Child stunting prevalence determination at sector level in Rwanda using small area estimation

Area of Science:

• Pediatrics and Child Health
• Public Health and Epidemiology
• Biostatistics

Background:

• Child stunting affects 148.1 million globally (22.3% in 2022).
• Rwanda's 2019/2020 Demographic Health Survey reported 33.5% stunting in children under five.
• Sector-level stunting data is insufficient for targeted interventions in Rwanda.

Purpose of the Study:

• To provide reliable, sector-level estimates of stunting prevalence in Rwandan children under five.
• To identify areas with high stunting rates for prioritized interventions.

Main Methods:

• Utilized Small Area Estimation (SAE) techniques.
• Employed a generalized linear mixed model with significant covariates.
• Generated model-based estimates with Mean Square Error (MSE) for all sectors.

Main Results:

• Only 40 out of 416 sectors met the national stunting target (<19%).
• 194 sectors exceeded the national prevalence (33.5%), predominantly in Northern and Western Provinces.
• Stunting prevalence was lowest in the City of Kigali.
• Factors like household size, residence, head's gender, and access to sanitation/clean water were linked to stunting.

Conclusions:

• Study findings can inform policy decisions for localized interventions in high-stunting sectors.
• Results support targeted strategies to address child stunting in Rwanda.