Risk factors associated with underweight status in children under five: an analysis of the 2010 Rwanda Demographic Health Survey (RDHS)

Abstract

Background: Under-nutrition contributes to childhood morbidity and mortality, particularly in low-income countries. While Rwanda is one of few countries on track to reduce the prevalence of underweight children under five years old by 50 % from 1990 to 2015 (a target of Millennium Development Goal1), underweight children remain a large public health problem with one out of ten children having low weight-for-age. Methods: We performed a cross-sectional study using 2010 RDHS data on 4177 children under five years of age with weight and height measurements. Children were classified as underweight if their weight-for-age Z scores (WAZs) were <2 standard deviations (SD) and severely underweight if WAZs were <3 SD from the mean of the reference population. We used multivariable logistic regression model to identify child, maternal, and household characteristics associated with being underweight. Results: Eleven percent (469) of the 4177 children sampled were underweight and 2.2 % (90) were severely underweight. After adjusting for possible confounders, we found that children were more likely to be underweight if they were male (OR = 1.42, 95 % confidence interval (CI):1.12, 1.79); had fever in the two weeks prior to survey administration (OR = 1.45, 95 % CI:1.07, 1.97) or were non-singletons compared to first-born singletons (OR = 4.04, 95 % CI:2.12, 7.71). Mothers were more likely to have underweight children if they were over 35 years of age compared to those age 17-24 years (OR = 1.67, 95 % CI:1.04, 2.70); with BMI <18.5 compared to BMI between 18.5 to 24.9 (OR = 2.62, 95 % CI:1.70, 4.04), who had no education or primary education only (OR = 3.56, 95 % CI:1.83, 6.95; OR = 3.49, 95 % CI:1. 87, 6.51, respectively) compared to secondary education or higher, and those who did not have delivery assisted by a skilled provider (OR = 1.33, 95 % CI:1.04, 1.72). Household characteristics associated with underweight children included status in the bottom two wealth quintiles compared to the highest (OR = 1.71, 95 % CI:1.27, 2.30). Conclusion: Rwanda was one of the first countries to achieve Millennium Development Goal1. However, even in light of this success, the prevalence of underweight children remains high. Our analysis of specific child, maternal and household risk factors for under-nutrition may help identify potential interventions to address this remaining burden.

Determinants of Nutritional Status among Children Under five age in Ethiopia: A Further Analysis of the Ethiopian Demographic and Health Survey (EDHS) 2016 Data

“…This is in line with previous related studies in Philippines(44), Libya (45), Ethiopia (17), Uganda (46), Mozambique (47), and Ghana (42). The reason was stated in different literatures; educated women are better informed about optimal child care practices (48), have better practices in terms of hygiene (49,50) feeding (51),and childcare during illness (51)(52)(53), have a greater ability to use the health system (54), are more empowered to make decisions (49). However, the majority (65%) of sampled households' did not attend formal education as a result knowledge of mothers on child care may not be enough.…”

Risk Factors Associated With Childhood Stunting in Rwanda: A Secondary Analysis of the 2014 Nutrition, Markets and Gender (NMG) Survey

“…Given the negative impact of stunting on individual growth, socio-economic development, and achieving the sustainable development goals, effective programs to reduce stunting must be developed. Although many malnutrition-related studies have been conducted in various countries, only one study was in Rwanda identifying the risk factors associated with being underweight (Mukabutera, et al, 2016). In order to design effective programs to further reduce stunting, understanding the risk factors associated with stunting specific to Rwanda is necessary.…”

Risk Factors for Pregnancies Among Females Age 15 to 19 in Rwanda: A Secondary Data Analysis of the 2014/2015 Rwanda Demographic and Health Survey (RDHS)

“…The latest Rwanda Demographic and Health Survey (RDHS 2014-15) found that teenage pregnancy rate had increased from 4.1% in 2005 to 7.3% in 2015, with the rate in some regions reaching as high as 15.8% (National Institute of Statistics of Rwanda (NISR), Ministry of Health (MOH) [Rwanda], 2015). While many studies have used DHS data to study risk factors related to antenatal care, postnatal care, fertility, and nutrition (Manzi et al, 2014;Mukabutera et al, 2016;Ndahindwa et al, 2014), none have studies those related to teenage pregnancies in Rwanda. Accordingly, this study utilized a secondary data analysis method to identify the risk factors contributing to teenage pregnancies in Rwanda.…”