2017 ANNUAL REPORT
It takes an integrated approach to end childhood
malnutrition. GLOBAL
24% 159 Million
RWANDA
38%
7,500 + families overall families this year 1,700 + Comprehensive nutrition education
Nutrition sensitive agriculture
Early childhood development
21 thousand children on improved growth trajectories Government capacity building
Scaling through external partners
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Letter from the Director
r the last seven years, your support has allowed us to redefine what is possible in providing effective long-term solutions to ildhood malnutrition for the most vulnerable communities in Rwanda.
king key learnings and successes from our core Health Center Program, this year our team focused on scaling key elements of our ork. After many years of deep community engagement, we are now poised to drive large-scale change in the nutrition sector. By rtnering with larger stakeholders to support the design and delivery of integrated nutrition programs, we will apply what we have arned to fundamentally change the nutrition landscape in Rwanda, and beyond.
is year we launched our Antenatal Care (ANC) Program, in partnership with the Clinton Global Initiative and the Academy of utrition and Dietetics. By working with pregnant women, our goal is to improve maternal nutrition, access to prenatal care and give ildren a healthier start in life. In just one year, we have already worked with more than 2,000 women, providing them the practical owledge and skills to improve nutrition in pregnancy and early childhood.
e have seen our model work for the most vulnerable families in rural Rwanda and this year we are reaching a new population with en greater needs - refugees. We will work with refugees in Mahama and Kigeme Refugee Camps to improve nutrition and health tcomes for more than 3,000 Burundian and Congolese refugees in Rwanda.
the coming year we will be working with the World Food Programme, Save the Children, and the U.S. Embassy to design and liver programs that will reach tens of thousands of vulnerable families across Rwanda. We also continue to invest in collaboration th the Government of Rwanda, where we are able to promote and advocate for policies and programs that affect nutrition erventions from the local to the national level.
hen we think about what the future holds for GHI, we could not be more excited and optimistic. We are at an exciting point of owth and are counting on your support now more than ever. Over the coming months and years we look forward to continuing iterate around our core model to ensure that every family we work with is set up for lasting success. At the same time, we will ntinue to share our key learnings with peer organizations and governments who are looking for a framework for malnutrition erventions that are both effective and sustainable. We can’t solve malnutrition alone, but we can tackle it together.
ith gratitude and vegetables,
olomon Makuza ountry Director
We’re not treating symptoms. We’re changing systems.
Household This year, we are partnering with 3,976 vulnerable families through our Health Center and Antenatal Care Programs, to provide caregivers with the seeds, knowledge, and individual support to prevent and treat malnutrition in their homes.
Community We partner with Community Health Workers to identify cases of malnutrition at the community level, and to give families practical strategies for improving nutrition with the resources they have on hand. This year, we weighed and measured more than 40,000 children, and led 150 community cooking demonstrations.
Health Center We partner with 20 health centers to train staff on how to holistically treat malnutrition and to help strengthen their connections with the communities they serve.
District
National
We work with the Heads of Health in three districts: Musanze, Gasabo, and Rulindo, to develop strategies to end malnutrition in their communities. In Musanze, we help author the District Plan for the Elimination of Malnutrition, which guides all nutrition interventions in the district.
We work with the Rwandan Ministries of Health and Agriculture, and participate in four technical working groups focused on nutrition, agriculture, and community health. For the past three years, our nutrition methodology has been adopted by the Ministry of Health and included in national campaigns. We have also worked with the Ministry of Agriculture to help author a set of “kitchen garden� guidelines. We have also recently begun working as a leading nutrition partner to the Ministry of Disaster Management and Refugee Affairs, advising on nutrition interventions in refugee settings.
Health Center Program Angelique enrolled in our program at Kingi Health Center in the fall of 2016, when her 19 month-old son, Modest, was diagnosed with chronic malnutrition. Seven months later, when our team visited her at her home, the toddler was bouncing happily around the small house. Angelique was proud to report that Modest had gained more than 3.5 kgs, and had officially reached a healthy weight for his age. Angelique credits GHI’s health and agriculture trainings with the transformation that she has seen in her child. Angelique is one of 1,795 caregivers who participated in our Health Center Program this year. Since graduating from our program, she reports, her garden – and her life – have changed for the better. “I learned how to grow vegetables on small pieces of land,” she explains. “Before (participating in GHI’s Health Center Program) I didn’t know how to grow carrots, but currently I grow them very well and always try different trials of amaranth and other vegetables including kale.” She is excited about the future, and is expecting a second baby later this year. “I hope that my next child won’t be malnourished … that is my first hope. I will practice whatever I learned during the program so that I [can] have a very healthy baby.” Angelique is not alone: 50% of children that are born to graduates of our program are at a healthy weight for age, demonstrating the long-lasting impact our program has on the entire family. However, Angelique isn’t waiting for the new baby to put GHI’s lessons into place. She points to a pot that is boiling on her outdoor cook-stove, and explains that today she is cooking “potato, kale, beans, and carrots – a perfect four color meal!”
