Manasseh Eric Muvandimwe2025-09-222025-09-222018-05-18https://dspace.ughe.org/handle/123456789/1008Introduction: Malnutrition globally remains a public health concern affecting 206 million under-nutrition children that is complex and needs special attention. In Rwanda, stunting continues to be a threat to the development in various ways, including weakening the intellectual capacity of children. Moderate acute malnutrition (MAM) is higher among under-five children than severe acute malnutrition (SAM) and easy to manage through outpatient malnutrition programs, but still receives less attention. Poor recovery of MAM is a leading factor in stunting, however, the factors affecting the delayed recovery of MAM children remains unknown. Objective: To identify the factors affecting poor growth among MAM children enrolled in the supplemental feeding program (SFP) in the rural health center of Rwanda, and provides proper recommendations. Methods: Mixed method study, with 24 participants, both caregivers and healthcare workers working in the SFP in December 2017. The sample of eligible caregivers were obtained from the nutrition register book available at the Health Center among those whose children were enrolled in SFP from April to June 2017. A survey and semi-structured interview guide were used. The quantitative data summarized using descriptive statistics, and the qualitative data using content and thematic analysis and presented as topics supported by quotes. Results: Six factors affecting the delayed recovery of MAM children enrolled in the SFP were identified, enrolled children do not consume the provided support due to sharing/ selling, limited family planning, insufficient food and poverty, inadequate child care, poor service, and low attendance at the community-based nutrition program (CBNP). Furthermore, increasing the support or the length of SFP, the involvement of local leaders, establishing early childhood development centers, improving health service including communication and home visit, and accountability of caregivers, were proposed as ways forward. The major benefit of the SFP was the knowledge of nutrition practices. Conclusion: Gaps in households and health facilities continue to affect MAM Children enrolled in the SFP. Interventions based on the identified contributing factors and suggestions obtained may improve the SFP and nutrition status of underfive children in Rwanda. Keywords: Malnutrition, Moderate acute malnutrition, Supplementary food program, delay recovery, RwandaenMalnutritionFood programRural health centerRwandaPublic healthNutritionHealth facilitiestext::thesis