title: Making progress towards food security: evidence from an intervention in three rural districts of Rwanda.
abstract: 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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: 1Partners In Health/Inshuti Mu Buzima,PO Box 3432,Kigali,Rwanda.
authors.forename: Vincent
authors.initials: V
authors.lastname: Nsabuwera
authors.affiliation: 1Partners In Health/Inshuti Mu Buzima,PO Box 3432,Kigali,Rwanda.
authors.forename: Bethany
authors.initials: B
authors.lastname: Hedt-Gauthier
authors.affiliation: 3Médecins sans Frontières (MSF)/Luxembourg.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khogali
authors.affiliation: 4International Union Against Tuberculosis and Lung Diseases,Paris,France.
authors.forename: Mary
authors.initials: M
authors.lastname: Edginton
authors.affiliation: 6Centre for International Health,University of Bergen,Norway.
authors.forename: Sven G
authors.initials: SG
authors.lastname: Hinderaker
authors.affiliation: 1Partners In Health/Inshuti Mu Buzima,PO Box 3432,Kigali,Rwanda.
authors.forename: Marie Paul
authors.initials: MP
authors.lastname: Nisingizwe
authors.affiliation: 7Kirehe District,Ministry of Local Government,Rwanda.
authors.forename: Jean de Dieu
authors.initials: Jde D
authors.lastname: Tihabyona
authors.affiliation: 8Kayonza District,Ministry of Local Government,Rwanda.
authors.forename: Benoit
authors.initials: B
authors.lastname: Sikubwabo
authors.affiliation: 9Burera District,Ministry of Local Government,Rwanda.
authors.forename: Samuel
authors.initials: S
authors.lastname: Sembagare
authors.affiliation: 1Partners In Health/Inshuti Mu Buzima,PO Box 3432,Kigali,Rwanda.
authors.forename: Antoinette
authors.initials: A
authors.lastname: Habinshuti
authors.affiliation: 1Partners In Health/Inshuti Mu Buzima,PO Box 3432,Kigali,Rwanda.
authors.forename: Peter
authors.initials: P
authors.lastname: Drobac
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005191:Family Characteristics; D005260:Female; D005523:Food Supply; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012424:Rural Population; D012432:Rwanda; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Food accessibility; Food consumption; Food security; Operational research