandesetokeeptheirculturethroughitsdifferentvaluessuchasnationalunity,socialsolidarity,patriotism,integrity,bravery, tolerance, the dos and don’ts of society, etc. Through this instrument, Rwandansarealso informedofgovernmentpoliciesandprograms,whichstrengthensownershipandpromotesthepopulation’sroleinimplementingthesesocial-economicdevelopmentprograms.Civiceducationisorganizedbythe‘Itorerory’igihugu’institutionundertheNationalItoreroCommission.

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Religious denominations

The majorityof Rwandans are religious.According to the2012 census, 44percentof theresidentpopulationof the countryareCatholics, followedbyProtestants (38percent) andAdventists(12percent).Muslimsrepresent2percentofresidentpopulation,andmorethanhalfofthemliveinurbanareas.Religiousleaders,althoughindependentfromgovernment,play an important role in forming and guiding social norms and individual behavior. Theyalsoserveasan importantsourceof information,especiallyfortheruralpopulationwherecommunicationchannelsarelimited.AtanadvocacymeetinginDecember2015,theleadersof the Catholic, Protestant andMuslim denominations expressed commitment to supportstuntingreductionandECD.UnderMIGEPROF’sguidance,asermonguideonECDforChristianandMuslimisbeingdeveloped.TheaimistostrengthenthecapacityofallreligiousleaderstodisseminateECDmessages,andtocorrectmisconceptionsaboutwhatthereligiousscripturessayaboutgenderroles.

Information Communication and Technologies (ICT) Recenttechnologicaladvanceshaveenabledthedevelopmentofnew,excitingapproachestocommunication,especiallyforurbanpopulationwithstableaccesstoelectricity.Thisstrategywill build on the advantages and benefits of using appropriate technology to reach targetaudiences.Themobilephonesareusedinhealthcommunication,particularlythroughshortmessageservice(SMS),aninexpensivewayofobtainingandsharinginformationandgettingfeedback.Similarly,ICTplatformsusingvoicemessagesorcall-inservicescancreateinteractiveopportunities where beneficiaries can use their own simplemobile phones to proactivelyretrieveinformationacrossarangeoftopicsinlocallanguage-anytime,anywhere,andfreeofcharge.Thisinteractiveformofmessagingallowsindividualstomakedecisionsregardingthechoiceonbehaviortopicsandcontents.Thecall-inservicescancoverabroadrangeoftopicareasincludinggender,health,agriculture,andmicro-finance.Inaseriesof“listen,thenchoose”steps,callerscanusetheirphonestoselectfromamonghundredsofrecordedvoicemessages.ThisnationalstrategywillencouragetheuseofsuchtechnologyfocusedchannelstoenhanceknowledgeandpromoteoptimumECD,NutritionandWASHrelatedmessages

Private sector

The private sector in Rwanda is growing rapidly. Domestic and foreign investments aredrivingthecountry’seconomy.Theprivatesectoremploysmanypeople,andtheworkforceis mostly young people and young parents who need to receive messages around ECD. In some instances, the busy schedules and work environment in the private sector do notallowtheseyoungparentsandcaregiverstoattendothercommunitygatheringandeventswhereECDsensitizationisdone.Private-sectorplatformscanthereforeserveasthechannelsof communication to disseminate messages to workers and stakeholders. Well-tailoredcommunicationmaterialssuchasoutreachinbusinessareas,communicationmaterialsandinterpersonalcommunicationcanallbeusedtoreachparentsandcaregiversworkingintheprivatesector.MIGEPROF,inpartnershipwithUNICEF, isexpandingitspartnershipwiththe

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privatesectortoadvancechildrenrights,byobservingtheChildRightsandBusinessPrinciples(CRBP). Capacity-building interventionswill be carriedout to raise awarenessof theCRBP,targetingbusiness sectorswhich affect the lives ofwomen and children, including the teasector,theICTsector,andleisureandtourism.Corporationswillbetechnicallysupportedtoimprovetheirpoliciesandproceduresandtomaketheirworkingenvironmentsmorechild-friendly.

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10. NATIONAL SBCC STRATEGY IMPLEMENTATION ARRANGEMENTS

ThischapteroutlineshowtheSBCCstrategywillberolledout. Italsocovers therolesandresponsibilities of implementing partners and community-based organizations. Finally,the chapter spells out how the strategy should be coordinated and suggests monitoringmechanisms.

10.1.CoordinationandCollaborationmechanism

The National Early Childhood Development Program (NECDP) will lead and oversee theimplementationoftheSBCCstrategyinclosecollaborationwithRwandaHealthCommunicationCenter(RHCC)atalllevels.TheSBCCactivitieswillbeinsertedintotheannualactionplansoflineministriesandpartnersaswellasrelevantnationaltechnicalworkinggroups.EverylineministryandimplementingpartnerwillrefertothisSBCCstrategywhendevelopingactivities.

All communication materials related to the implementation of ECD, nutrition and WASHactivitieswillbereviewedandvalidatedbytheNationalHealthPromotionTechnicalWorkingGroup.

10.2.Rolesandresponsibilities

10.2.1 Social Cluster Ministries and Rwandan Parliamentarians Network on Population and Development (RPRPD)

TostrengthentheconsistencyandefficiencyofSBCCactionsundertakenbymanysectorsandpartners,theNationalSBCCStrategywillbecoordinatedfrom,atminimum,atcentral,districtlevelandsectorlevels.TheSocialClusterMinistrieswillcontributetostrengthexistingrelatedpoliciesandstrategies,advocacyforSBCCimplementation,mobilizeresources,andsupportlocalgovernmentsinimplementingthisSBCCStrategy.

The Rwandan Parliamentarians Network on Population and Development (RPRPD) willcontributeinadvocacyandcommunityengagementrelatedactivitiesforbetterimplementationofSBCCactivities.

10.2.2. National Early Childhood Development Program (NECDP)

TheNationalEarlyChildhoodDevelopmentProgram(NECDP)wasestablished inDecember2017as per thePrimeMinisterial Instructionpublished in theNationalGazetteno.03/003 24/12/2017. The NECDP is an autonomous agency both administratively and financiallyreportingtotheMinistryofGenderandFamilyPromotion.Withthedecreethat institutedNECDP,theprogramreceivedthegeneralmissiontocoordinateandimplementallinterventions

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thatsupportadequateearlychildhooddevelopmentforchildrenfromtheirconceptiontosixyears of age as outlined in the Early Childhood Development Policy.

TheGovernmentcommissionedtheNationalECDProgram(NECDP)withtheoverallgoalofreducingstuntingthroughECD.NECDPisalsomandatedtocoordinateallprogramsrelatedtoECDandnutritiontoattainthedesiredchilddevelopmentoutcomesonthepremisethatprogram integration is critical for holistic child growth and development. A child needs toreceive comprehensivequality early stimulationand learning, health, nutrition,WASHandprotectionservicestogrowanddeveloptofullpotential.NECDPenvisagetoincreasechildren(0-6years)accesstoECDservicesfromthecurrent13%to45%by2024.Similarly,itintendstoreducestuntingfrom38%to19%duringthesameperiod.

TheNECDPisthereforetaskedtocarryouttheresponsibilitiescitedbelow:

In close collaboration and coordination of all sectors playing a role in Early ChildhoodDevelopment,specificallyNECDPisresponsiblefor:

• Increasingchildren’spreparednesstotheprimaryschoolenvironment;

• Promotingoptimalchilddevelopment;

• Enhancingpositiveparentingandcommunityparticipationinchildprotection;

• Reducingmalnutritionandstuntedgrowthamongyoungchildren;

• Eliminatingphysical,moral,andpsychologicalabuseofyoungchildren;

• Enhancing equal access to early childhood development services for children with disabilitiesandspecialneeds.

TheNECDPwilloverseetheoverallcoordinationand implementationofthisNationalSBCCStrategy including but not limited to organizing quarterly meeting of all related technicalgroupsincludingHealthPromotionTWGtomonitortheprogressonregularbasis.AstrongcoordinationandmonitoringmechanismensureseffectiveandcomplementarypackagingofinterventionssothatECD,NutritionandWASHrelatedsocialservicesandmessagescanbedeliveredseamlesslywithoutduplicatingefforts.

10.2.3. The Rwanda Health Communication Centre (RHCC)

RHCCisthecommunicationarmoftheentirehealthsector.Itisresponsibleforthecoordinationofhealthpromotioninterventions,handlesmediaandpublicrelationsthesector.RHCCwillchairNationalHealthPromotionTechnicalWorkingGroupactivitiestoensureallcommunicationstoolsrelatedtotheimplementationofSBCCStrategyarereviewedandapproved.Thisincludescoordination,monitoringandreportingofSBCCactivitiestoNECDPcoordinationonquarterlybasis.TheNationalHealthPromotionTWGmembersincludeallsocialclustersministriesand

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implementingpartnersandco-chairedbyUNICEF.

10.2.4. Technical Working Groups (TWGs)

All technical working groups operating in areas of ECD, Nutrition an WASH will have arepresentativewithinNationalHealthPromotionTWGtoensurethatallrelatedcommunicationtoolsaresubmittedforreviewandvalidationbythesaidteam.ThetechnicalworkinggroupsincludeECD,FoodandNutrition,WaterandSanitationandAgricultureSectorTWGs.

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11. MONITORING AND EVALUATION FRAMEWORK

This National Integrated ECD, Nutrition andWASH SBCC Strategy represents national-levelguidelinesforallECD,NutritionandWASHstakeholdersandwillmonitorregularlytheirECD&SBCCimplementationplans.DifferentindicatorswillbeusedbasedonspecificECD&SBCCrelatedprogramandactivities.

EvaluationofthisstrategywillconsidermeasuringECD,NutritionandWASHrelatedindicatorsatvariouslevelsincludinginputs,outputs,andprocess,outcomeandimpactindicators.Moreformative research will be undertaken periodically to monitor the changes in knowledge,attitudes, beliefs, self-efficacy and perceived risks which will contribute to the process ofadaptingmessages,communicationmaterialsandsomebehaviorchangeactions.Thissectionwilldefinehowthemonitoringandevaluationwillbedoneandatwhatfrequenciesdatawillbecollected.

ItalsohighlightstheprogramleveloroutcomeindicatorsthatareexpectedtobemeasuredatmidtermandendlineofagivenECD,nutritionandWASHrelatedSBCCinterventions.

Objectives of M&E plan:

TheobjectivesoftheM&Eplansinclude:

- TooutlinekeyECD,NutritionandWASHindicatorsforimplementingthiscommunicationstrategyatalllevelsbehaviorchangecommunicationmonitoringandevaluation

- Toguidethemonitoringofplannedstrategyactivities,measureexpectedoutcomesandimpacts

- Document challenges /generate evidence on key ECD, nutrition and WASH relatedpracticestoinformsubsequentbehaviorchangeplanning,implementationandstrategicdecisions.

Monitoring the behavior change interventions or routine tracking: This is done throughrecordkeeping,periodicreviewofimplementationreports(e.g.supervisor’sreport,meetingand training reports).

Thiswillhelptogeneratedataonoutputindicators(e.g.:messagedeliveredandreachedtotheaudience,materialsdisseminated,andchannelsused)overaplannedtime.ItwillassesstheextenttowhichtheimplementationofplannedactivitiesisconsistentwiththeM&Eplansand to determine which areas require more focus.

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Formative or qualitative research:Thisisakeysteptocreateprogrammaterials,toolsandapproachesthatareculturallyappropriatetothelocalcontext.Qualitativemethodscollectdatatoanswerquestionssuchas“why?”and“how?”Althoughthisapproachprovidesrichanddetailed information, it isnotmeant togeneralize toanentirepopulationor intendedaudience.

The National ECD, Nutrition and WASH SBCC Strategy recommends undertaking regularformativeresearchtoidentifyandtrackemergingchanges,currentlevelofknowledge,beliefsandattitudes,impactofchannelsthroughwhichmessagesweredeliveredandtocustomizecontents and approaches accordingly.

Indicators for evaluating Integrated EDC nutrition and WASH impacts:By improvingtheECD,NutritionandWASHbehaviors,thisNational Integratedstrategywillassist Rwandan Government effort to promote optimal Early Childhood Development anddeclinethestuntingamongchildrenunder5andcreatingpositiveoutcomeswhicharereflectedintheFourthHealthSectorStrategicPlan(2018–2024)andthroughstrategyimplementationplans,thisstrategywillmonitortheseindicatorsreflectedinRwandaDHS2015andHSSPIV(2018-2024).

