Peer-reviewed article
Spatio-temporal variation of child stunting and associated risk factors in Rwanda.
François Niragire, Jeanine Ahishakiye, Innocent Ngaruye, Charles Ruranga, Joseph Nzabanita et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study analysed data from three Rwandan Demographic and Health Surveys (2010, 2014/15, and 2019/20) to understand why child stunting rates vary across different regions and time periods in Rwanda. The researchers found that certain factors like child's age and birth weight, mother's height, household wealth, and antenatal care visits consistently increase stunting risk. However, the importance of other factors like mother's education and water access changed over time, and stunting patterns differed notably between Rwanda's provinces.
Key points
- Child's gender, birth order, age, birth weight, mother's height, marital status, antenatal care visits, household economic status, and altitude were consistently significant risk factors for stunting across 2010-2020
- The influence of place of residence, mother's education, water source, and toilet facility type varied over the study period
- Spatial effects (district-level variation) decreased in the Eastern province but increased in the Western and Northern provinces
- Risk factors and their importance changed considerably over the ten-year period studied
- Findings indicate need for targeted, district-specific intervention programs from multiple sectors
Limitations
The study identifies associations between risk factors and stunting but does not evaluate any specific intervention, so cannot show what works to reduce stunting. The analysis uses cross-sectional survey data which cannot establish causality.
Abstract
BACKGROUND: The under-five child stunting has remained a public health problem in the world. In Rwanda, child stunting rates have fluctuated significantly and remained higher than the targets despite a continuing decline of the national average rate. The key drivers of the persistently high child stunting rates and their geographical variation in Rwanda are currently not well known. This study examined the spatial and temporal variation of the under-five child stunting rates and associated factors in Rwanda between 2010 and 2020. METHODS: This study analysed data from the 2010 Rwanda Demographic and Health Survey (RDHS) (n = 4075), the 2014/15 RDHS (n = 3538), and the 2019/20 RDHS (n = 3809). A series of geo-additive binary logistic regression analyses were used to identify the key risk factors for child stunting and their variation in Rwanda between 2010 and 2020. RESULTS: The results show significant variation in the key risk factors over the studied period. The child's gender, birth order, age, and birth weight, mother's height and marital status, number of antenatal care visits, household economic status, and altitude were consistently significant factors of child stunting in Rwanda. The influence of place of residence, mother's education, water source, and type of toilet facility varied. The district-level spatial effects significantly attenuated in the Eastern province while they intensified in the Western and Northern provinces. CONCLUSIONS: The key risk factors for the under-five child stunting and their importance varied considerably over time in Rwanda. The findings suggest the need to improve the household-level welfare by strengthening targeted and district-tailored intervention programs from a multi-sectorial perspective, and sustain the programs outcomes beyond the intervention period.