Child stunting and associated risk factors in selected food-insecure areas in Rwanda: an analytical cross-sectional
François Niragire1, Celestin Ndikumana2, Marie Gaudence Nyirahabimana3
1Department of Applied Statistics, University of Rwanda, Kigali, Rwanda.
Insights
In Rwanda, higher birth weight, economic status, urban living, and health insurance significantly reduce child stunting. Targeted nutrition programs are crucial for vulnerable populations.
Area of Science:
- Child Nutrition
- Public Health
- Socioeconomic Determinants
Background:
- Child stunting remains a significant public health challenge in Rwanda, with unexpectedly lower rates in impoverished districts.
- This study investigates protective factors against stunting in under-five children within high-poverty areas.
Purpose of the Study:
- To identify key factors that mitigate child stunting in the poorest districts of Rwanda.
- To understand the drivers of lower-than-expected stunting rates in these areas.
Main Methods:
- Analysis of cross-sectional data from the 2019/2020 Rwanda Demographic and Health Survey (RDHS).
- Inclusion of 477 under-five children from Karongi, Rulindo, Nyanza, and Gisagara districts.
- Application of univariate, bivariate, and multivariable binary logistic regression analyses.
Main Results:
- Child stunting rate in study districts was 30%, lower than the national average.
- Protective factors included birth weight ≥ 2.5 kg, high household economic status, urban residence, and health insurance coverage.
- Increased odds of stunting were associated with older children (≥1 year) and female-headed households.
Conclusions:
- High health insurance uptake significantly improves healthcare access and nutritional outcomes.
- Child nutrition programs should enhance healthcare service utilization and nutrition education, particularly for pregnant and lactating women.
- Interventions targeting socioeconomic factors and healthcare access are vital for reducing child stunting in low-income Rwandan settings.
Introduction:
stunting rates among the under-five children are generally high in Rwanda. They are unexpectedly lower than the national average stunting rate in some districts where poverty rates are the highest in the country. This study aimed to ascertain the key factors that protect children from stunting in these poorest areas, where stunting rates are lower than expected.
Methods:
we analysed cross-sectional data from 2019/2020 Rwanda Demographic and Health Survey (RDHS) for 477 under-five children from Karongi, Rulindo, Nyanza, and Gisagara districts. Univariate and bivariate statistical analyses were used to find out the factors to retain for multivariable analysis. We obtained the key risk factors of child stunting through a multivariable binary logistic regression analysis.
Results:
the child stunting rate in the study districts was 30 percent, which is three percent lower than the national average rate. Child stunting was negatively associated with a birth weight of at least 2.5 kg (AOR = 0.393, 95% CI: 0.180 - 0.856), a high household economic status (AOR = 0.506, 95%CI: 0.273 - 0.937), urban residence (AOR = 0.467; 95% CI: 0.222 - 0.984), and health insurance coverage (AOR = 0.418; 95% CI: 0.228 -0.767). Children aged one year and above, as well as female-headed households, were associated with at least three times and two times greater odds of child stunting than children aged below 12 months and those from male-headed households respectively.
Conclusion:
the nutritional performance of children in the study districts is substantially driven by the high uptake of health insurance, which fosters increased access to healthcare services. To address child-stunting gaps in low-income areas in Rwanda, child nutrition programs should improve the utilization of healthcare services, and leverage the potential high effect of nutrition education, especially during pregnancy and lactation.
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