Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study

Abstract Background Childhood stunting, defined as height-for-age below − 2 standard deviations (SD), disproportionately affects the Northern Province of Rwanda. We investigated risk factors contributing to stunting in this region at individual, household, and societal/community levels to inform fut...

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Main Authors: Albert Ndagijimana, Kristina Elfving, Aline Umubyeyi, Torbjörn Lind
Format: Article
Language:English
Published: BMC 2025-03-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-22329-8
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author Albert Ndagijimana
Kristina Elfving
Aline Umubyeyi
Torbjörn Lind
author_facet Albert Ndagijimana
Kristina Elfving
Aline Umubyeyi
Torbjörn Lind
author_sort Albert Ndagijimana
collection DOAJ
description Abstract Background Childhood stunting, defined as height-for-age below − 2 standard deviations (SD), disproportionately affects the Northern Province of Rwanda. We investigated risk factors contributing to stunting in this region at individual, household, and societal/community levels to inform future interventions. Methods We conducted a population-based, cross-sectional study using a quantitative questionnaire in households with children aged 1–36 months in the Northern Province. Anthropometric measurements of children and mothers were taken to estimate nutritional status. Multivariable logistic regressions were performed to identify independent risk factors of stunting, reporting odds ratios, 95% confidence intervals and p-values. Results Overall, stunting prevalence was 27.1% in children aged 1–36 months. At the individual level, boys exhibited 82% higher risk of stunting compared to girls (aOR: 1.82, 95% CI: 1.19, 2.78). Household-level factors such as maternal height and BMI were inversely associated with the risk of childhood stunting (aOR: 0.94, 95% CI: 0.90, 0.97 and aOR: 0.92, 95% CI: 0.86, 0.99, respectively). Other risk factors included no breastfeeding at the time of interview (aOR: 2.00, 95% CI: 1.23, 3.25), presence of twins or triplets aged 1–36 months (aOR: 2.60, 95% CI: 1.21, 5.57), female-headed (single parent) households (aOR: 2.07, 95% CI: 1.00, 4.26), and absence of handwashing facilities near the toilet (aOR: 3.30, 95% CI: 1.36, 7.98). No societal/community factors were significantly associated with childhood stunting in the Northern Province. Conclusion Childhood stunting in the Northern Province of Rwanda is associated with several factors that could lend themselves to interventions, e.g., improved handwashing facilities, improved childcare practices and targeting vulnerable groups such as boys, households with twins or single parents. Additionally, a thorough exploration of identified risk factors through qualitative approaches involving all stakeholders in child and maternal nutrition is warranted.
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spelling doaj-art-3efb01c4b22e43eea756302d4073651f2025-08-20T03:39:57ZengBMCBMC Public Health1471-24582025-03-0125111110.1186/s12889-025-22329-8Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based studyAlbert Ndagijimana0Kristina Elfving1Aline Umubyeyi2Torbjörn Lind3Department of Clinical Sciences, Pediatrics, Umeå UniversitySchool of Public Health and Community Medicine, Gothenburg University and The Queen Silvia’s Children HospitalCollege of Medicine and Health Sciences, School of Public Health, University of RwandaDepartment of Clinical Sciences, Pediatrics, Umeå UniversityAbstract Background Childhood stunting, defined as height-for-age below − 2 standard deviations (SD), disproportionately affects the Northern Province of Rwanda. We investigated risk factors contributing to stunting in this region at individual, household, and societal/community levels to inform future interventions. Methods We conducted a population-based, cross-sectional study using a quantitative questionnaire in households with children aged 1–36 months in the Northern Province. Anthropometric measurements of children and mothers were taken to estimate nutritional status. Multivariable logistic regressions were performed to identify independent risk factors of stunting, reporting odds ratios, 95% confidence intervals and p-values. Results Overall, stunting prevalence was 27.1% in children aged 1–36 months. At the individual level, boys exhibited 82% higher risk of stunting compared to girls (aOR: 1.82, 95% CI: 1.19, 2.78). Household-level factors such as maternal height and BMI were inversely associated with the risk of childhood stunting (aOR: 0.94, 95% CI: 0.90, 0.97 and aOR: 0.92, 95% CI: 0.86, 0.99, respectively). Other risk factors included no breastfeeding at the time of interview (aOR: 2.00, 95% CI: 1.23, 3.25), presence of twins or triplets aged 1–36 months (aOR: 2.60, 95% CI: 1.21, 5.57), female-headed (single parent) households (aOR: 2.07, 95% CI: 1.00, 4.26), and absence of handwashing facilities near the toilet (aOR: 3.30, 95% CI: 1.36, 7.98). No societal/community factors were significantly associated with childhood stunting in the Northern Province. Conclusion Childhood stunting in the Northern Province of Rwanda is associated with several factors that could lend themselves to interventions, e.g., improved handwashing facilities, improved childcare practices and targeting vulnerable groups such as boys, households with twins or single parents. Additionally, a thorough exploration of identified risk factors through qualitative approaches involving all stakeholders in child and maternal nutrition is warranted.https://doi.org/10.1186/s12889-025-22329-8ChildCommunityFactorsHouseholdIndividualLMICs
spellingShingle Albert Ndagijimana
Kristina Elfving
Aline Umubyeyi
Torbjörn Lind
Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study
BMC Public Health
Child
Community
Factors
Household
Individual
LMICs
title Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study
title_full Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study
title_fullStr Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study
title_full_unstemmed Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study
title_short Identification of amendable risk factors for childhood stunting at individual, household and community levels in Northern Province, Rwanda – a cross-sectional population-based study
title_sort identification of amendable risk factors for childhood stunting at individual household and community levels in northern province rwanda a cross sectional population based study
topic Child
Community
Factors
Household
Individual
LMICs
url https://doi.org/10.1186/s12889-025-22329-8
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AT alineumubyeyi identificationofamendableriskfactorsforchildhoodstuntingatindividualhouseholdandcommunitylevelsinnorthernprovincerwandaacrosssectionalpopulationbasedstudy
AT torbjornlind identificationofamendableriskfactorsforchildhoodstuntingatindividualhouseholdandcommunitylevelsinnorthernprovincerwandaacrosssectionalpopulationbasedstudy