AdditionaltothekeyindicatorsdefinedinM&Eplan,anygovernmentorcivilsocietyorganizationsconductingcommunication,advocacyandsocialmobilizationactivitiesforECD,NutritionandWASHinRwandaareencouragedtousetheaboveoutputandoutcomeindicatorstomeasureprogressandresults.UsingthesameindicatorswillallowharmonizedcumulativereportingacrossawiderangeofECD,NutritionandWASHpartnersandstakeholders.Theresultsshouldbe sharedwith National NECD Program as a platform for knowledgemanagement. Theseindicators include: Outcome indicators

- Prevalenceofstuntingamongchildren(0–59months)

- Prevalence of underweight children (0–59 months)

- Prevalenceofwasting(Ht/Wt)

Indicators to measure implementation progress, communication and advocacy activities:

- #ofdistrictswithECDincorporatedintotheirplansandbudgets

- #offamilies/parentsreachedwithcommunicationmessagesonresponsivecaregiving/positiveparenting.

- #ofchildrenreachedwithchild-friendlymassmediaprograms(radio,TV).

- #oflocalauthoritiesreachedwithawareness-raisingmessagesonECD

- #ofcommunication/advocacyeventsorganizedatdifferentlevels(national,district,

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sector,community)

- #offrontlineworkerstrainedoninter-personalcommunicationskills.

- # of children reached with growth monitoring

- # of ECD service providers / caregivers trained.

- #ofparentsreachedwithparentingeducation.

- # of parents reached with integrated messages.

- #ofIntegratedECD,NutritionandWASHmessagesdeveloped,communicationmaterialsproducedanddistributed

- #ofsensitizationmeetingorganizedwithlocalleaders

- #ofECD&NutritionandWASHradiomaterialsproduced.

12. CONCLUSIONThe implementation of this National Integrated ECD, Nutrition and WASH SBCC StrategywillbeledbyNationalECDProgramwiththesupportfromlineministries,centralandlocalgovernment,andnon-governmentalagencies,includinglocalandinternationalorganizations,U.N.agencies,developmentpartners,privatesector,andotherhealthsector implementingpartners. Collaborationamongall stakeholders is key for successful implementationof theNationalIntegratedECD,NutritionandWASHSBCCStrategyactivitiesatthenational,district,and community levels.

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13ANNEXES

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p to

revi

ew a

nd a

dapt

IEC

m

ater

ials

and

mes

sage

  

  

  

 80

,000

,000

NEC

DP

NEC

DP

, UN

ICEF

, RB

C

AN

NEX

1: S

BCC

inte

grat

ed Im

plem

enta

tion

pla

n

52

 D

istr

ict W

orks

hops

  

  

  

  

  

1.5

Cas

cade

d D

issem

inat

ion

Wor

ksho

ps fo

r Int

egra

ted

SBCC

Str

ateg

y at

Dist

rict

leve

l

  

  

  

 24

,950

,000

NEC

DP

NEC

DP

, UN

ICEF

, RB

C

II.Co

mm

unit

y M

obili

zati

on

  

  

  

  

  

2.1

Aw

ards

of c

ham

pion

s /co

mm

unity

vol

unte

ers

to

prom

ote

Soci

al b

ahav

ior

chan

ge c

omm

unic

atio

n EC

D, N

utrit

ion

and

WA

SH

(EC

D, N

utrit

ion

and

WA

SH

Serv

ices

pro

vide

rs, I

ZU,

CH

W, M

odel

Par

ents

, Art

ists,

Jour

nalis

t etc

  

  

  

 10

5,00

0,00

0N

ECD

P N

ECD

P , U

NIC

EF,

RBC

2.2

Cond

uct c

omm

unity

m

obili

zatio

n th

roug

h Pa

rent

foru

ms,C

omm

unity

W

ork/

Um

ugan

da, I

ntek

o z’A

batu

rage

, Ito

rero

ry

’Um

udug

udu;

Com

mun

ity

Dra

ma,

Cin

e M

obile

, IC

T Pl

atfo

rms,

Relig

ious

For

ums,

Spor

t eve

nts,V

illag

e co

okin

g de

mon

stra

tion

sess

ions

.

  

  

  

 42

1,00

0,00

0N

ECD

P N

ECD

P, RB

C,

UN

ICEF

,

53

2.3

Cond

uct I

nter

pers

onal

Co

mm

unic

atio

n th

roug

h H

ome

Visi

ts th

roug

h co

mm

unity

vol

unte

ers

  

  

  

 

10

5,00

0,00

0 N

ECD

P an

d RB

CN

ECD

P, RB

C,

UN

ICEF

,CRS

III.

Aw

aren

ess C

ampa

igns

  

  

  

  

  

3.1

Day

of A

fric

an C

hild

(DA

C) /

SBC

rela

ted

inte

rven

tions

  

  

  

 90

,000

,000

NEC

DP

NEC

DP,R

BC,

UN

ICEF

, NCC

and

N

WC

3.2

Fam

ily C

ampa

igns

/SBC

re

late

d in

terv

entio

ns 

  

  

  

15,0

00,0

00N

ECD

P an

d M

INA

GRI

NEC

DP,M

INA

GRI

, W

FP,FA

O

3.3

Han

d W

ashi

ng a

nd

Toile

t Day

/SBC

rela

ted

inte

rven

tions

  

  

  

 80

,000

,000

NEC

DP

NEC

DP,U

NIC

EF

3.4

Inte

rnat

iona

l Day

of P

erso

ns

with

Disa

bilit

ies

  

  

  

 50

,000

,000

NEC

DP

 

3.5

Wor

ld B

reas

feed

ing

Wee

k /

SBC

rela

ted

inte

rven

tions

  

  

  

 10

5,00

0,00

0N

ECD

P, RB

CN

ECD

P ,U

NIC

EF

3.6

Wor

ld F

ood

Day

/SBC

re

late

d in

terv

entio

ns 

  

  

  

50,0

00,0

00 

NEC

DP

,MIN

AG

RI,FA

O,

WFP

3.7

MC

H w

eek

/ SBC

rela

ted

inte

rven

tions

  

  

  

 

15

0,00

0,00

0 N

ECD

PN

ECD

P,UN

ICEF

, RB

C, C

RS

3.8

Day

of A

fric

an C

hild

(DA

C) /

SBC

rela

ted

inte

rven

tions

  

  

  

 

9

0,00

0,00

0 N

ECD

PN

ECD

P, RB

C,

UN

ICEF

, NCC

and

N

WC

54

IV.

Prod

ucti

on o

f med

ia a

nd

IEC

Mat

eria

ls 

  

  

  

  

 

4.1

Prod

uce

and

broa

dcas

t m

edia

adv

erts

(Rad

io a

nd

TV sp

ots )

  

  

  

 55

0,00

0,00

0N

ECD

PN

ECD

P,UN

ICEF

,R

BC,C

RS

4.2

Prod

uce

and

broa

dcas

t Ra

dio

and

TV P

rogr

ams

( Rad

io a

nd T

V T

alk

show

s; Pr

e re

cord

ed

mag

azin

es ,

Aud

io V

isual

D

ocum

enta

ries,

Chi

ld

frie

ndly

Dra

ma

(e.g

: Ite

tero

an

d D

J men

tions

)

  

  

  

 12

5,00

0,00

0N

ECD

PN

ECD

P,UN

ICEF

,R

BC,C

RS

4.3

Prod

uce

and

publ

ish

artic

les a

nd su

plim

ents

in

new

pape

rs a

nd w

eb b

ased

m

edia

incl

udin

g W

eb B

anne

r

  

  

  

 92

,000

,000

NEC

DP

NEC

DP,U

NIC

EF

,RBC

4.4

Test

and

dist

ribut

e th

e ex

istin

g IE

C m

ater

ials

and

m

essa

ges (

broc

hure

s ,fly

ers,

bann

ers ,

book

lets

etc

)

  

  

  

 2,

400,

000,

000

NEC

DP

NEC

DP

,RBC

,UN

ICEF

V.Tr

aini

ngs

  

  

  

  

  

5.1

Cond

uct T

oT fo

r EC

D,

Nut

ritio

n an

d W

ASH

se

rvic

e pr

ovid

ers o

n re

vise

d,

adap

ted

and

prod

uced

IEC

m

ater

ials

and

mes

sage

s

  

  

  

 

2

4,60

0,00

0 N

ECD

PN

ECD

P, U

NIC

EF,

Oth

er P

artn

ers

55

5.2

Cond

uct c

asca

ded

Trai

ning

fo

r Com

mun

ity v

olun

teer

s on

on

revi

sed,

ada

pted

and

pr

oduc

ed IE

C m

ater

ials

  

  

  

 

12

0,00

0,00

0 N

ECD

PN

ECD

P, U

NIC

EF,

Oth

er P

artn

ers

5.3

Cond

uct t

rain

ings

with

Jo

urna

lists

on

repo

rtin

g ab

out I

nteg

rate

d EC

D,

Nut

ritio

n an

d W

ASH

ba

havi

or c

hang

e re

late

d se

rvic

es

  

  

  

 44

,250

,000

NEC

DP

NEC

DP,

UN

ICEF

, O

ther

Par

tner

s

VI.

Tech

nica

l and

fina

ncia

l Su

ppor

t  

  

  

  

  

 

6.1

Crea

te a

nd su

ppor

t med

ia

netw

orks

to p

rom

ote

ECD

,Nut

ritio

n an

d W

ASH

be

havi

or c

hang

e re

late

d ac

tiviti

es

  

  

  

 12

5,00

0,00

0N

ECD

PN

ECD

P ,

UN

ICEF

,RBC

6.2

Supp

ort c

hild

frie

ndly

art

s pr

oduc

tion

  

  

  

 22

5,00

0,00

0N

ECD

PN

ECD

P ,

UN

ICEF

,RBC

VII.

Adv

ocac

y m

eeti

ngs

  

  

  

  

  

7.1

Adv

ocac

y m

eetin

gs w

ith

stak

ehol

ders

on

effec

tive

serv

ice

prov

ision

of

inte

grat

ed E

CD

, Nut

ritio

n an

d W

ASH

  

  

  

 

1

2,60

0,00

0 N

ECD

PN

ECD

P, U

NIC

EF,

CRS

, Oth

er

Part

ners

acc

ordi

ng

to th

eir D

istric

t of

Inte

rven

tion

56

7.2

Cas

cade

d ad

voca

cy

mee

tings

with

com

mun

ity

lead

ers o

n eff

ectiv

e se

rvic

e pr

ovisi

on o

f int

egra

ted

ECD

,N

utrit

ion

and

WA

SH

  

  

  

 

14

4,00

0,00

0 N

ECD

PN

ECD

P, U

NIC

EF,

CRS

, Oth

er

Part

ners

acc

ordi

ng

to th

eir D

istric

t of

Inte

rven

tion

VIII

.M

&E

  

  

  

  

  

8.1

Evid

ence

bas

ed K

now

ledg

e sh

arin

g w

ithin

the

com

mun

ity

  

  

  

 68

,000

,000

NEC

DP

NEC

DP

,UN

ICEF

RB

C

8.2

Cond

uct f

orm

ativ

e re

sear

ch

on E

CD

,Nut

ritio

n an

d W

ASH

bah

avio

rs a

nd re

view

th

is SB

CC st

rate

gy (2

022)

  

  

  

 14

0,00

0,00

0N

ECD

PN

ECD

P ,U

NIC

EF

,RBC

8.3

Surv

eys (

KA

P, M

id T

erm

an

d En

dlin

e Ev

alua

tions

) on

SBC

C a

ctiv

ities

on

ECD

, N

utrit

ion

and

WA

SH

  

  

  

 21

0,00

0,00

0N

ECD

PN

ECD

P ,U

NIC

EF

,RBC

Tota

l5,

756,

850,

000 

57

AN

NEX

2: S

BCC

M&

E fr

amew

ork

A

udie

nces

/Ta

rget

Com

mun

icat

ion

Obj

ecti

ves

Eval

uati

on

indi

cato

rsBa

selin

eTa

rget

s/m

ilest

ones

Dat

a so

urce

Freq

uenc

y D

ata

colle

ctio

n Re

spon

sibl

e

  

  

Y1Y2

Y3Y4

Y5Y6

  

 

Out

com

e: E

nhan

ced

opti

mal

Ear

ly c

hild

dev

elop

men

t, c

hild

ren’

s pre

pare

dnes

s to

the

prim

ary

scho

ol e

nvir

onm

ent,

pos

itiv

e pa

rent

ing

and

com

mun

ity

part

icip

atio

n in

chi

ld p

rote

ctio

n an

d re

duce

d m

alnu

trit

ion

and

stun

ted

grow

th a

mon

g yo

ung

child

ren.

