Trend and determinants of underweight among children aged under five years in Rwanda: secondary data analysis using...

Area of Science:

• Pediatrics
• Public Health
• Global Health

Background:

• Underweight among children under five years old is a persistent global public health challenge, disproportionately affecting low- and middle-income countries.
• Globally, significant numbers of children experience stunting (149 million), wasting (45 million), and overweight (37 million), highlighting the complex spectrum of child malnutrition.
• Rwanda has focused on improving child health outcomes, necessitating an understanding of the trends and drivers of underweight within its population.

Purpose of the Study:

• To analyze the trends in underweight prevalence among children under five years old in Rwanda from 2005 to 2020.
• To identify the key determinants associated with underweight in this vulnerable age group.
• To provide evidence for targeted interventions to further reduce child underweight and achieve Sustainable Development Goals (SDGs).

Main Methods:

• A pooled data analysis was conducted using four consecutive Rwanda Demographic and Health Surveys (RDHS) from 2005, 2010, 2015, and 2019/20.
• A total of 15,561 children under five years were included, with sample weights applied for national representativeness.
• Descriptive statistics, bivariate analysis, and multivariable logistic regression were employed to assess trends and identify significant risk and protective factors.

Main Results:

• The prevalence of underweight among children under five in Rwanda decreased substantially by 64% over 15 years, from 21.7% in 2005 to 7.7% in 2020.
• Independent risk factors for underweight included male sex, very small or smaller than average birth size, low birth weight (<2.5 kg), lack of antenatal care, recent diarrhea, and Muslim religion.
• Maternal age groups 20-24, 25-29, and 35-39 years showed protective effects against underweight compared to mothers aged 40 years and above.

Conclusions:

• Rwanda has made significant and sustained progress in reducing child underweight, attributed to enhanced maternal health services, nutrition programs, and socioeconomic development.
• Despite progress, underweight remains a concern, particularly for male children, those with low birth weight, and those experiencing illness or inadequate antenatal care.
• Continued multi-sectoral efforts focusing on strengthening antenatal care, reducing low birth weight, and managing childhood illnesses are crucial for achieving SDG targets.