Peer-reviewed article
Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda - a cross-sectional population-based study.
Albert Ndagijimana, Kristina Elfving, Aline Umubyeyi, Torbjörn Lind ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study identified risk factors for childhood stunting (poor height growth) affecting 27% of children aged 1-36 months in Rwanda's Northern Province. Boys had nearly twice the risk of stunting compared to girls. Key household risks included mothers with lower height or weight, lack of breastfeeding, presence of twins or triplets, single-parent households, and absence of handwashing facilities near toilets. The findings suggest interventions targeting vulnerable groups and improving nutrition and sanitation practices could help reduce stunting.
Key points
- Stunting prevalence was 27.1% in children aged 1-36 months in Northern Province, Rwanda
- Boys had 82% higher risk of stunting than girls (aOR: 1.82)
- Not breastfeeding at interview doubled stunting risk (aOR: 2.00)
- Absence of handwashing facilities near toilets increased stunting risk 3.3-fold (aOR: 3.30)
- Households with twins/triplets and single-parent households faced significantly elevated stunting risk (aOR: 2.60 and 2.07 respectively)
Limitations
This is a cross-sectional study, so it identifies associations but cannot establish causation or temporal relationships. The study does not evaluate any intervention, only identifies risk factors, so it cannot tell us whether addressing these factors would actually reduce stunting.
Abstract
BACKGROUND: Childhood stunting, defined as height-for-age below - 2 standard deviations (SD), disproportionately affects the Northern Province of Rwanda. We investigated risk factors contributing to stunting in this region at individual, household, and societal/community levels to inform future interventions. METHODS: We conducted a population-based, cross-sectional study using a quantitative questionnaire in households with children aged 1-36 months in the Northern Province. Anthropometric measurements of children and mothers were taken to estimate nutritional status. Multivariable logistic regressions were performed to identify independent risk factors of stunting, reporting odds ratios, 95% confidence intervals and p-values. RESULTS: Overall, stunting prevalence was 27.1% in children aged 1-36 months. At the individual level, boys exhibited 82% higher risk of stunting compared to girls (aOR: 1.82, 95% CI: 1.19, 2.78). Household-level factors such as maternal height and BMI were inversely associated with the risk of childhood stunting (aOR: 0.94, 95% CI: 0.90, 0.97 and aOR: 0.92, 95% CI: 0.86, 0.99, respectively). Other risk factors included no breastfeeding at the time of interview (aOR: 2.00, 95% CI: 1.23, 3.25), presence of twins or triplets aged 1-36 months (aOR: 2.60, 95% CI: 1.21, 5.57), female-headed (single parent) households (aOR: 2.07, 95% CI: 1.00, 4.26), and absence of handwashing facilities near the toilet (aOR: 3.30, 95% CI: 1.36, 7.98). No societal/community factors were significantly associated with childhood stunting in the Northern Province. CONCLUSION: Childhood stunting in the Northern Province of Rwanda is associated with several factors that could lend themselves to interventions, e.g., improved handwashing facilities, improved childcare practices and targeting vulnerable groups such as boys, households with twins or single parents. Additionally, a thorough exploration of identified risk factors through qualitative approaches involving all stakeholders in child and maternal nutrition is warranted.