Stra

tegi

c ou

tput

s 1:

Child

ren

have

incr

ease

d ex

posu

re to

ear

ly st

imul

atio

n by

thei

r fam

ilies

, inc

ludi

ng a

cces

s to

age-

appr

opri

ate

med

ia p

rogr

amm

es, b

ooks

, and

pla

y an

d le

arni

ng m

ater

ials

.

Chi

ldre

n (0

-6

year

s old

) Co

mm

unic

atio

n ob

ject

ive

1: B

y 20

24, a

50%

in

crea

se in

the

prop

ortio

n of

chi

ldre

n lis

teni

ng to

age

-ap

prop

riate

and

in

clus

ive

med

ia

prog

ram

mes

.

% o

f chi

ldre

n ag

ed to

0-6

ye

ars l

isten

ing

to

age-

appr

opria

te

med

ia

prog

ram

mes

.

Nee

d ba

selin

e in

form

atio

n5%

of c

hild

ren

aged

to 0

-6

year

s list

enin

g to

ag

e-ap

prop

riate

m

edia

pr

ogra

mm

es

5% o

f chi

ldre

n ag

ed to

0-6

ye

ars l

isten

ing

to

age-

appr

opria

te

med

ia

prog

ram

mes

10%

of c

hild

ren

aged

to 0

-6

year

s list

enin

g to

ag

e-ap

prop

riate

m

edia

pr

ogra

mm

es

10%

of c

hild

ren

aged

to 0

-6

year

s list

enin

g to

ag

e-ap

prop

riate

m

edia

pr

ogra

mm

es

10%

of c

hild

ren

aged

to 0

-6

year

s list

enin

g to

ag

e-ap

prop

riate

m

edia

pr

ogra

mm

es

10%

of c

hild

ren

aged

to 0

-6

year

s list

enin

g to

ag

e-ap

prop

riate

m

edia

pr

ogra

mm

es

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Qua

rter

ly

NEC

DP:

Con

duct

A

dvoc

acy

RHCC

: des

ign

med

ia p

rogr

ams

HM

C: C

hann

eliz

e m

edia

pro

gram

s

Chi

ldre

n (0

-6

year

s old

)Co

mm

unic

atio

n ob

ject

ive

2:

By 2

024,

a

50%

incr

ease

in

pro

port

ion

of c

hild

ren

play

ing

with

ag

e-ap

prop

riate

bo

oks,

and

incl

usiv

e pl

ay

and

lear

ning

m

ater

ials.

% o

f chi

ldre

n ag

ed to

0-6

ye

ars c

hild

ren

play

ing

with

ag

e-ap

prop

riate

bo

oks,

and

play

an

d le

arni

ng

mat

eria

ls

30 %

of c

hild

ren

unde

r 5 a

ges

have

acc

ess t

o to

ys a

nd p

lay-

thin

gs a

nd o

nly

1

% o

f chi

ldre

n un

der 5

age

s w

ith a

cces

s to

child

ren’

s boo

ks

(RD

HS

2015

)

8 %

of c

hild

ren

unde

r 5 a

ges h

ave

acce

ss to

toys

an

d pl

ay-t

hing

s

1

% o

f chi

ldre

n un

der 5

age

s w

ith a

cces

s to

child

ren’

s boo

ks

8 %

of c

hild

ren

unde

r 5 a

ges h

ave

acce

ss to

toys

an

d pl

ay-t

hing

s

1

% o

f chi

ldre

n un

der 5

age

s w

ith a

cces

s to

child

ren’

s boo

ks

8 %

of c

hild

ren

unde

r 5 a

ges h

ave

acce

ss to

toys

an

d pl

ay-t

hing

s

1

% o

f chi

ldre

n un

der 5

age

s w

ith a

cces

s to

child

ren’

s boo

ks

8% o

f chi

ldre

n un

der 5

age

s hav

e ac

cess

to to

ys

and

play

-thi

ngs

1 %

of c

hild

ren

unde

r 5 a

ges

with

acc

ess t

o ch

ildre

n’s b

ooks

8% o

f chi

ldre

n un

der 5

age

s hav

e ac

cess

to to

ys

and

play

-thi

ngs

1 %

of c

hild

ren

unde

r 5 a

ges

with

acc

ess t

o ch

ildre

n’s b

ooks

10 %

of c

hild

ren

unde

r 5 a

ges h

ave

acce

ss to

toys

an

d pl

ay-t

hing

s

1

% o

f chi

ldre

n un

der 5

age

s w

ith a

cces

s to

child

ren’

s boo

ks

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

N

ECD

P:

Adv

ocac

y

RSA

U: R

wan

da

Soci

ety

of

Aut

hors

Fa

cilit

ate

the

publ

icat

ion

of

age-

appr

opria

te

book

s, R

AC

: Rw

anda

A

rts C

ounc

il

outp

uts 2

: Pa

rent

s’ re

spon

sive

car

e to

you

ng c

hild

ren

prov

ided

Pare

nts w

ith

child

ren

0-6

year

s ol

d / a

dole

scen

t gi

rls a

nd b

oys

Com

mun

icat

ion

obje

ctiv

e 1:

By

2024

, a 5

0%

incr

ease

in th

e pr

opor

tion

of P

aren

ts

unde

rsta

ndin

g th

e im

port

ance

of

EC

D, e

spec

ially

re

spon

sive

care

of

you

ng c

hild

ren

incl

udin

g PW

Ds (

talk

ing,

in

tera

ctin

g,

read

ing

and

play

ing)

% o

f par

ents

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

13%

of

child

ren

age

36-5

9 m

onth

s at

tend

ing

an

orga

nize

d ea

rly

child

hood

ed

ucat

ion

prog

ram

(RD

HS

2015

)

5 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

5 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

10 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

10 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

10%

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

10 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s w

ith in

crea

sed

know

ledg

e of

the

impo

rtan

ce o

f EC

D, e

spec

ially

re

spon

sive

care

of y

oung

ch

ildre

n (t

alki

ng,

inte

ract

ing,

re

adin

g an

d pl

ayin

g)

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ual

NEC

DP:

Pro

vide

ke

y m

essa

ges

NCP

D: P

rovi

de

key

mes

sage

s ap

prop

riate

to

PWD

s. N

WC

, NCC

, M

IGEP

ROF,

M

INA

LOC

, Loc

al

Aut

hori

ties

, ch

urch

le

ader

s,et

c.

D

issem

inat

e ke

y m

essa

ges

58

Pare

nts w

ith

child

ren

0-6

year

s ol

d / a

dole

scen

t gi

rls a

nd b

oys

Com

mun

icat

ion

obje

ctiv

e 2:

By

202

4, a

50%

in

crea

se in

the

prop

ortio

n of

bo

th fa

ther

s an

d m

othe

rs

part

icip

ate

equa

lly in

ch

ild c

are

and

stim

ulat

ion.

% o

f bot

h fa

ther

s an

d m

othe

rs w

ith

child

ren

0-6

year

s ol

d / a

dole

scen

t gi

rls a

nd b

oys

part

icip

atin

g eq

ually

in

child

car

e an

d st

imul

atio

n

Base

line

Dat

a:

(RD

HS

2015

): 35

% o

f chi

ldre

n un

der 5

yea

rs

wer

e le

ft a

lone

or

in th

e ca

re o

f ot

her c

hild

ren

5 %

of b

oth

fath

ers a

nd

mot

hers

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pa

rtic

ipat

ing

equa

lly in

ch

ild c

are

and

stim

ulat

ion

5 %

of b

oth

fath

ers a

nd

mot

hers

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pa

rtic

ipat

ing

equa

lly in

ch

ild c

are

and

stim

ulat

ion

10 %

of b

oth

fath

ers a

nd

mot

hers

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pa

rtic

ipat

ing

equa

lly in

ch

ild c

are

and

stim

ulat

ion

10 %

of b

oth

fath

ers a

nd

mot

hers

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pa

rtic

ipat

ing

equa

lly in

ch

ild c

are

and

stim

ulat

ion

10 %

of b

oth

fath

ers a

nd

mot

hers

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pa

rtic

ipat

ing

equa

lly in

ch

ild c

are

and

stim

ulat

ion

10 %

of b

oth

fath

ers a

nd

mot

hers

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pa

rtic

ipat

ing

equa

lly in

ch

ild c

are

and

stim

ulat

ion

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

Pro

vide

ke

y m

essa

ges.

NW

C, N

CC,

MIG

EPRO

F,

MIN

ALO

C, L

ocal

A

utho

riti

es,

chur

ch

lead

ers,

etc

:

Diss

emin

ate

key

mes

sage

s G

MO

: Mon

itor

gend

er e

qual

ity

Pare

nts w

ith

child

ren

0-6

year

s ol

d / a

dole

scen

t gi

rls a

nd b

oys

Com

mun

icat

ion

obje

ctiv

e 3:

By

202

4, a

50%

in

crea

se in

the

prop

ortio

n of

par

ents

pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res.

% o

f par

ents

with

ch

ildre

n 0-

6 ye

ars

old

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

Base

line

Dat

a:

(RD

HS

2015

): 49

% o

f chi

ldre

n en

gage

d w

ith a

n ad

ult h

ouse

hold

m

embe

r in

four

or

mor

e ac

tiviti

es

that

pro

mot

e le

arni

ng a

nd

scho

ol re

adin

ess

5 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

5 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

10 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

10 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

10%

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

10 %

of p

aren

ts

with

chi

ldre

n 0-

6 ye

ars o

ld

/ ado

lesc

ent

girls

and

boy

s pr

actic

ing

posit

ive

pare

ntin

g sk

ills,

incl

udin

g po

sitiv

e di

scip

linar

y m

easu

res

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

NCP

D: P

rovi

de

key

mes

sage

s ap

prop

riate

to

PWD

s. N

WC

, NCC

, M

IGEP

ROF,

M

INA

LOC

, Loc

al

Aut

hori

ties

, ch

urch

le

ader

s etc

:

Diss

emin

ate

key

mes

sage

s

Stra

tegi

c ou

tput

s 3: P

aren

ts p

ract

ice

appr

opria

te h

ealth

, nut

ritio

n an

d W

ASH

pra

ctic

es

Mat

erna

l Nut

ritio

n - I

ncre

ase

inta

ke o

f nut

rient

-ric

h fo

ods b

y pr

egna

nt a

nd la

ctat

ing

wom

en

Preg

nant

wom

en

Com

mun

icat

ion

obje

ctiv

e 1:

By

20

24, a

50%

in

crea

se in

the

prop

ortio

n of

pr

egna

nt w

omen

ea

ting

daily

an

ext

ra m

eal

or sn

ack

that

co

ntai

n fo

od ri

ch

in e

nerg

y, vi

tam

in

A o

r iro

n

% o

f pre

gnan

t w

omen

eat

ing

daily

an

extr

a m

eal o

r sna

ck

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

Dat

a ga

ps:

need

bas

elin

e in

form

atio

n

5 %

of p

regn

ant

wom

en e

atin

g da

ily a

n ex

tra

mea

l or s

nack

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

5 %

of p

regn

ant

wom

en e

atin

g da

ily a

n ex

tra

mea

l or s

nack

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

10%

of p

regn

ant

wom

en e

atin

g da

ily a

n ex

tra

mea

l or s

nack

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

10%

of p

regn

ant

wom

en e

atin

g da

ily a

n ex

tra

mea

l or s

nack

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

10%

of p

regn

ant

wom

en e

atin

g da

ily a

n ex

tra

mea

l or s

nack

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

10%

of p

regn

ant

wom

en e

atin

g da

ily a

n ex

tra

mea

l or s

nack

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

Pro

vide

ke

y m

essa

ges

MoH

: Dev

elop

gu

idel

ines

RB

C:

part

icip

ate

in

impl

emen

tatio

n LO

DA

: Dist

ribut

e ex

tra

mea

l to

Ubu

dehe

1&

2 R

AB:

Fac

ilita

te to

pr

oduc

e ex

tra-

food

. CH

Ws:

cond

uct

sens

itiza

tion

of

extr

a m

eal t

o be

nefic

iarie

s

59

Lact

atin

g M

othe

rsCo

mm

unic

atio

n ob

ject

ive

2:

