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By Annonciata Byukusenge
The nutritious foods access program aimed to end malnutrition and boost the health of stunted children and pregnant women. Unfortunately, Rwanda still has vulnerable people suffering from malnutrition because corruption became a barrier to the vulnerable people who are eligible for this program.
After the Genocide against the Tutsi in 1994, the government of Rwanda established a program of providing nutritious foods for stunted children and poor pregnant women in 1995. This program also started with the Rwanda Community Health program, which had about 12,000 cell-level volunteers to mobilize communities through health education/public awareness to seek medical care in health facilities. The number of Community Health Workers expanded to 58,567 in 2018 with the service packages.
To address corruption in the health sector, health providers must stay accountable. This would help them make decisions based on the transparency they have acquired especially through the health service provided to the community. In Rwanda, like in many African countries population and some leaders still respect accountability as a sure source of transparency. However, this would not be possible if many public and private institutions were ignorant of the corruption danger.
A mother named Umwiza wakes up at five in the morning every day. Her main activity consists of farming in the farms of her neighbors located at Karama, a remote rural village in the Ruhashya sector, the Huye district in Southern Rwanda.
This 26-year-old mother never envisioned that she would use her energy to farm on her neighbors’ farms to get food for her children to live well.
He said, “The government has done everything possible to fight malnutrition for children, stunting among children and pregnant women from vulnerable families. But it is not being achieved due to the corruption of some local leaders who demand money that our children be allowed nutritious food; unfortunately, we don’t have money because we are poor to be supported.”
In Rwanda, stunted children and pregnant women receive support with nutritious foods. Out of the many people who need aid, local authorities must choose the most vulnerable individuals for this support. However, this may constitute a gap as the Rwanda Governance Board (RGB, 2018) has found that some local leaders act corruptly when choosing the beneficiaries of other programs aimed at helping the poor. RGB found evidence of fraudulent practices used by the GIRINKA Program’s beneficiaries, including bribery (RGB, 2018).
In 2024, the data shows that the Local Government (LG) has the highest share of bribes at 56%. This indicates a significant level of corruption within local government institutions, which can lead to inefficiency in governance, misuse of public funds, and loss of public trust. For the community, this translates to poor service delivery, limited access to essential services, and increased inequality. People might have to pay bribes to get basic services like permits or approvals, which can delay projects and increase costs unfairly.
Umwiza is sitting in front of the door; she is breastfeeding a one-month and ten-day-old baby. Behind her are three other children. The firstborn is four years old, the second is three years old, and the third is two years old.
“From the eldest child to the breasting kid, in the community assembly known as (Inteko y’abaturage), the people vote for vulnerable families to support, but the health community workers do not write me, because they change everything. What the assembly voted for is not the same as what they submit to the district level, “said Umwiza.
Her colleague named Karabo is breastfeeding a three-month-old baby. She is sitting on the maize farm. She is reaching for sweet potatoes for dinner. When she was pregnant, she received nutritious porridge for four months only.
“A Health Community worker in our village told me that the porridge packages ended. For the next month, she told me the same message, and the third month too, but other pregnant women still receive it. I decided to stay at home even though the other pregnant women from rich families are receiving porridge,” said Karabo.
She added that she tried to ask a health community worker if the porridge ended or if there was another requirement to be eligible, but she did not get feedback.
“She told me what you want to understand again. The porridge ended. You are poor; you are not eligible for the rest packages. Until now, I am afraid that my kid could suffer from malnutrition and stunting because I do not have enough nutritious food as a breastfeeding woman.”
How corruption affected the daily life of vulnerable families in the Gisagara district
Poor pregnant women and stunted children from vulnerable families supposed to be enrolled in government Food aid, now are struggling with malnutrition and stunting because they are not able to feed their kids nutritious food themselves.
A mother named Mugisha lives in the Save sector, Gisagara district. Last year was a beneficiary of the nutritious food program. In August 2024, a health community worker told her if she could not provide any amount, the next month’s machine would forget her name.
“The reality here is that when you are not able to provide money to some authorities, you cannot access any service. As he said, in September 2024 my name disappeared from the list of people eligible for the porridge and money.”
The nutritious foods access program aimed to end malnutrition and boost the health of stunted children and pregnant women. Unfortunately, some health community workers and some local leaders’ tranche for other services.
“Each month we suppose to receive ten thousand Rwandan francs (10.000 Frws), but they settled a good thing to give us that money periodically in three months 30.000 Frws, to use the important things in our family.”
“On the day of withdrawing that money, they tranche seven thousand (7.000 Frws) for social security (Ejo Heza), five thousand (5.000 Frws) for RPF contribution, three thousand (3.000 Frws) for supporting the unknown person and one thousand (1.000 Frws) for service commission. The rest money is 14.000 Rwfrs cannot help me to buy any food for my four kids.” Said Mugisha.
[30.000 Frws-7.000 Frws-5.000 Frws-3.000 Frws-1.000 Frws= 14.000Frws]
“When the time of withdrawing that money you go to the shop and get a loan of food for kids. I can keep food for 20.000 Frws and finally, I can get 14.000 Frws. This is the problem.”
Her neighbor named Kaliza lives in Byamaguri village in the Save sector, Gisagara district. She has one kid one year and four months old. In February 2023, she was eligible for monetary aid, but in August 2023 received a message that she was not eligible for the monetary aid.
