Stories of Change: Rwanda: Understanding how Rwanda created an enabling environment for improvements in nutrition and the challenges that remain

Understanding the context-specific causes of child malnutrition, including those related to political commitment and program and policy coherence, is essential for effectively reducing the prevalence of nutrition-related problems such as stunting and anemia and their subsequent negative impacts on human and national development [1–4]. Between 2005 and 2015 Rwanda made substantial progress in reducing malnutrition, reducing stunting and anemia among children < 5 years of age by 14 and 15 percentage points, respectively [5–7]. Despite these improvements, stunting and anemia remain important nutrition issues for young children in Rwanda with the prevalence of stunting (38%) among the highest in the world [8]. Furthermore, stunting reduction has varied across the country with some districts experiencing declines in stunting (“reduced stunting districts”), while in others stunting has either increased or stayed the same (“nonreduced stunting districts”).