By

2024

, a 5

0%

incr

ease

in th

e pr

opor

tion

of

lact

atin

g w

omen

ea

ting

daily

tw

o ex

tra

mea

ls or

snac

ks th

at

cont

ain

food

rich

in

ene

rgy,

vita

min

A

or i

ron

% o

f lac

tatin

g w

omen

eat

ing

daily

two

extr

a m

eals

or sn

acks

th

at c

onta

in fo

od

rich

in e

nerg

y, vi

tam

in A

or i

ron

Dat

a ga

ps:

need

bas

elin

e in

form

atio

n

5 %

of l

acta

ting

wom

en e

atin

g da

ily tw

o ex

tra

mea

ls or

snac

ks

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

5 %

of l

acta

ting

wom

en e

atin

g da

ily tw

o ex

tra

mea

ls or

snac

ks

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

10 %

of l

acta

ting

wom

en e

atin

g da

ily tw

o ex

tra

mea

ls or

snac

ks

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

10 %

of l

acta

ting

wom

en e

atin

g da

ily tw

o ex

tra

mea

ls or

snac

ks

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

10 %

of l

acta

ting

wom

en e

atin

g da

ily tw

o ex

tra

mea

ls or

snac

ks

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

10 %

of l

acta

ting

wom

en e

atin

g da

ily tw

o ex

tra

mea

ls or

snac

ks

that

con

tain

food

ric

h in

ene

rgy,

vita

min

A o

r iro

n

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

Pro

vide

ke

y m

essa

ges

MoH

: Dev

elop

gu

idel

ines

RB

C:

part

icip

ate

in

impl

emen

tatio

n LO

DA

: Dist

ribut

e ex

tra

mea

l to

Ubu

dehe

1&

2 R

AB:

Fac

ilita

te to

pr

oduc

e ex

tra-

food

. CH

Ws:

con

duct

se

nsiti

zatio

n of

ex

tra

mea

l to

bene

ficia

ries

Impr

ove

Infa

nt a

nd Y

oung

Chi

ldre

n N

utri

tion

(IYC

N)

Chi

ldre

n (0

-6

mon

ths)

Com

mun

icat

ion

obje

ctiv

e 1:

By

2024

, a 1

0%

incr

ease

in th

e pr

opor

tion

of

child

ren

unde

r 6

excl

usiv

ely

brea

stfe

ed fo

r the

fir

st 6

mon

th

% o

f inf

ants

un

der 6

mon

ths

of a

ge w

ho

are

excl

usiv

ely

brea

stfe

d (r

ecei

ving

bre

ast

milk

, and

not

re

ceiv

ing

any

othe

r flui

ds o

r fo

ods,

with

the

exce

ptio

n of

or

al re

hydr

atio

n so

lutio

n,

vita

min

s, m

iner

al

supp

lem

ents

and

m

edic

ines

)

Base

line

Dat

a:

(RD

HS

2015

): 87

% o

f chi

ldre

n un

der 6

mon

ths

are

excl

usiv

ely

brea

stfe

d

2 %

of i

nfan

ts

unde

r 6 m

onth

s of

age

who

ar

e ex

clus

ivel

y br

east

fed

1% o

f inf

ants

un

der 6

mon

ths

of a

ge w

ho

are

excl

usiv

ely

brea

stfe

d

1% o

f inf

ants

un

der 6

mon

ths

of a

ge w

ho

are

excl

usiv

ely

brea

stfe

d

2% o

f inf

ants

un

der 6

mon

ths

of a

ge w

ho

are

excl

usiv

ely

brea

stfe

d

2 %

of i

nfan

ts

unde

r 6 m

onth

s of

age

who

ar

e ex

clus

ivel

y br

east

fed

2 %

of i

nfan

ts

unde

r 6 m

onth

s of

age

who

ar

e ex

clus

ivel

y br

east

fed

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

1.

Cond

uct

awar

enes

s ca

mpa

ign

2.

Prov

ide

key

mes

sage

s M

oH: D

evel

op

guid

elin

es

RBC

: pa

rtic

ipat

e in

im

plem

enta

tion

LOD

A: D

istrib

ute

extr

a m

eal t

o U

bude

he 1

&2

RA

B: F

acili

tate

to

prod

uce

extr

a-fo

od.

CHW

s: c

ondu

ct

sens

itiza

tion

of

extr

a m

eal t

o be

nefic

iarie

s N

WC

, NCC

, M

IGEP

ROF,

M

INA

LOC

, Loc

al

Aut

hori

ties

, ch

urch

lead

ers,

Diss

emin

ate

key

60

Chi

ldre

n (6

-23

mon

ths)

Co

mm

unic

atio

n ob

ject

ive

2: B

y 20

24, a

50%

in

crea

se in

the

prop

ortio

n of

ch

ildre

n ag

ed

6-23

mon

ths f

ed

in a

ccor

danc

e to

all

3 (h

ealt

h,

nutr

itio

n an

d W

ASH

) re

com

men

ded

prac

tices

%

of c

hild

ren

aged

6-2

3 m

onth

s fed

in

acco

rdan

ce to

all

3 re

com

men

ded

prac

tices

Base

line

Dat

a:

(RD

HS

2015

): 18

% o

f chi

ldre

n ag

ed 6

-23

mon

ths a

re

curr

ently

fed

in

acco

rdan

ce to

all

3 re

com

men

ded

prac

tices

10%

of

chi

ldre

n ag

ed 6

-23

mon

ths f

ed in

ac

cord

ance

to a

ll 3

reco

mm

ende

d pr

actic

es

10%

of

chi

ldre

n ag

ed 6

-23

mon

ths f

ed in

ac

cord

ance

to a

ll 3

reco

mm

ende

d pr

actic

es

10%

of

chi

ldre

n ag

ed 6

-23

mon

ths f

ed in

ac

cord

ance

to a

ll 3

reco

mm

ende

d pr

actic

es

10%

of

chi

ldre

n ag

ed 6

-23

mon

ths f

ed in

ac

cord

ance

to a

ll 3

reco

mm

ende

d pr

actic

es

10%

of

chi

ldre

n ag

ed 6

-23

mon

ths f

ed in

ac

cord

ance

to a

ll 3

reco

mm

ende

d pr

actic

es

10%

of

chi

ldre

n ag

ed 6

-23

mon

ths f

ed in

ac

cord

ance

to a

ll 3

reco

mm

ende

d pr

actic

es

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

1.

Cond

uct

awar

enes

s ca

mpa

ign

2.

Pro

vide

key

m

essa

ges

MoH

: Dev

elop

gu

idel

ines

RB

C:

part

icip

ate

in

impl

emen

tatio

n LO

DA

: Dist

ribut

e ex

tra

mea

l to

Ubu

dehe

1&

2 R

AB:

Fac

ilita

te to

pr

oduc

e ex

tra-

food

. CH

Ws:

cond

uct

sens

itiza

tion

of

extr

a m

eal t

o …

N

WC

, NCC

, M

IGEP

ROF,

M

INA

LOC

, Loc

al

Aut

hori

ties

, ch

urch

le

ader

s etc

Diss

emin

ate

key

mes

sage

s

61

Impr

ove

Wat

er, H

ygie

ne a

nd S

anit

atio

n pr

acti

ces

- H

and

Was

hing

at a

ll Cr

itic

al ti

mes

wit

h a

soap

, dis

pose

s all

fece

s inc

lude

d ch

ildre

n’s i

n a

safe

; hyg

ieni

c la

trin

e; D

rink

alw

ays p

rope

rly

trea

ted

wat

er;

Mot

her /

Car

egiv

er

of c

hild

ren/

te

ache

rs (0

-59

mon

ths)

Com

mun

icat

ion

obje

ctiv

e 1:

By

2024

, a 5

0%

incr

ease

in th

e pr

opor

tion

of m

othe

rs o

r ca

regi

vers

of

child

ren

0-59

m

onth

s was

h th

eir h

ands

and

ch

ildre

n’s h

ands

w

ith so

ap a

t all

criti

cal t

imes

% o

f mot

hers

/ca

regi

vers

was

h th

eir h

ands

with

so

ap a

t crit

ical

tim

es

need

bas

elin

e in

form

atio

n5

% o

f mot

hers

/ca

regi

vers

was

h th

eir h

ands

with

so

ap a

t crit

ical

tim

es

5 %

of m

othe

rs/

care

give

rs w

ash

thei

r han

ds w

ith

soap

at c

ritic

al

times

10 %

of m

othe

rs/

care

give

rs w

ash

thei

r han

ds w

ith

soap

at c

ritic

al

times

10 %

of m

othe

rs/

care

give

rs w

ash

thei

r han

ds w

ith

soap

at c

ritic

al

times

10 %

of m

othe

rs/

care

give

rs w

ash

thei

r han

ds w

ith

soap

at c

ritic

al

times

10 %

of m

othe

rs/

care

give

rs w

ash

thei

r han

ds w

ith

soap

at c

ritic

al

times

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

1.

Cond

uct

awar

enes

s ca

mpa

ign

2. P

rovi

de k

ey

mes

sage

s W

ASA

C: P

rovi

de

trea

ted

wat

er

MIN

EDU

C:

Mon

itor W

ASH

gu

idel

ines

im

plem

enta

tion

at S

choo

ls D

istr

icts

: 1.

Con

duct

ad

voca

cy to

W

ASC

to su

pply

sa

fe d

rinki

ng

wat

er

2. T

o en

sure

the

new

and

exi

stin

g Sc

hool

s hav

e w

ater

har

vest

s. CH

Ws:

con

duct

se

nsiti

zatio

n fo

r ap

prop

riate

han

d w

ash.

62

Mot

her /

Car

egiv

er

of c

hild

ren/

te

ache

rs (0

-59

mon

ths)

Com

mun

icat

ion

obje

ctiv

e 2:

By

2024

, a 5

0%

incr

ease

in th

e pr

opor

tion

of m

othe

rs o

r ca

regi

vers

of

child

ren

0-59

m

onth

s disp

ose

of fe

ces,

incl

udin

g ch

ildre

n’s,

in

latr

ines

with

co

ver

% o

f mot

hers

/ca

regi

vers

of

child

ren

0-59

m

onth

s disp

ose

of fe

ces,

incl

udin

g ch

ildre

n’s,

in

latr

ines

with

co

ver

need

bas

elin

e in

form

atio

n5%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths d

ispos

e of

fece

s, in

clud

ing

child

ren’

s, in

la

trin

es w

ith

cove

r

5% o

f mot

hers

/c

areg

iver

s of

child

ren

0-59

m

onth

s disp

ose

of fe

ces,

incl

udin

g ch

ildre

n’s,

in

latr

ines

with

co

ver

10 %

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths d

ispos

e of

fece

s, in

clud

ing

child

ren’

s, in

la

trin

es w

ith

cove

r

10%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths d

ispos

e of

fece

s, in

clud

ing

child

ren’

s, in

la

trin

es w

ith

cove

r

10 %

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths d

ispos

e of

fece

s, in

clud

ing

child

ren’

s, in

la

trin

es w

ith

cove

r

10%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths d

ispos

e of

fece

s, in

clud

ing

child

ren’

s, in

la

trin

es w

ith

cove

r

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

1.

Cond

uct

awar

enes

s ca

mpa

ign

2. P

rovi

de k

ey

mes

sage

s W

ASA

C: P

rovi

de

trea

ted

wat

er

MIN

EDU

C:

Mon

itor W

ASH

gu

idel

ines

im

plem

enta

tion

at S

choo

ls D

istr

icts

: 1.

Con

duct

ad

voca

cy to

W

ASC

to su

pply

sa

fe w

ater

for

latr

ines

use

. 2.

To

ensu

re th

e ne

w a

nd e

xist

ing

Scho

ols h

ave

appr

opria

te

latr

ines

CH

Ws:

con

duct

se

nsiti

zatio

n fo

r ap

prop

riate

han

d w

ash.

63

Mot

her /

Car

egiv

er

of c

hild

ren/

te

ache

rs (0

-59

mon

ths)

Com

mun

icat

ion

obje

ctiv

e 2:

By

202

4, a

50%

in

crea

se in

the

prop

ortio

n of

mot

hers

or

care

give

rs o

f ch

ildre

n 0-

59

mon

ths

% o

f mot

hers

/ca

regi

vers

of

child

ren

0-59

m

onth

s tre

atin

g dr

inki

ng-

wat

er w

ith

reco

mm

ende

d m

etho

ds

Base

line

Dat

a:

(RD

HS

2015

) : 4

4 %

of

hous

ehol

ds u

se

an a

ppro

pria

te

trea

tmen

t m

etho

d pr

ior t

o dr

inki

ng

5%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths t

reat

ing

drin

king

-w

ater

with

re

com

men

ded

met

hods

5 %

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths t

reat

ing

drin

king

-w

ater

with

re

com

men

ded

met

hods

5%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths t

reat

ing

drin

king

-w

ater

with

re

com

men

ded

met

hods

5%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths t

reat

ing

drin

king

-w

ater

with

re

com

men

ded

met

hods

5 %

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths t

reat

ing

drin

king

-w

ater

with

re

com

men

ded

met

hods

5%

of m

othe

rs

/car

egiv

ers o

f ch

ildre

n 0-

59

mon

ths t

reat

ing

drin

king

-w

ater

with

re

com

men

ded

met

hods

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Ann

ually

NEC

DP:

1.

