Risk Factors of Underweight Among Under-Five Years Children in Rwanda, 2010

Background: Malnutrition contributes to child morbidity and mortality, impaired psycho-motor development and loss in national productivity in developing countries. Underweight is assessed by weight-for-age index which is a composite index of height-for-age and weight-for-height. It takes into account both acute and chronic malnutrition. Our aim was to determine major risk factors of underweight in children aged from 6 to 59 months in Rwanda.

Methods: A Rwanda Demographic and Health Survey 2010 enrolled 4504 under-fives children from 6270 households. Logistic regression was used to determine risk factors of underweight in bivariate and multivariate analyses.

Results: Anthropometric measurements were valid for 4068 children. Among the 465 under-weighted children (11.4%), 265 were boys (12.8%) and 203 were girls (10%). In multivariate analysis the following risks factors were identified. Being a boy (OR=2.3, 95% CI: 1.6-3.3), birth order (third: OR=2.1, 95% CI:1.1-3.8; fourth: OR=1.8, 95% CI: 1.06-3.3), low birth weight (OR=3.7, 95% CI:1.9-7.3), mother age at childbirth (more than 40th years: OR=4.2 95% CI: 1.9-9.5) and exclusive breast feeding (OR=1.8, 95% CI: 1.1-3.1). Protective factors were children with mother who took iron when pregnancy (OR=0.6 95% CI: 0.42-0.93), mother education (secondary or higher: OR = 0.09, 95% CI: 0.01-0.57) and living in richer and richest households (richer: OR=0.52, 95% CI: 0.28-0.96; richest: OR=0.41, 95% CI: 0.18-0.91).

Conclusion: Mixtures of multilevel actions are needed to improve nutritional status of under-fives children in Rwanda. At risk-groups include birth order (third and fourth); boys; mother’s low educational level; middle, poor and poorest households; low birth weight, age of mother at childbirth (40-49) and children not exclusively breastfeed.

Key words: Rwanda, children, under-fives, underweight, risk factors