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Food and Nutrition Survey, Rwanda 2010‐2011

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Food and Nutrition Survey, Rwanda 2010‐2011 Food and Nutrition Survey, Rwanda 2010‐2011 FINAL TECHNICAL REPORT FROM HEALTHBRIDGE TO HARVEST PLUS Re: HarvestPlus Challenge Program – Phase II Agreement #8213 Submitted by: Peter R. Berti (HealthBridge) In collaboration with: Jacqueline K. Kung’u (formerly with HealthBridge, now with the Micronutrient Initiative in Kenya) Pierrot L. Tugirimana, Butare Teaching Hospital/National University of Rwanda) Kendra Siekmans (HealthBridge) Mourad Moursi (HarvestPlus) Abdelrahman Lubowa (Consultant) 7 October 2011 Food and Nutrition Survey, Rwanda 2010‐2011 Role of Contributors PRB was co‐PI. He co‐drafted the protocol, analysed the household and food data, and drafted this report. JKK was co‐PI. She co‐drafted the protocol, drafted the background section of this report, coordinated HealthBridge’s work in Rwanda, including training, arranging for blood analysis and supervision of the first week of data collection, and reviewed this report. PLT lead the field team in Rwanda, coordinating logistics, supervising data and blood collection and data entry, and assisting with a locally relevant interpretation of results. KS analysed the biochemical data and drafted the results for that part of this report. MM co‐led training of the enumerators in Rwanda, and trained the data entry team. AL supervised data entry and managed data cleaning and archiving. Acknowledgements Many organizations and individuals were involved in carrying out this work and we are grateful to all of them. First of all, we thank the women, men and children of the Northern and Southern Provinces who took the time out of their busy lives to answer our very many questions. We thank the students from the University of Butare who conducted the interviews and entered the data, and the phlebotomists and drivers who completed the data collection team. We thank Health Development Initiative‐Rwanda who served as the local organizing partner, managing local logistics and finances. We thank Juergen Erhardt for the analysis of the blood proteins. We thank Alex Miloff of HarvestPlus who provided logistics and administrative support and we thank HarvestPlus who provided funding for this project. We especially thank Erick Boy of HarvestPlus who provided managerial and technical guidance and support throughout this work. His efforts and encouragement helped the project surmount all hurdles. Rwanda is a poor and food insecure country. To date, there has been relative little research done on the food and nutrition situation in Rwanda. We trust that this report will help to fill in some of the knowledge gaps and it is our hope that it will be useful in improving food security, nutrition and health in Rwanda. 1 Food and Nutrition Survey, Rwanda 2010‐2011 Table of Contents 1. SUMMARY ......................................................................................................................................... 5 2. BACKGROUND ................................................................................................................................. 6 Introduction .................................................................................................................................................... 6 Rwanda ............................................................................................................................................................ 6 Nutritional and anaemia status of women and children in Rwanda .......................................................... 8 The Rwandan diet .......................................................................................................................................... 10 Processing and consumption of beans ......................................................................................................... 12 3. METHODS ....................................................................................................................................... 13 Study design and Sampling ................................................................................................................................ 13 The appropriate 24‐hour recall schedule .................................................................................................... 17 Preparations for 24 hour recall interviews ................................................................................................. 18 Focus Group Discussion .......................................................................................................................................... 18 Compiling a local food composition table and retention factors .......................................................................... 18 Training Interviewers .............................................................................................................................................. 19 Pilot testing the interactive 24‐hour recall ............................................................................................................. 19 Interactive 24‐hour recall procedure .......................................................................................................... 19 Biochemical indicators of iron status .......................................................................................................... 20 PARTICIPANTS ..................................................................................................................................... 22 Confidentiality ............................................................................................................................................... 22 Compensation ................................................................................................................................................ 22 Informed Consent Process ............................................................................................................................ 22 ETHICS REVIEWS ................................................................................................................................. 22 4. RESULTS ......................................................................................................................................... 23 Sample Characteristics .................................................................................................................................. 23 Illness, Supplements, Meds and ITN use ...................................................................................................... 25 Socioeconomic Status .................................................................................................................................... 27 Beans ............................................................................................................................................................... 28 Dietary Data ................................................................................................................................................... 33 Dietary data quality check ....................................................................................................................................... 33 Nutrient Intakes ...................................................................................................................................................... 37 Intake of foods, by food groups .............................................................................................................................. 40 Dietary Adequacy .................................................................................................................................................... 45 Biochemical indicators of iron status .......................................................................................................... 46 Children ........................................................................................................................................................... 46 Anaemia .................................................................................................................................................................. 46 Iron Deficiency ....................................................................................................................................................... 47 Women ............................................................................................................................................................ 50 Anaemia .................................................................................................................................................................. 50 Iron Deficiency ....................................................................................................................................................... 52 5. DISCUSSION ................................................................................................................................... 55 Sample population characteristics ............................................................................................................... 55 Diet .................................................................................................................................................................. 58 The likelihood and nature of under‐reporting .................................................................................................... 58 Dietary patterns ....................................................................................................................................................
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