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Ali Mansourian

Ali Mansourian

Professor

Ali Mansourian

How do household living conditions and gender-related decision-making influence child stunting in Rwanda? : A population-based study

Author

  • Jean Nepo Utumatwishima
  • Ingrid Mogren
  • Aline Umubyeyi
  • A Mansourian
  • Gunilla Krantz

Summary, in English

Child stunting (chronic undernutrition) is a major public health concern in low- and middle-income countries. In Rwanda, an estimated 33% of children are affected. This study investigated the household living conditions and the impact of gender-related decision-making on child stunting. The findings contribute to ongoing discussion on this critical public health issue. In December 2021, a population-based cross-sectional study was conducted in Rwanda's Northern Province; 601 women with children aged 1-36 months were included. Stunting was assessed using low height-for-age criteria. The Multidimensional Poverty Index (MPI) was used to determine household socioeconomic status. Researcher-designed questionnaires evaluated gender-related factors such as social support and household decision-making. Multivariable logistic regression analysis identified risk factor patterns. Six hundred and one children were included in the study; 27.1% (n = 163) were diagnosed as stunted; there was a higher prevalence of stunting in boys (60.1%) than girls (39.9%; p<0.001). The MPI was 0.265 with no significant difference between households with stunted children (MPI, 0.263; 95% confidence interval [CI], 0.216-0.310) and non-stunted children (MPI, 0.265; 95% CI, 0.237-0.293). Most households reported a lack of adequate housing (78.9%), electricity (63.0%), good water sources (58.7%), and proper toilets (57.1%). Male-headed households dominated (92% vs. 8.0%; p = 0.018), and women often shared decision-making with their partners. However, 26.4% of women reported forced sexual intercourse within marriage (Odds Ratio [OR] 1.81; 95% CI, 1.15-2.85). Lack of support during illness ([OR], 1.93; 95% CI, 1.13-3.28) and absence of personal guidance (OR, 2.44; 95% CI, 1.41-4.26) were significantly associated with child stunting. Poverty contributes to child stunting in the Northern Province of Rwanda. Limited social support and women's lack of decision-making power in the household increase stunting rates. Interventions should empower women and address the broader social and economic context to promote both women's and children's health.

Department/s

  • Centre for Geographical Information Systems (GIS Centre)
  • Dept of Physical Geography and Ecosystem Science

Publishing year

2024

Language

English

Publication/Series

PLoS ONE

Volume

19

Issue

3

Document type

Journal article

Publisher

Public Library of Science (PLoS)

Topic

  • Public Health, Global Health, Social Medicine and Epidemiology
  • Health Sciences

Keywords

  • Child
  • stunting
  • Gender
  • Social Conditions
  • epidemiology
  • Prevalence
  • Rwanda/
  • Cross-Sectional Studies
  • Growth Disorders
  • Women's Health

Status

Published

ISBN/ISSN/Other

  • ISSN: 1932-6203