Livestock ownership, ASF consumption and child nutrition in Rwanda: a multilevel mixed effect approach

Livestock-derived animal source foods (ASF) provide macro and micronutrients required for child growth and development, yet are under-consumed in many parts of the world where undernutrition persists. Using a modified conceptual framework of the social determinants of health, this study investigates the interrelationship between livestock ownership, ASF consumption, and child undernutrition (wasting, stunting, and underweight) in Rwanda. Using Demographic and Health Survey (DHS) data from 3438 children aged 6-59 months and employing a multilevel mixed effects model, we investigate these interrelationships nationally, then focus on the Eastern Province and Nyagatare district, an area of high livestock production. Findings reveal that livestock ownership is significantly negatively associated with stunting ( $-0.056,p=0.048$ ) and underweight $(-0.047,p=0.003$ ); no significant association was found with wasting. No direct relationship between ASF consumption and child undernutrition was identified at the national level, though children who consumed ASF and lived in households with livestock were 6% ( $-0.063,p=0.048$ ) less likely to be stunted and 3.6% ( $-0.036,p=0.047)$ less likely to be underweight. The effect of livestock ownership was particularly pronounced in Nyagatare district, where children in households with livestock were 35% ( $-0.355,p=0.032$ ) less likely to be stunted than children in households without livestock. The study also found important associations with other social determinants of health, including maternal education and economic status, among others. Findings underscore the important role of livestock ownership in Rwanda and the need for a multi-disciplinary approach in leveraging increased ASF consumption to improve child nutrition outcomes.