Prevalence of Stunting and Associated Factors Among Children of Under Five Years with Disabilities in Bugesera District, Eastern Province of Rwanda

Abstract

Background: There are nearly 240 million children with disabilities globally among numerous challenges they face nutrition difficulties are very common and this leads to inadequate nutrition which seriously affects disabled children in terms of thriving, brain development, physical growth and prone to diseases. Stunting is still a public health problem among the general population in LMIC. The burden doubles among children with disabilities due to inadequate or excess dietary intake which worsens their nutrition status and deterioration of their conditions. The aim of this study was to assess prevalence of stunting and associated factor among disabled children under five years in Bugesera district.

Method: This was a cross-sectional descriptive study with the main objective of assessing prevalence of stunting and associated factors among children under the age of five years with disabilities in Bugesera District. Multistage sampling technique was applied where 8 sectors have been randomly selected and from each sector probability proportion to size sampling (PPS) was applied to identify the study participants in each sector. Weight was obtained using standard electronic balance scale, height was measured using wooden height board and children less than 24 months lengths were obtained in recumbent position. Height for age was classified according WHO z-score standards. Socioeconomic factors and sociodemographic were obtained through an administered questionnaire. Description of independent variables was done through Percentages and frequency tables. Height for age(haz) was obtained by zscore06 stata function, bivariate analysis was obtained with chi-square (X2 ) test to determine the associated factors among children with disabilities. Logistic regression was used for multivariate analysis to test the strength of association of multiple factors.

Results: In total 265 children were recruited and the majority were aged between 25-59 months. The high attained level of education by the parents was primary school 51.70% and 53.96% father and mother respectively. The most occupation for both parents was farming. Prevalence of stunting among disabled children under the age of five in Bugesera district was 44.91%. A positive association of being stunted was found in: age 25-59 months (aOR = 4.18 [95% CI: 1.71 - 10.23]), incomplete child immunization (aOR = 4.4 [95% CI: 1.16 - 16.69]) and rural residence (aOR = 3.08 [95% CI: 1.05 - 8.99] and parents education.

Conclusion: The prevalence of stunting among under five children with disabilities is high and being in preschool age, incompletely immunized, living in rural and no formally educated parents are associated with high risk of stunting among these children. There is a need to address stunting among disabled children through a strong program on parental education about nutritional guidance and support, quality healthcare including child full immunization. Further studies on magnitude of stunting among disabled children on national level are also needed.