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

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.

• Författare: Jean Nepo Utumatwishima; Ingrid Mogren; Aline Umubyeyi; A Mansourian; Gunilla Krantz
• Avdelning/ar: Centrum för geografiska informationssystem (GIS-centrum); Institutionen för naturgeografi och ekosystemvetenskap
• Publiceringsår: 2024
• Språk: Engelska
• Publikation/Tidskrift/Serie: PLoS ONE
• Volym: 19
• Issue: 3
• Länkar: http://dx.doi.org/10.1371/journal.pone.0290919
• Dokumenttyp: Artikel i tidskrift
• Förlag: Public Library of Science (PLoS)
• Ämne: Public Health, Global Health, Social Medicine and Epidemiology; Health Sciences
• Nyckelord: Child; stunting; Gender; Social Conditions; epidemiology; Prevalence; Rwanda/; Cross-Sectional Studies; Growth Disorders; Women's Health
• Status: Published
• ISBN/ISSN/Övrigt: ISSN: 1932-6203