Assessing factors associated with stunting among children aged 6 to 59 months in Nyabihu District. A Case Control

Abstract

INTRODUCTION: Malnutrition is a leading cause of mortality among children around the world, with over 6 million deaths occurring each year and an estimated 155 million worldwide being stunted in 2016. Rwanda has one the highest rates of child stunting in the world with 33%. Therefore, the study aimed to identify factors associated with stunting among 6 to 59 months’ children in Nyabihu district, Rwanda.

METHODS: A matched case-control study design was used to identify factors associated with stunting among children aged 6 to 59 months who attended health centers in Nyabihu district from March to April 2023.A total of 402 (134 cases and 268 control) children with 6 to 59 months of age were included in the study. Cases were selected based on WHO anthropometric measurements and matched with children of the same age and residence. Primary data on social demographic, hygiene and sanitation, feeding practices and clinical characteristics were collected using a structured questionnaire. The data were entered in Excel and exported in STATA for analysis. Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. P values < 0.05 with a 95% confidence level were used to declare statistical significance.

RESULTS: The following factors were significant to child’s stunting: being in Ubudehe cat 1 (AOR 11.1; 95% CI 4.3–8.4), Non-parental caregivers (AOR 3.8; 95% CI 2-7.4) and having more than 2 under-five children (AOR 5; 95% CI 1.5–6.2), mostly Sell agriculture use (AOR 4.3; 95% CI 2.3–7.9), Not treating drinking water (AOR 2.4; 95% CI 1.3- 4.5), Washing hands (AOR 0.08; 95% CI 0.04- 0.1), Not attending ANC (OR 8; 95% CI 1.8– 4.7), Attending mass campaign (AOR 0.34; 95%CI 0.1–0.6).

CONCLUSION: Child stunting remains a public health problem in Nyabihu District. The findings show that the first Ubudehe category, washing hands before child feeding, treating drinking water, more number of under-five children in the household, attending ANC and vaccination campaigns were determinants of stunting. Relieving poverty, strengthening antenatal care, child vaccination and improvement in hygiene and sanitation can help to reduce the stunting rate.