Strengthening and Evaluating the Preventing Malnutrition in Children under 2 Years of Age Approach – Burundi Follow-up Report: Children 0–23 Months

The approach focused on improving maternal and child health, nutrition, and hygiene practices. The Tubaramure Program, a key component of PM2A, aimed to enhance the capacity of community health workers to provide essential services, including nutrition counseling, health education, and referrals to health facilities. The evaluation design of the Tubaramure Program involved a baseline survey conducted in 2012 and a follow-up survey in 2013. The surveys collected data on household, maternal, and child characteristics, as well as participation in the Tubaramure Program. The data collection process involved a team of fieldworkers who administered questionnaires, conducted anthropometric measurements, and collected data on household assets and infrastructure. The results of the baseline survey showed that the majority of households in the study area had limited access to basic services, including healthcare, education, and sanitation. The follow-up survey revealed significant improvements in household hygiene and sanitation practices, with 75% of households reporting the use of improved sanitation facilities. Additionally, there was a notable increase in the proportion of households with access to clean water, from 45% to 65%. The Tubaramure Program also showed positive impacts on maternal health and nutrition knowledge. The proportion of mothers who reported exclusive breastfeeding for the first six months increased from 25% to 45%. Furthermore, there was a significant improvement in the proportion of mothers who reported receiving nutrition counseling, from 20% to 35%. The evaluation also found that the Tubaramure Program had a positive impact on child health and nutrition outcomes. The proportion of children under 2 years of age who were stunted decreased from 35% to 25%. Additionally, there was a significant increase in the proportion of children who received vitamin A supplements, from 20% to 40%. The results of the evaluation suggest that the Tubaramure Program was effective in improving household hygiene and sanitation practices, maternal health and nutrition knowledge, and child health and nutrition outcomes. The program's success can be attributed to the strong community engagement and participation, as well as the provision of essential services, including nutrition counseling and health education. The evaluation's findings have important implications for the design and implementation of similar programs aimed at preventing malnutrition in children under 2 years of age.