“At the health center told me that I am not eligible for the monetary aid, because my money is pending in the sky. The system of registering people is not working for me. From August 2023 till now I am eligible for nutritious porridge only.” Said Kaliza.
I tried to contact the officials from Gisagara and Huye districts, but not yet get their feedback.
What does Transparency International Rwanda say about paying free services?
Transparency International Rwanda says that there are many reasons for paying free services according to the findings from the Rwanda Bribery Index (RBI) 2024.
Perceived reasons for paying bribe 2024
Most people, 41.8%, paid bribes to speed up services. This shows that many services are slow, and people feel they need to pay to get things done faster. Another 25.9% paid bribes because they thought it was the only way to get the service. Smaller groups paid bribes to avoid problems with authorities, which accounted for 13.3%, or to avoid paying the full cost of services, which was 3.9%. Some, 12.2%, paid bribes to get services they were not entitled to.
What is about corruption risk assessment in the Health sector and paying bribe 2024?
The nutritious foods are supports given to the most vulnerable people including poor pregnant women and stunted children. In the process of selecting beneficiaries of this support, local leaders and community health workers use the categories of UBUDEHE. Eligible beneficiaries are those from low- income families in categories 1 or 2 who have been diagnosed by community health providers as malnourished. However, these activities are sometimes characterized by corruption in the form of bribery and illegal benefits given to local leaders, especially at the cell level to be registered among the beneficiaries of such government programs aimed at supporting vulnerable citizens.
There are also some cases where beneficiaries are selected based on favouritism. An FGD participant from one of the districts selected for this assessment In fact, the guidelines say that nutritious foods are given to pregnant women and children who show signs of malnutrition who are in UBUDEHE category 1. However, in some instances, selection criteria are not being followed, and nutritious foods are sometimes given to families who are not eligible. Members of the community health worker program together with local leaders select the most vulnerable citizens to receive nutritious foods. Although you generally see that they are trying to perform these duties well, there is some favouritism in the process. A participant in FGDs of healthcare clients.
In fact, there are families who receive nutritious foods yet are not eligible while on the other hand some poor families are denied this assistance. This makes one suspect that it is due to family ties or friendships between some recipients of such aid and community health members who are in charge of selecting beneficiaries. A participant in FGDs of healthcare clients
The National Child Development Agency (NCDA) has few staff but it’s held accountable on issues that should be sorted out and followed-up by the Ministry of Local Government (MINALOC) and districts. For instance, for some cases, health facilities decry shortage of the stock while the stock is full at district level. Over and above, due to lack of coordination and monitoring, some nutritious foods are misused swindled or be provided on the basis of corruption. One senior staff from national level health institutions
The report also highlights bribery in the judiciary and healthcare sectors. In local government offices, 39.1% of respondents reported bribery related to issuing construction permits. Police corruption related to driving licenses stands at 36.6%, while judges have been found accepting bribes ranging from 500,000 to 600,000 RWF.
In 2024, Rwandans paid a total of 17,041,203 RWF in bribes, down from 22,814,500 RWF in 2023. The majority of bribes came from local government offices (56%), followed by the police (18%) and the judiciary (11%).
Dr. Bruce Gashema is a researcher at Transparency International Rwanda. He says that some leaders require money from the people to pay free services, does not mean they are not aware of the corruption.
“Transparency International is always engaged with government institutions to raise awareness about corruption among leaders at both the national and local levels. Using Rwanda’s anti-corruption laws, regulations, and guidelines, training, workshops, and media campaigns are used to raise awareness among leaders and other key stakeholders. Therefore, it is corrupt for certain leaders to demand payment for services that are provided for free, and they should not behave as though they are unaware of this.” Said Dr. Gashema.
About the support of Transparency to the people who have problems of paying free services in their villages, Dr. Gashema says that “TI-Rwanda maintains solid relations with the government institutions responsible for the legal system, the anti-corruption organizations, and other entities. Therefore, when corruption issues are found, advocacy is done and solutions are often sought.”
Perception on whether corruption has decreased in Rwanda (2024)
Most respondents, 65.8%, believe that corruption has decreased over the past year.
Specifically, 56.7% think it has decreased somewhat, and 9.1% believe it has decreased a lot. This indicates that the government’s anti-corruption measures are having a positive impact. However, 12.2% of respondents feel that corruption has increased, with 3.5% saying it has increased a lot and 8.7% saying it has increased somewhat. Additionally, 16.3% believe the level of corruption has remained the same, and 5.8% are unsure. This mixed perception suggests that while there is significant progress, there are still areas that need attention.
According to the Rwanda Governance Board, the Anti-Corruption, Transparency & Accountability scored 86.65% in the 11th edition of the Rwanda Governance Scorecard (RGS) 2024.
CHAPTER III: OFFENCES AND PENALTIES FOR CORRUPTION
Article 4: Solicit, accept, or offer illegal benefit
Any person, who solicits, accepts, or receives, by any means, an illegal benefit for himself/ herself or another person or accepts a promise to render, or omit a service under his or her mandate or uses his or her position to render or omit a service commits an offense.
Upon conviction, he/she is liable to imprisonment for a term of more than five (5) years but not more than seven (7) years with a fine of three (3) to five (5) times the value of the illegal benefit solicited received.
