Objective: Determining interventions to address food insecurity and poverty, as
well as setting targets to be achieved in a specific time period have been a
persistent challenge for development practitioners and decision makers. The
present study aimed to assess the changes in food access and consumption at the
household level after one-year implementation of an integrated food security
intervention in three rural districts of Rwanda.
Design: A before-and-after intervention study comparing Household Food
Insecurity Access Scale (HFIAS) scores and household Food Consumption Scores
(FCS) at baseline and after one year of programme implementation.
Setting: Three rural districts of Rwanda (Kayonza, Kirehe and Burera) where the
Partners In Health Food Security and Livelihoods Program (FSLP) has been
implemented since July 2013.
Subjects: All 600 households enrolled in the FSLP were included in the study.
Results: There were significant improvements (P<0·001) in HFIAS and FCS. The
median decrease in HFIAS was 8 units (interquartile range (IQR) -13·0, -3·0) and
the median increase for FCS was 4·5 units (IQR -6·0, 18·0). Severe food insecurity
decreased from 78 % to 49 %, while acceptable food consumption improved from
48 % to 64 %. The change in HFIAS was significantly higher (P=0·019) for the
poorest households.
Conclusions: Our study demonstrated that an integrated programme, implemented
in a setting of extreme poverty, was associated with considerable improvements
towards household food security. Other government and non-government
organizations’ projects should consider a similar holistic approach when designing
structural interventions to address food insecurity and extreme poverty.