Cond

uct

awar

enes

s ca

mpa

ign

2. P

rovi

de k

ey

mes

sage

s W

ASA

C: P

rovi

de

trea

ted

wat

er

MIN

EDU

C:

Mon

itor W

ASH

gu

idel

ines

im

plem

enta

tion

at S

choo

ls D

istr

icts

: 1.

Con

duct

ad

voca

cy to

W

ASC

to su

pply

sa

fe w

ater

for

latr

ines

use

. 2.

To

ensu

re th

e ne

w a

nd e

xist

ing

Scho

ols h

ave

appr

opria

te

latr

ines

CH

Ws:

con

duct

se

nsiti

zatio

n fo

r ap

prop

riate

han

d w

ash.

Impr

ove

Hea

lth

Seek

ing

beha

vior

at c

omm

unit

y le

vel

Preg

nant

wom

enBy

202

4, a

50%

in

crea

se in

the

prop

ortio

n of

wom

en

atte

nded

the

reco

mm

ende

d fo

ur A

NC

visi

ts

durin

g th

eir

preg

nanc

y

% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

Base

line

Dat

a:

(RD

HS

2015

) :

44%

of w

omen

at

tend

ed th

e re

com

men

ded

four

AN

C v

isits

du

ring

thei

r pr

egna

ncy

5% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

5% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

5% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

5% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

5% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

5% o

f pre

gnan

t w

omen

who

at

tend

the

four

-re

com

men

ded

ante

nat

al c

are

visit

s

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Qua

rter

lyN

ECD

P: 1

. Co

nduc

t aw

aren

ess

cam

paig

n

2.

Pro

vide

key

m

essa

ges

RBC

: Rei

nfor

ce

heal

th fa

cilit

ies

leve

ls CH

Ws:

con

duct

se

nsiti

zatio

n fo

r A

NC

N

WC

, M

IGEP

ROF

Chu

rch

lead

ers,

U

MU

GO

ROBA

W

’ABA

BYEY

I: co

nduc

t m

obili

zatio

n an

d di

ssem

inat

e ke

y m

essa

ges o

n A

NC

64

Mot

her o

f new

bo

rn in

fant

By 2

024,

a 5

0%

incr

ease

in th

e pr

opor

tion

of

mot

her o

f new

bo

rn in

fant

re

port

ing

to

heal

th fa

cilit

ies t

o se

ek p

rofe

ssio

nal

care

% o

f mot

her o

f ne

w b

orn

infa

nt

repo

rtin

g to

he

alth

faci

litie

s to

seek

pro

fess

iona

l ca

re

Base

line

Dat

a:

(RD

HS

2015

): 43

% w

omen

w

ho g

ave

birt

h in

the

two

year

s pr

eced

ing

the

surv

ey re

ceiv

ed

a po

stna

tal c

are

chec

kup

in th

e fir

st tw

o da

ys

afte

r del

iver

y.

5 %

of m

othe

r of

new

bor

n in

fant

re

port

ing

to

heal

th fa

cilit

ies t

o se

ek p

rofe

ssio

nal

care

5% o

f mot

her o

f ne

w b

orn

infa

nt

repo

rtin

g to

he

alth

faci

litie

s to

seek

pro

fess

iona

l ca

re

10 %

of m

othe

r of

new

bor

n in

fant

re

port

ing

to

heal

th fa

cilit

ies t

o se

ek p

rofe

ssio

nal

care

10 %

of m

othe

r of

new

bor

n in

fant

re

port

ing

to

heal

th fa

cilit

ies t

o se

ek p

rofe

ssio

nal

care

10%

of m

othe

r of

new

bor

n in

fant

re

port

ing

to

heal

th fa

cilit

ies t

o se

ek p

rofe

ssio

nal

care

10 %

of m

othe

r of

new

bor

n in

fant

re

port

ing

to

heal

th fa

cilit

ies t

o se

ek p

rofe

ssio

nal

care

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Qua

rter

lyN

ECD

P: 1

. Co

nduc

t aw

aren

ess

cam

paig

n

2.

Pro

vide

key

m

essa

ges

RBC

: Rei

nfor

ce

heal

th fa

cilit

ies

leve

ls C

HW

s: co

nduc

t se

nsiti

zatio

n fo

r A

NC

N

WC

, C

hurc

h le

ader

s, U

MU

GO

ROBA

W

’ABA

BYEY

I: co

nduc

t m

obili

zatio

n an

d di

ssem

inat

e ke

y m

essa

ges o

n A

NC

Mot

her o

f new

bo

rn in

fant

sBy

202

4, a

1 %

in

crea

se in

the

prop

ortio

n of

fu

lly im

mun

ized

ch

ildre

n at

age

on

e ye

ar p

er

pres

crib

ed b

y he

alth

car

e pr

ovid

ers

% o

f ful

ly

imm

uniz

ed

child

ren

at a

ge

one

year

per

pr

escr

ibed

by

heal

th c

are

prov

ider

s

Base

line

Dat

a:

(RD

HS

2015

) :

99%

of c

hild

ren

age

12-2

3 m

onth

s ha

ve re

ceiv

ed a

ll ba

sic v

acci

nes (

  

  

 10

0 %

of f

ully

im

mun

ized

ch

ildre

n at

age

on

e ye

ar p

er

pres

crib

ed b

y he

alth

car

e pr

ovid

ers

RDH

S Re

port

s, K

AP

surv

eys,

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ram

ba

selin

es, F

GD

s, N

ECD

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port

s

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rter

lyN

ECD

P: 1

. Co

nduc

t aw

aren

ess

cam

paig

n

2.

Pro

vide

key

m

essa

ges

RBC

: Rei

nfor

ce

heal

th fa

cilit

ies

leve

ls CH

Ws:

con

duct

se

nsiti

zatio

n fo

r A

NC

N

WC

, C

hurc

h le

ader

s,

UM

UG

ORO

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W’A

BABY

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cond

uct

mob

iliza

tion

and

diss

emin

ate

key

mes

sage

s on

AN

C

65

Mot

her o

f U5

child

/ C

areg

iver

s te

ache

rs/ a

nd

ECD

s ser

vice

s pr

ovid

ers

By 2

024,

a 1

0 %

incr

ease

in

the

prop

ortio

n of

Mot

her /

Hus

band

of

child

ren

unde

r fiv

e at

tend

ing

regu

lar g

row

th

mon

itorin

g an

d pr

omot

ion

sess

ions

(GM

P

% o

f Mot

her /

Hus

band

of

child

ren

unde

r fiv

e at

tend

ing

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lar g

row

th

mon

itorin

g an

d pr

omot

ion

sess

ions

(GM

P)

need

bas

elin

e in

form

atio

n 1

% o

f Mot

her

/Hus

band

of

child

ren

unde

r fiv

e at

tend

ing

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lar g

row

th

mon

itorin

g an

d pr

omot

ion

sess

ions

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P)

1 %

of M

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nd o

f ch

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n un

der

five

atte

ndin

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gula

r gro

wth

m

onito

ring

and

prom

otio

n se

ssio

ns (G

MP)

2 %

of M

othe

r /H

usba

nd o

f ch

ildre

n un

der

five

atte

ndin

g re

gula

r gro

wth

m

onito

ring

and

prom

otio

n se

ssio

ns (G

MP)

2 %

of M

othe

r /H

usba

nd o

f ch

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n un

der

five

atte

ndin

g re

gula

r gro

wth

m

onito

ring

and

prom

otio

n se

ssio

ns (G

MP)

2 %

of M

othe

r /H

usba

nd o

f ch

ildre

n un

der

five

atte

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g re

gula

r gro

wth

m

onito

ring

and

prom

otio

n se

ssio

ns (G

MP)

2 %

of M

othe

r /H

usba

nd o

f ch

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n un

der

five

atte

ndin

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gula

r gro

wth

m

onito

ring

and

prom

otio

n se

ssio

ns (G

MP)

RDH

S Re

port

s, K

AP

surv

eys,

Prog

ram

ba

selin

es, F

GD

s, N

ECD

P Re

port

s

Mon

thly

NEC

DP:

1.

Cond

uct

awar

enes

s ca

mpa

ign

2. P

rovi

de k

ey

mes

sage

s RB

C: R

einf

orce

he

alth

faci

litie

s le

vels

CHW

s: c

ondu

ct

sens

itiza

tion

for

AN

C

NW

C,

Chu

rch

lead

ers,

U

MU

GO

ROBA

W

’ABA

BYEY

I:

co

nduc

t m

obili

zatio

n an

d di

ssem

inat

e ke

y m

essa

ges o

n A

NC

66

AN

NEX

3: M

essa

ges f

or S

BCC

Inki

ngi y

’Imbo

neza

mik

urire

: 1.

Ubu

zim

a n’

Imiri

re

Imite

rere

y’ik

ibaz

o (N

egat

ive

baha

vior

)Im

pam

vu z

ibite

raIm

yitw

arire

yifu

zwa

(Des

ired

beha

vior

)A

bo u

butu

mw

a bu

gene

we

Ubu

ryo

bw’ih

erer

ekan

yabu

tum

wa

bush

obok

aU

butu

mw

a bw

’inge

nzi

1. K

utita

ku

kam

aro

k’im

irire

myi

za

y’U

mw

ana

mu

min

si 10

00 y

a m

bere

y’

ubuz

ima

bwe,

bitu

ma

aban

a ba

daku

ra n

eza

mu

giha

gara

ro n

o m

u bw

enge

bik

anon

gera

impf

u z’a

bana

bat

o Ba

mw

e m

u ba

byey

i nt

ibon

sa

aban

a ku

isah

a ya

mbe

re b

akiv

uka

Bam

we

mu

baby

eyi b

avan

gira

ab

ana

amas

here

ka n

’ibin

di m

u m

ezi

6 ya

mbe

re

Nyu

ma

y’am

ezi 6

, bam

we

mu

baby

eyi

baha

aba

na b

abo

ifash

aber

e

arik

o ba

kayi

baha

idah

agije

kan

di

itagi

zwe

n’in

dyo

yuzu

ye, b

igat

uma

bagw

ingi

ra c

yang

wa

baka

rwar

a bw

aki

• Ubu

men

yi b

uke

ku m

irire

m

yiza

y’u

mw

ana

mut

o

• Kut

amen

ya a

kam

aro

k’im

irire

mu

min

si 10

00 y

a m

bere

y’U

mw

ana

• A

baga

bo b

atita

bira

in

yigi

sho

zijy

anye

n’

imbo

neza

mik

urire

y’ab

ana

bato

• K

uba

mu

igen

amig

ambi

ry

’inze

go z

imw

e na

zi

mw

e ha

taba

mo

ibik

orw

a bi

shyi

giki

ra

imbo

neza

mik

urire

y’ab

ana

bato

nko

mu

mih

igo

• A

baby

eyi n

tibaz

i aka

mar

o ko

gus

hyira

um

wan

a ku

iber

e ak

ivuk

a • A

baby

eyi n

tibaz

i aka

mar

o ko

nsa

gusa

mu

mez

i at

anda

tu y

a m

bere

• A

baby

eyi n

tibaz

i aka

mar

o k’

ifash

aber

e

• Aba

byey

i bum

va k

o gu

ha

umw

ana

iber

e bi

hagi

je

• Har

i aba

byey

i bab

ura

ifash

aber

e ku

bera

ubu

kene

• H

ari a

bata

zi g

uteg

ura

neza

ifa

shab

ere

igiz

we

n’in

dyo

yuzu

ye

• Har

i aba

tazi

igih

e n’

insh

uro

umw

ana

akw

iriye

guh

abw

a am

afun

guro

• Ubu

fata

nye

bw’ab

agiz

e um

urya

ngo

kwita

ku

buzi

ma

n’im

irire

by’

umw

ana

mu

gihe

cy’

imin

si 10

00 y

a m

bere

y’

ubuz

ima

• A

bayo

bozi

mu

nzeg

o zo

se: K

ugira

uru

hare

mu

guka

ngur

ira a

bo b

ayob

oye

kwita

ku

mbo

neza

mik

urire

y’

aban

a ba

to, k

u bu

zim

a n

o ku

miri

re m

yiza

mu

gihe

cy

’imin

si 10

00 y

a m

bere

y’

ubuz

ima

bw’u

mw

ana

• Kon

sa u

mw

ana

ku is

aha

ya

mbe

re a

kim

ara

kuvu

ka

• Kon

sa u

mw

ana

igih

e cy

’amez

i 6 n

ta k

indi

ava

ngiw

e • G

uha

umw

ana

imfa

shab

ere

igiz

we

ni’in

dyo

yuzu

ye i

gizw

e n’

ibiry

o bi

tand

ukan

ye b

yuzu

zany

a m

u nt

unga

mub

iri k

uva

agiz

e am

ezi a

tand

atu

Aba

byey

i bom

bi

n’ab

andi

bar

era

aban

a.