Knowledge Gains
Cultivated four vegetables after graduation
Health outcomes
99%
Cultivated one vegetable before enrollment
60% At graduation
Of caregivers we work with can identify the components of a balenced meal after our program.
Behavior Change
Of all children are on improved growth trajectories
65%
Continue to be on improved growth trajectories
2-5 years after enrolling
Antenatal Care Program
The first 1,000 days between conception and a child’s second birthday offer a critical window of opportunity to establish a lasting foundation for health. Given the linkages between maternal and child undernutrition, it is essential that health interventions help pregnant women achieve optimum nutrition as early as possible during pregnancy. In September 2016, GHI launched an Antenatal Care (ANC) program to improve maternal nutrition and give children a healthier start in life. Like our Health Center Program, this program works through existing health structures, to deliver an integrated and preventative model to combatting malnutrition.
This year we’ve reached ANC Visits
2,217pregnant women.
Dietary Diversity Indicators
Knowledge Gains
Our Farm
Our farm is our headquarters, and the heart of our work. The land serves as a space for agricultural research and innovation, a source of seeds and seedlings for our Health Center Program, and provides for food our daily community lunch. Perhaps most importantly, our farm is the epicenter of our community engagement efforts. We hire women from the community to serve as casual labor, while also providing them with free childcare and empowerment education. The income they earn and the lessons they take away about sustainable agriculture practices serves as complements to our other programmatic interventions.
Agricultural Inputs
Many of the seeds and seedlings we provide to each of our partner families to establish their own nutritious kitchen gardens come directly from our farm.
Community Lunch
Every day we host a community lunch at our large farm table, inviting neighbors, staff, and any visiting guests to join us for a farm-to-table meal.
Research Trials
We are constantly innovating around our model, trialing crops and testing techniques, to ensure our approach is relevant and rooted in the communities we serve.
Turikumwe Fund In Kinyarwanda turikumwe means “we are together.” This phrase serves as GHI’s unofficial motto because, at Gardens for Health, we are more than an organization. We are a community. We are family. While we work to provide holistic solutions to malnutrition, the vulnerable families that we serve often struggle with challenges beyond the scope of our programs. Our staff realized that, in many cases, the hurdles families face can be resolved with just a little extra help. That is why our staff created our Turi Kumwe Fund in 2011. By providing a mix of advocacy, funds, and support, we are able to help families overcome these hurdles and build a healthy future. We know that if families are struggling with issues external to our program, like housing or other medical conditions, they will not be able to focus on proper nutrition. We have helped families access medical insurance, rebuild destroyed houses, access care for complex medical conditions, and more. This year, our Turi Kumwe Committee has impacted the lives of 445 additional families. With an average investment of less than $30 per case, we were able to help families weather some of the most significant shocks that they face in life.
“Turi Kumwe means we are together...at any time, in any circumstance. To listen to the people is our culture at GHI.” -Annonciata, GHI Health Coordinator
Expanding Our Reach Working With Refugees
We have seen our model work for some of the most at risk families living in rural Rwanda. This year, we are growing our impact by serving a new population with even greater needs, refugees. Forced displacement is one of the leading drivers of hunger and malnutrition globally, affecting a staggering number of women and children. Food aid is a key component of food security strategies in refugee camps, but fails to address long-term food needs for the populations they serve. In most Rwandan camps, registered refugees receive monthly food rations to meet their caloric needs however these rations are not designed to promote adequate dietary diversity, which has contributed to the stunningly high prevalence of malnutrition among many refugee populations in Rwanda. In coordination with Rwanda’s Ministry of Disaster Relief and Refugee Affairs (MIDIMAR) and UNHCR, we will be working with families in Kigeme and Mahama refugee camps to improve nutrition at the household level. By helping families grow nutritious crops and diversify their diets in limited resource settings, we will empower them to create more sustainable solutions to malnutrition in their homes and communities.
57%
20%
In Rwandan camps, 57% of households have inadequate food consumption.
A refugee child is about 20% more likely to be chronically malnourished than a non-displaced child.
159, 854 Refugees
In Partnership With
MIDIMAR
Save the Children
UNHCR
U.S. State Department
Financials
Our Board Archie McIntyre Daphne Petri Emily Morell Balkin Emma Clippinger John LeClaire Julie Carney Kara Weiss Tom Huntington Bill Fletcher Pamela Boll
Our Advisors Dr. Paul Farmer Alice Waters Dr. David Morell Jake Blehm Dr. Michael Merson Dr. Sara Stulac Dr. Judy McLean
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