• Aba

yobo

zi m

u nz

ego

zita

nduk

anye

• I

nzeg

o za

Let

a • A

mad

ini

• Aba

jyan

ama

b’ub

uzim

a • I

nshu

ti z’u

mur

yang

o • A

bajy

anam

a b’

ubuh

inzi

A

bafa

sham

yum

vire

• Ibi

gani

ro n

’abag

ize

umur

yang

o (H

ome

Visi

ts)

• Ubu

jyan

ama

buko

zwe

n’ab

ajya

nam

a b’

ubuz

ima

(Cou

nsel

ing

Talk

s by

CH

Ws)

• U

butu

mw

a bu

tanz

we

n’In

shut

i z’

Um

urya

ngo

• U

butu

mw

a bu

nyuz

e m

u m

asib

o,

inga

mba

n’an

di m

ahur

iro a

tegu

rwa

n’Ito

rero

ry’Ig

ihug

u • U

mug

orob

a w

’abab

yeyi

(Eve

ning

Pa

rent

s For

um)

• Ish

uri m

bone

zam

irire

ry

’um

udug

udu

(Vill

age

Nut

ritio

n Sc

hool

)

• Im

irim

a sh

uri (

Farm

er F

ield

Le

arni

ng S

choo

l)

• Aho

bap

imira

aba

na ib

iro m

u m

udug

udu

(Gro

wth

Mon

itorin

g Pr

omot

ion)

• A

mat

sinda

yo

kubi

tsa

no

kugu

rizan

ya/I

bim

ina

(Sav

ing

and

Inte

rnal

Len

ding

Com

mun

ities

) • K

alab

u z’

isuku

n’is

ukur

a (C

omm

unity

Hea

lth C

lub

sess

ions

)

• Ibi

gani

ro b

itang

irwa

kwa

mug

anga

(IE

C se

ssio

ns)

• Ibi

tabo

n’iz

indi

nya

ndik

o (P

rinte

d m

ater

ials)

1. K

wita

ku

miri

re m

yiza

y’

Um

wan

a w

awe

mu

min

si 10

00

ya m

bere

y’u

buzi

ma

bwe,

ni

inge

nzi k

u m

ikur

ire, h

aba

mu

giha

gara

ro, m

u bw

enge

no

mu

mba

mut

ima.

Fat

a in

dyo

yuzu

ye

kand

i iha

gije

mu

gihe

utw

ite n

o m

u gi

he w

onsa

. Shy

ira u

mw

ana

ku ib

ere

mu

isaha

ya

mbe

re

akiv

uka,

ons

a um

wan

a nt

a ki

ndi u

muv

angi

ye h

abe

n’am

azi

mu

mez

i 6 y

a m

bere

, m

uhe

ifash

aber

e ig

izw

e n’

indy

o yu

zuye

ku

va k

u m

ezi 6

avu

tse

kuge

za

kuri

24, b

izam

urin

da k

ugw

ingi

ra

akur

e ne

za a

fite

ubuz

ima

bwiz

a,

azig

irire

aka

mar

o, a

kagi

rire

umur

yang

o n’

igih

ugu

mur

i ru

sang

e.

2. O

nsa

umw

ana

ku is

aha

ya m

bere

aki

mar

a ku

vuka

ku

ko b

imuf

asha

kug

uman

a ub

ushy

uhe,

guh

umek

a ne

za,

bika

nam

uha

ubud

ahan

garw

a bw

’ um

ubiri

67

• Ibi

nyam

akur

u by

andi

ka

(New

spap

ers)

• I

ngo

mbo

neza

mik

urire

/Am

arer

ero

(EC

D c

ente

rs)

• I

nam

a za

VU

P (V

UP

Mee

tings

) • I

biga

niro

kur

i Rad

iyo

na T

V (R

adio

ta

lk sh

ow T

V)

• Sin

ema

zo h

anze

(Cin

e m

obile

s)

• Ibi

gani

ro m

bwirw

aruh

ame

na z

a vi

dew

o bi

kore

we

hanz

e (R

oad

show

s an

d m

obile

vid

eo sh

ows)

, • U

mug

anda

(Com

mun

ity w

ork)

• I

ntek

o z

’abat

urag

e (C

omm

unity

M

eetin

g)

• Ubu

tum

wa

buta

ngw

a n’

abas

hinz

we

irang

amim

erer

e (C

ivil

stat

us a

nd n

otar

y offi

cers

) • A

mat

orer

o/in

seng

ero

n’im

isigi

ti (c

hurc

h an

d m

osqu

e)

• Am

ashu

ri: A

ho a

bany

eshu

ri ba

tera

niye

(Stu

dent

s’ as

sem

blie

s)

Ibig

aniro

mpa

ka (d

ebat

es in

…)

• Am

akor

aniro

y’u

ruby

iruko

(You

th

corn

ers)

• I

kina

mic

o (D

ram

a), I

miv

ugo

(poe

m),

Ubu

tum

wa

buny

ujijw

e m

u nd

irim

bo (

song

for c

omm

unity

ou

trea

ch),

• U

butu

mw

a bu

nyuj

ijwe

ku m

buga

nk

oran

yam

baga

na

Inte

rinet

e (B

CC

ICT)

3. O

nsa

umw

ana

igih

e cy

’amez

i 6

ya m

bere

nta

kin

di u

muv

angi

ye

habe

n’am

azi k

uko

bim

urin

da

indw

ara

zita

nduk

anye

har

imo

im

pisw

i, um

uson

ga n

’imiri

re

mib

i. K

uva

ku m

ezi 6

kug

ezak

m

yaka

2, k

omez

a w

onse

kan

di

uhe

umw

ana

imfa

shab

ere

igiz

we

ni’in

dyo

yuzu

ye i

gizw

e n’

ibyu

baka

um

ubiri

, ibi

tera

im

bara

ga n

’ibiri

nda

indw

ara.

4.

Ni i

nshi

ngan

o z’u

mug

abo

mu

kwita

ku

miri

re n

’ubu

zim

a bw

’um

wan

a w

e m

u m

insi

1000

ya

mbe

re y

’ubu

zim

a bw

e. F

asha

um

ugor

e w

awe

gufa

ta in

dyo

yuzu

ye k

andi

ihag

ije m

u gi

he

atw

ite n

o m

u gi

he y

onsa

.; guh

yira

um

wan

a ku

iber

e m

u isa

ha y

a m

bere

aki

vuka

, ku

mw

onsa

nta

ki

ndi a

muv

angi

ye h

abe

n’am

azi

mu

mez

i 6 y

a m

bere

, ku

muh

a ifa

shab

ere

igiz

we

n’in

dyo

yuzu

ye

kuva

ku

mez

i 6 a

vuts

e ku

geza

ku

ri 24

, biz

amur

inda

kug

win

gira

ak

ure

neza

afit

e ub

uzim

a bw

iza,

az

igiri

re a

kam

aro,

aka

girir

e um

urya

ngo

n’ig

ihug

u m

uri

rusa

nge.

68

• Ubu

kang

uram

baga

bw

ose

buga

mije

kw

ita k

u bu

zim

a bw

’aban

a ba

to (I

cyum

wer

u cy

ahar

iwe

ubuz

ima

bw’u

mub

yeyi

n’u

mw

ana

(MC

H c

ampa

ign)

, Icy

umw

eru

cy’u

mur

yang

o (F

amily

cam

paig

n)…

• U

buvu

gizi

mu

nam

a na

bafa

taya

biko

rwa

(adv

ocac

y Pa

rtne

rshi

p m

eetin

gs)

• Ubu

kang

uram

baga

n’in

ama

kuri

seriv

isi z

ikom

atan

yije

z’

imbo

neza

ikur

ire y

’aban

a ba

to

(cam

paig

n an

d m

eetin

gs o

n in

tegr

ated

EC

D se

rvic

es)

5. N

i ins

hing

ano

z’aba

yobo

zi

mu

nzeg

o zi

tand

ukan

ye;

aban

yam

adin

i, ab

ajya

nam

a b’

ubuz

ima,

insh

uti z

’um

urya

ngo,

ab

ajya

nam

a b’

ubuh

inzi

, n’

abaf

asha

myu

mvi

re m

u kw

ita

ku m

irire

myi

za n

’ubu

zim

a bw

’aban

a. K

angu

rira

umub

yeyi

ut

wite

n’u

won

sa g

ufat

a in

dyo

yuzu

ye k

andi

ihag

ije ;

guhy

ira

umw

ana

ku ib

ere

mu

isaha

ya

mbe

re a

kivu

ka,

kum

won

sa n

ta

kind

i am

uvan

giye

hab

e n’

amaz

i m

u m

ezi 6

ya

mbe

re ,

kum

uha

ifash

aber

e ig

izw

e n’

indy

o yu

zuye

ku

va k

u m

ezi 6

avu

tse

kuge

za

kuri

24, b

izam

urin

da k

ugw

ingi

ra

akur

e ne

za a

fite

ubuz

ima

bwiz

a,

azig

irire

aka

mar

o, a

kagi

rire

umur

yang

o n’

igih

ugu

mur

i ru

sang

e.

69

2. K

utita

bira

gup

imish

a ab

ana

mu

rweg

o rw

o gu

kurik

irana

no

gute

za

imbe

re im

ikur

ire y

abo

• Kut

amen

ya n

o ku

daha

ag

aciro

ikur

ikira

na im

ikur

ire

y’um

wan

a • U

bum

enyi

buc

ye k

u ka

mar

o ko

kw

ita k

u m

wan

a m

u gi

he

cy’im

insi

1000

ya

mbe

re

y’ub

uzim

a bw

e

• Kut

amen

ya u

ko b

agom

ba

kubi

taho

• G

upim

isha

ibiro

, ub

ureb

ure,

… k

u gi

he k

ugira

ha

kurik

iranw

e im

ikur

ire

y’ab

ana

• Kw

ita k

u m

irire

y’u

mw

ana

mut

o m

u gi

he c

y’im

insi

1000

ya

mbe

re y

’ubu

zim

a bw

e

• Aba

byey

i bom

bi

n’ab

andi

bar

era

aban

a.

• Aba

yobo

zi m

u nz

ego

zita

nduk

anye

; • I

nzeg

o za

Let

a • A

mad

ini

• Aba

jyan

ama

b’ub

uzim

a • I

nshu

ti z’u

mur

yang

o • A

bajy

anam

a b’

ubuh

inzi

, A

bafa

sham

yum

vire

1. M

ubye

yi, k

urik

irana

imik

urire

y’

umw

ana

waw

e um

upim

isha

ibiro

n’u

muz

engu

ruko

w’ik

izig

ira

cy’u

kubo

ko k

u ba

jyan

ama

b’ub

uzim

a n’

ubur

ebur

e .k

u ki

go n

dera

buzi

ma

kugi

ra n

go

ugirw

e in

ama,

biz

atum

a m

u gi

he

agar

agay

eho

ikib

azo

cy’im

irire

m

ibi,

yita

bwah

o n’

abaj

yana

ma

b’ub

uzim

a cy

angw

a n’

ibig

o nd

erab

uzim

a.

2. M

ubye

yi, g

ana

urug

o m

bone

zam

ikur

ire r

ukw

eger

eye

cyan

gwa

ikig

o nd

erab

uzim

a,

kugi

ra n

go u

habw

e in

yigi

sho

ku m

irire

n’im

ikur

ire ib

oney

e y’

umw

ana

waw

e

3. H

ari a

baby

eyi b

atita

bira

kw

ipim

isha

no k

wisu

zum

isha

kwa

mug

anga

igih

e ba

twite

na

nyum

a yo

kub

yara

• Ubu

men

yi b

uke

ku k

amar

o ko

kw

ipim

isha

igih

e um

ugor

e at

wite

• Kw

itabi

ra k

wip

imish

a no

kw

isuzu

mish

a kw

a m

ugan

ga

igih

e um

ugor

e at

wite

nib

ura

insh

uro

enye

zag

enw

e

• Aba

gore

bat

wite

n’

abag

abo

babo

• A

bajy

anam

a b’

ubuz

ima

• Aba

yobo

zi b

’inze

go

z’ib

anze

, abo

mu

miry

ango

itar

i iya

Let

a • A

bajy

anam

a b’

ubuz

ima,

Insh

uti

z’um

urya

ngo

...

Mub

yeyi

, igi

he u

twite

itab

ire

kwip

imish

a in

da in

shur

o en

ye z

agen

we,

biz

aguf

asha

gu

kurik

irana

imik

urire

myi

za

y’um

wan

a ur

i mu

nda

no

kwita

ku

buzi

ma

bwaw

e n’

ubw

’um

wan

a ut

wite

; igi

he

cyo

kuby

ara

niki

gera

, uby

arire

kw

a m

ugan

ga k

uko

biza

gufa

sha

kuby

ara

neza

kan

di u

byar

e m

wan

a m

uzim

a

70

4. H

ari a

baby

eyi b

atita

bira

gu

king

iza

aban

a in

king

o zo

se• U

bum

enyi

buk

e bw

’abab

yeyi

ku

kam

aro

ko

guki

ngiz

a ab

ana

inki

ngo

zose

• Kw

itabi

ra g

ukin

giza

um

wan

a uk

o in

king

o zo

se

ziku

rikira

na

• Aba

gore

bat

wite

n’

abag

abo

babo

• A

bajy

anam

a b’

ubuz

ima

• Aba

yobo

zi b

’inze

go

z’ib

anze

, abo

mu

miry

ango

itar

i iya

Let

a • A

bajy

anam

a b’

ubuz

ima,

Insh

uti

z’um

urya

ngo

…

Mub

yeyi

, kin

giza

um

wan

a w

awe

inki

ngo

zose

uko

zi

tega

nyijw

e, b

izam

urin

da

indw

ara

ziza

haza

aba

na c

yane

cy

ane

ko n

’iyo

indw

ara

zije

zi

tam

ugira

ho u

buka

na n

k’ub

wo

zigi

ra k

’uda

king

iye.

Gan

a ik

igo

nder

abuz

ima

kikw

eger

eye

ahat

angi

rwa

inki

ngo

zirim

o ur

w’im

basa

, ise

ru, a

kani

ga,

igitu

ntu,

aga

kweg

a, u

mw

ijim

a w

o m

u bw

oko

bwa

B nd

etse

n’

umus

onga

.

5. H

ari a

baby

eyi b

atita

bira

ku

bone

za u

ruby

aro

• Ubu

men

yi b

uke

bw’ab

abye

yi k

uri g

ahun

da y

o ku

bone

za u

ruby

aro

• Uru

hare

ruto

rw’ab

agab

o bu

mva

ari

uruh

are

rw’ab

agor

e gu

sa

• Im

yem

erer

e ish

ingi

ye k

u m

adin

i • I

myu

mvi

re is

hing

iye

ku

muc

o w

o ku

byar

a ab

ana

bens

hi

Kwita

bira

kub

onez

a ur

ubya

ro

ku b

uryo

bub

erey

e bu

ri w

ese

kand

i yih

itiye

mo

• Aba

gore

bat

wite

n’

abag

abo

babo

• A

bajy

anam

a b’

ubuz

ima

• Aba

yobo

zi b

’inze

go

z’ib

anze

, abo

mu

miry

ango

itar

i iya

Let

a • A

bajy

anam

a b’

ubuz

ima,

Insh

uti

z’um

urya

ngo

…

1. K

ubon

eza

urub

yaro

biri

nda

imfu

z’ab

abye

yi, k

ugw

ingi

ra

kw’ab

ana

n’ub

uken

e m

u m

iryan

go. M

ubye

yi, i

tabi

re

gahu

nda

yo k

ubon

eza

urub

yaro

ku

ko b

itum

a ub

ona

umw

anya

uh

agije

wo

kons

a no

kw

ita

ku m

wan

a uk

iri m

uto

cyan

e cy

ane

mu

min

si 10

00 y

a m

bere

y’

ubuz

ima

bwe.

Ubu

ryo

bwo

kubo

neza

uru

byar

o bu

bone

ka

ku b

ajya

nam

a b’

ubuz

ima

mu

mud

ugud

u, k

u ki

go n

dera

buzi

ma

cyan

gwa

ku k

igo

cyun

gani

ra ik

igo

nder

abuz

ima

(pos

te d

e sa

nte)

no

ku b

itaro

. Aba

kozi

bab

ihug

ukiw

e ba

zagu

ha ib

isoba

nuro

bih

agije

ku

gira

ngo

wifa

tire

icye

mez

o un

ihiti

rem

o ub

uryo

buk

unog

eye.

71

2. K

ubon

eza

urub

yaro

ni

insh

inga

no y

’um

ugor

e n’

umug

abo.

Mug

abo,

fash

a um

ugor

e w

awe

kwita

bira

ga

hund

a yo

kub

onez

a ur

ubya

ro

kuko

bitu

ma

abon

a um

wan

ya

uhag

ije w

o ko

nsa

no k

wita

ku

mw

ana

ukiri

mut

o cy

ane

cyan

e m

u m

insi

1000

ya

mbe

re

y’ub

uzim

a bw

e. H

erek

eza

umug

ore

waw

e k

u ba

jyan

ama

b’ub

uzim

a m

u m

udug

uidu

, ku

kigo

nde

rabu

zim

a no

mu

bita

ro

ahat

angi

rwa

seriv

isi z

o ku

bone

za

urub

yaro

. Aba

kozi

bab

ihug

ukiy

e ba

zaba

ha ib

isoba

nuro

bih

agije

ku

gira

ngo

mw

ifatir

e ic

yem

ezo

mw

umvi

kane

uza

bone

za

urub

yaro

mur

i mw

e n’

ubur

yo

bum

unog

eye.

Inki

ngi y

’Imbo

neza

mik

urire

: 2.

Am

azi m

eza,

isuk

u n’

isuku

ra6.

Isuk

u nk

e ku

ri ba

mw

e m

u ba

byey

i n’ab

andi

bar

era

aban

a,

umuc

o w

o gu

kara

ba in

toki

ha

kore

shej

we

amaz

i mez

a n’

isabu

ne u

kiri

hasi,

isuk

u nk

e y’

ibiry

o, in

go z

idafi

te u

bwih

erer

o n’

ingo

zifi

te u

bwih

erer

ero

butu

juje

ib

yang

ombw

a

• Har

i aba

ntu

bagi

fite

umuc

o m

ubi w

o ku

tita

ku

isuku

y’u

mub

iri, i

biko

resh

o n’

ahad

ukik

ije…

• U

bum

enyi

buk

e no

kut

ita

ku k

amar

o ko

guk

arab

a in

toki

uko

bik

wiy

e • U

bum

enyi

buk

e no

kut

agira

um

uco

w’is

uku

mu

gute

gura

ib

iribw

a • U

bum

enyi

buk

e ku

kam

aro

ko k

ugira

no

guko

resh

a ub

wih

erer

o bw

ujuj

e ib

yang

ombw

a

• Isu

ku ig

ihe

cyos

e ku

mub

iri,

ku b

ikoe

sho,

n’ah

andi

hak

ikije

ab

antu

• U

muc

o w

o gu

kara

ba in

toki

ne

za m

u bi

he b

yage

nwe

• Gut

egur

ana

amaf

ungu

ro

isuku

ihag

ije

• Kug

ira u

bwih

erer

o bu

fite

isuku

,bw

ujuj

e ib

yang

ombw

a ka

ndi b

ukor

eshw

a ne

za k

u ng

o n’

ahan

di h

ahur

ira a

bant

u be

nshi

Abo

ubu

tum

wa

buge

new

e:

• Aba

byey

i bom

bi

n’ab

andi

bar

era

aban

a • A

bana

• I

nzeg

o za

Let

a • A

mad

ini

• Aba

jyan

a b’

ubuz

ima

• Ins

huti

z’um

urya

ngo

 

1. Is

uku

ni is

oko

y’ub

uzim

a.

Um

wan

da n

i iso

ko y

’indw

ara

nyin

shi h

arim

o: in

zoka

zo

mu

nda,

mu

bwon

ko n

’izo

mu

miy

obor

o y’

amar

aso;

kol

era;

im

pisw

i; sh

ishik

ara;

am

avun

ja;

n’iz

indi

nyi

nshi

. Izi

ndw

ara

zose

zi

kaba

ziz

ahaz

a uz

irway

e, z

igat

era

kugw

ingi

ra k

’um

wan

a n’

imiri

re

mib

i mur

i rus

ange

, zik

aba

zam

uhita

na c

yang

wa

zika

mut

era

ubum

uga.

72

2. G

ira u

muc

o w

’isuk

u un

ywa

amaz

i asu

kuye

, uka

raba

in

toki

uko

resh

eje

amaz

i mez

a n’

isabu

ne m

bere

yo

gute

gura

am

afun

guro

, ugi

ye g

ufun

gura

, ug

iye

kons

a cy

angw

a ku

gabu

rira

umw

ana

n’ig

ihe

cyos

e uv

uye

mu

bwih

erer

ero.

kan

di u

gire

isuk

u ku

bi

kore

sho

byos

e by

o m

u ru

go.

3. G

ira u

bwih

erer

o bu

suku

ye

kugi

ra n

go w

irind

e in

zoka

zo

mu

nda

n’iz

indi

ndw

ara

zose

zi

kom

oka

ku m

wan

da n

k’in

zoka

zo

mu

nda,

mu

bwon

ko n

’izo

mu

miy

obor

o y’

amar

aso;

kol

era;

im

pisw

i; sh

ishik

ara;

am

avun

ja;

n’iz

indi

nyi

nshi

. 4.

Gira

isuk

u ku

mub

iri

wiy

uhag

ira u

mub

iri w

ose

buri

mun

si uk

ores

heje

am

azi m

eza

n’isa

bune

, kan

di u

gire

n’is

uku

ku m

yam

baro

no

ku b

uriri

; w

ite k

u isu

ku y

’aho

utuy

e n’

aho

ugen

da k

andi

wiri

nde

kura

rana

n’

amat

ungo

, biz

atum

a w

irind

a ka

ndi u

rinde

n’ab

awe

indw

ara

zose

zik

omok

a ku

mw

anda

nk

’inzo

ka z

o m

u nd

a, m

u bw

onko

n’iz

o m

u m

iyob

oro

y’am

aras

o; k

oler

a; im

pisw

i; sh

ishik

ara;

am

avun

ja; n

’izin

di

nyin

shi.

73

Inki

ngi y

’Imbo

neza

mik

urire

: 3.

Kur

enge

ra u

mw

ana

7. H

ari a

bana

bat

o ba

giko

rerw

a ih

ohot

erw

a ha

rimo

n’iri

shin

giye

ku

gits

ina,

irib

abaz

a um

ubiri

, iri

baba

za u

mut

ima,

kut

itabw

aho,

gu

shak

irwah

o in

yung

u,

guko

resh

wa

imiri

mo

itajy

anye

n’

imya

ka y

abo

…

• Im

yum

vire

ya

bam

we

itaki

jyan

ye n

’igih

e m

u bi

jyan

ye

no k

urin

da u

mw

ana,

• A

bana

bas

igirw

a a

band

i ba

ntu

baba

rera

arik

o ba

taba

fitiy

e ur

ukun

do

cyan

gwa

bada

shob

oye

• I

mw

e m

u m

iryan

go ih

oran

a am

akim

bira

ne m

u ng

o

• Kur

eres

ha a

bana

aba

ntu

bize

we

bana

bifit

iye

ubum

enyi

• K

uran

dura

um

uco

mub

i wo

guho

hote

ra a

bana

bat

o •

Kuba

hiriz

a ub

uren

ganz

ira

bw’ab

ana

bato

• K

urw

anya

am

akim

bira

ne

mu

miry

ango

hag

amijw

e in

yung

u z’a

bana

bat

o

Abo

ubu

tum

wa

buge

new

e:

• Aba

byey

i bom

bi

• Aba

ndi b

arer

a ab

ana

• Aba

yobo

zi m

u nz

ego

zita

nduk

anye

• I

nzeg

o za

Let

a • A

bafa

sham

yum

vire

(c

are

give

rs)

 

1. M

ubye

yi,

ita k

u m

utek

ano

w’ab

ana

baw

e ub

aher

ekez

a ig

ihe

bagi

ye k

u ish

uri n

’igih

e ba

tash

ye,

biza

barin

de k

ugira

impa

nuka

, gu

huta

zwa

cyan

gwa

guko

rerw

a ih

ohot

erw

a iry

o ar

i ryo

ryos

e ha

rimo

n’ih

ohot

erw

a ris

hing

iye

ku g

itsin

a.

2. M

ubye

yi, i

hutir

e kw

andi

kish

a ab

ana

mu

bita

bo

by’ir

anga

mim

erer

e m

u gi

he

kita

renz

e im

insi

30 n

k’uk

o bi

tega

nyw

a n’

itege

ko k

ugira

ngo

bi

bafa

she

kubo

na u

bure

ngan

zira

bw

abo

imbe

re y

’amat

egek

o ka

ndi b

ifash

e ig

ihug

u m

u ig

enam

igam

bi

3. M

ubye

yi, m

utur

anyi

, muy

oboz

i na

we

mur

ezi,

ihut

ire g

utan

ga

amak

uru

ku g

ihe

ku n

zego

z’u

mut

ekan

o n’

iz’u

buyo

bozi

ig

ihe

umen

ye k

o um

wan

a ya

huye

n’

ihoh

oter

wa

iryo

ari r

yo ry

ose

8. H

ari a

baby

eyi b

atan

diki

sha

aban

a ba

bo m

u gi

he c

yage

nwe

mu

bita

bo b

y’ira

ngam

imer

ere

 • K

utam

enya

am

ateg

eko

n’am

abw

iriza

age

nga

irang

amim

erer

e ku

ri ba

mw

e m

u ba

byey

i • K

udah

a ag

aciro

aka

mar

o ko

kw

andi

kish

a ab

ana

mu

bita

bo

by’ir

anga

mim

erer

e

• Kw

andi

kish

a ab

ana

mu

irang

amim

erer

e ba

kivu

ka m

u gi

he c

y’im

insi

30

 

 

9. H

arac

yaga

raga

ra ik

ibaz

o cy

’aban

a ba

to b

ajya

ku

ishur

i ba

dafit

e um

untu

muk

uru

ubah

erek

eje

  • Ubu

rang

are

bw’ab

abye

yi n

o ku

tita

ku m

utek

ano

w’ab

ana

babo

Aba

byey

i bak

wiy

e gu

here

keza

ab

ana

babo

igih

e ba

giye

ku

ishu

ri ka

ndi b

akaj

ya

kuba

kura

yo ig

ihe

cyo

guta

ha 

74

Inki

ngi y

’Imbo

neza

mik

urir

e:

4. U

bure

re b

ubon

eye

10. A

baby

eyi b

ensh

i b’ab

agab

o nt

ibat

etes

ha a

bago

re b

abo

batw

ite

cyan

gwa

ngo

bite

ku

buzi

ma

bw’ab

ana

babo

bak

iri m

u nd

a

 

• Um

uco

wa

kera

utu

ma

abag

abo

bada

tete

sha

abag

ore

babo

• U

bum

enyi

bud

ahag

ije k

u bu

ryo

n’ak

amar

o ko

kw

ita k

u m

wan

a uk

iri m

u nd

a • I

myu

mvi

re y

’uko

um

ugab

o ut

etes

ha u

mug

ore

yitw

a in

ganz

wa

Aba

gabo

bak

wiy

e kw

ita k

u ba

gore

bab

o n’

igih

e ba

twite

, ku

byin

irira

no

kurir

imbi

ra

inda

no

guku

rikira

na

imik

urire

yay

o

• A

baby

eyi b

ombi

• A

band

i bar

era

aban

a • I

nzeg

o za

Let

a,

Aba

nyam

adin

i • A

bafa

sham

yum

vire

(c

are

give

rs)

 

1. M

ugab

o, G

ira u

ruha

re m

u m

ikur

ire n

’ubu

rere

bub

oney

e bw

’aban

a ba

we.

Irin

de

guho

hote

ra, g

utot

eza

cyan

gwa

gufa

ta n

abi u

mub

yeyi

utw

ite

kuko

big

ira in

garu

ka m

bi k

u bu

zim

a bw

’um

wan

a ak

iri m

u nd

a ya

nyi

na n

’igih

e cy

e ki

zaza

. 2.

Mug

abo,

ita

ku b

uzim

a bw

’um

ugor

e w

awe

igih

e ba

twite

, um

wita

ho, u

mut

etes

ha. T

angi

ra

kuga

niriz

a um

wan

a w

awe

akiri

m

u nd

a ku

gira

ngo

uta

ngire

gu

kang

ura

ubw

onko

bw

e ha

kiri

kare

bity

o az

akur

ane

uruk

undo

. 3.

Bab

yeyi

, mug

aniri

ze a

bana

ba

kiri

bato

, mub

akin

ishe

uduk

ino

duta

nduk

anye

bity

o bi

tum

e ub

won

ko b

wab

o bu

kang

uka

kare

bi

zaba

fash

a ku

baka

n’im

iban

ire

myi

za n

’aban

di.

3. B

abye

yi, m

wiri

nde

guku

bita

um

wan

a cy

angw

a ku

muh

a ib

ihan

o bi

baba

za u

mub

iri

n’im

bam

utim

a ze

, ahu

bwo

mum

ugan

irize

, mum

ukos

oran

e ur

ukun

do.

4. B

abye

yi n

amw

e ba

rezi

, m

ujye

muc

ira a

bana

imig

ani,

mub

ariri

mbi

re, m

ubas

omer

e ud

ukur

u …

kug

ira n

go

muk

angu

re u

bwon

ko b

wab

o ha

kiri

kare

, am

aran

gam

utim

a n’

imib

anire

myi

za n

’aban

di

11. H

ari a

baby

eyi b

atag

aniri

za

aban

a ba

bo b

akiri

bat

o

 

• Im

yum

vire

idah

a ag

aciro

ib

iteke

rezo

by’

aban

a • I

myu

mvi

re it

uma

abag

abo

baha

rira

abag

ore

babo

ub

urer

e bw

’aban

a bo

nyin

e • I

myu

mvi

re y

’abag

abo

yum

va k

o gu

hahi

ra u

rugo

bi

hagi

je

• Aba

byey

i bom

bi b

akw

iye

kugi

ra u

mw

anya

wo

kuga

nira

n’

aban

a ba

bo b

ato

• Aba

byey

i bom

bi b

akw

iye

guki

nish

a ab

ana

babo

ud

ukin

o tu

jyan

ye n

’imya

ka

yabo

kan

di b

akab

acira

im

igan

i, in

dirim

bo,

kuba

som

era

uduk

uru

…

kugi

ra n

go b

akan

gure

ub

won

ko b

wab

o ka

re

12. H

ari a

baby

eyi b

agita

nga

ibih

ano

biba

baza

um

ubiri

n’im

bam

utim

a by

’aban

a ba

to

 

• Kw

ibw

ira (i

myu

mvi

re)

ko ig

itsur

e gi

kabi

je a

ri cy

o ki

goro

ra u

mw

ana

• Ubu

men

yi b

uke

ku n

garu

ka

ibih

ano

bibi

big

ira k

u ba

na

bato

• Kur

era

no g

uhan

a ha

dako

resh

ejw

e ib

ihan

o bi

baba

za u

mub

iri n

’um

utim

a by

’um

wan

a (in

koni

, ibi

tuts

i,...)

75

Inki

ngi y

’Imbo

neza

mik

urir

e:

5. G

uteg

urira

um

wan

a kw

iga

amas

huri

aban

za

13. S

eriv

isi m

bone

zam

ikur

ire

ziki

ri nk

e ug

erer

anyi

je n

’um

ubar

e w

’aban

a ba

zike

neye

 

• Aba

fata

nyab

ikor

wa

baki

ri ba

ke m

u gu

tang

a se

rivisi

z’

imbo

neza

mik

urire

y’ab

ana

bato

•

Aba

byey

i bad

afite

ub

umen

yi k

u ka

mar

o k’

ingo

m

bone

zam

ikur

ire y

’aban

a ba

to

• Aba

fata

nyab

ikor

wa

bata

nduk

anye

ba

kwiy

e kw

injir

a m

uri

gahu

nda

ikom

atan

yije

y’

imbo

neza

mik

urire

y’ab

ana

bato

• A

baby

eyi b

akw

iye

kujy

ana

aban

a ba

bo b

ato

mu

ngo

mbo

neza

mik

urire

• Aba

byey

i bom

bi

• Aba

ndi b

arer

a ab

ana

• Aba

yobo

zi m

u nz

ego

zita

nduk

anye

• A

biko

rera

• A

bany

amad

ini

• Im

iryan

go it

ari i

ya

Leta

 

1. B

abye

yi, m

wish

yire

ha

mw

e m

ushy

ireho

Ing

o M

bone

zam

ikur

ire z

’Aba

na B

ato

(EC

D) k

u rw

ego

rw’u

mud

ugud

u bi

zaba

fash

a kw

ita k

u m

ikur

ire

n’ub

urer

e bw

’aban

a ba

nyu

no k

urw

anya

igw

ingi

ra ry

abo

n’ub

uize

rere

zi. M

wib

umbi

re m

u m

atsin

da y

’ingo

ziri

hag

ati y

a 10

na

15, m

ugen

e ur

ugo

aban

a ba

nyu

bari

mun

si y’

imya

ka 6

ba

zajy

a ba

hurir

amo

mu

mas

aha

mw

agiy

e m

u m

irim

o, m

aze

muj

ye ib

ihe

byo

kure

ra a

bo b

ana.

M

usho

bora

kan

di g

ukor

ana

n’ab

ayob

ozi b

anyu

n’ab

andi

ba

fata

nyab

ikor

wa

mu

gush

aka

ibyu

mba

byo

se m

u m

udug

udu;

nk

’ibyu

mba

by’

inam

a, in

seng

ero

cyan

gwa

ibin

di b

yum

ba

by’ab

anya

mad

ini,

ndet

se

n’ a

mas

huri

atag

ikor

eshw

a,

byas

anw

a bi

gako

resh

wa

mur

i ga

hund

a m

bone

zam

ikur

ire

y’ab

ana

bato

. 2.

Bas

hora

mar

i nam

we

biko

rera

, ni

mus

hore

imar

i mu

mik

urire

m

yiza

y’ab

ana

bato

mus

hyira

ho

ingo

mbo

neza

mik

urire

n’

amas

huri

y’in

shuk

e cy

ane

cyan

e ah

o bi

tari,

bity

o m

ugire

ur

uhar

e m

u gu

tegu

ra a

bana

ba

to g

utan

gira

nez

a am

ashu

ri ab

anza

; bi

zatu

ma

biga

nez

a,

muz

aba

mut

anze

um

usan

zu m

u ku

baka

igih

ugu

kita

rang

wam

o ig

win

gira

.

14. H

arac

yari

aban

a ba

daha

bwa

amah

irwe

yo k

wig

a am

ashu

ri y’

insh

uke

cyan

gwa

mu

ngo

mbo

neza

mik

urire

y’ab

ana

bato

 

• Aka

men

yero

gas

hing

iye

ku m

yum

vire

y’u

ko a

bana

ba

tang

ira k

wig

a (k

uva

mu

rugo

) bafi

te im

yaka

7

• Gut

angi

za a

bana

kw

iga

mu

mas

huri

y’in

shuk

e no

kub

ajya

na m

u ng

o m

bone

zam

ikur

ire h

akiri

kar

e

15. I

nyin

shi m

u ng

o m

bone

zam

ikur

ire n

’Am

ashu

ri y’

insh

uke

men

shi n

tiyak

ira a

bana

ba

ri m

u ns

i y’im

yaka

itat

u

 

• Am

ikor

o m

ake

n’U

bush

oboz

i bw

’ingo

m

bone

zam

ikur

ire n

tibut

uma

bash

obor

a kw

akira

abo

ban

a

Kong

era

amas

huri

y’in

shuk

e n’

ingo

mbo

neza

mik

urire

y’

aban

a ba

to h

irya

no h

ino

mu

gihu

gu

16. A

bana

bafi

te u

bum

uga

n’ab

aken

eye

kwita

bwah

o by

’um

wih

arik

o nt

ibita

bwah

o uk

o bi

kwiy

e

 

Um

uco

wo

guhe

za n

’akat

o bi

kore

rwa

aban

a ba

fite

ubum

uga

n’ib

ibaz

o by

ihar

iye

hari

aho

biki

ri

Ubu

rezi

n’u

bure

re b

udah

eza

aban

a ba

fite

ubum

uga

n’ab

afite

ibib

azo

byih

ariy

e

76

3. B

abye

yi, b

arez

i nam

we

bayo

bozi

, mur

i gah

unda

zi

shin

giye

kur

i ser

ivisi

zos

e z’

imbo

neza

mik

urire

, muz

irika

ne

ubur

ezi b

udah

eza

aban

a ba

fite

ubum

uga

n’ab

aken

eye

ubuf

asha

bw

ihar

iye;

biz

abaf

asha

guk

urira

m

u bu

zim

a b

uzira

aka

to.

77

78