An empirical study of factors associated with height-for-agez-scores of children aged 6−23 months in northwest Rwanda: the role of care practices related to child feeding and health

Abstract

We aimed to identify the factors influencing child height-for-age z-scores (HAZ) as a measure of child nutritional status in Rwanda, and to examine the role of child feeding and health practices. We conducted a cross-sectional study involving 379 children (aged 6–23 months) and their mothers in northwest Rwanda. Data were collected using a pre-tested, structured questionnaire. An infant and young child feeding practices index (ICFI) and health practices index (HPI) were developed and categorised into tertiles, and linear regression analyses were performed to assess their association with child HAZ. Overall, mothers of non-stunted children exhibited better feeding and health practices than those of stunted children. ICFI was positively associated with child HAZ. We found an adjusted mean HAZ difference of 0·14 between children whose mothers were in high ICFI tertile compared with those in low tertile. Neither HPI nor any of its components were significantly associated with child HAZ. Other factors that were positively associated with child HAZ were infant birth weight (P < 0·001) and maternal height (P < 0·001). Child age, sex (male) (P < 0·05) and altitude (P < 0·05) were negatively associated with child HAZ. Diarrhoea (P < 0·05) and respiratory infections (P < 0·05) were negatively associated with HAZ in younger children aged 6–11 months. Policies to reduce stunting in this population must focus on both pre- and postnatal factors. Appropriate child feeding practices, particularly breast-feeding promotion and improvement in children’s dietary diversity combined with measures to control infections should be given priority.

Spatial variation and determinants of inappropriate complementary feeding practice and its effect on the undernutrition of infants and young children aged 6 to 23 months in Ethiopia by using the Ethiopian Mini-demographic and health survey, 2019: spatial and multilevel analysis

“…The prevalence of underweight and wasting in this study was lower than in studies in Indonesia (26 and 23%, respectively) ( 51 ) and India (43.4 and 43.7%, respectively) ( 50 ). The stunting in this study was lower than in a study in Rawad (39%) ( 52 ), but higher than in studies in Indonesia (28%) ( 51 ), Mongolia (6.3%) ( 14 ), and rural areas of China (7.1%) ( 53 ). Wasting in this study was also higher than in studies in Tanzania (6%) ( 48 ) and rural areas of China (3.0%) ( 53 ).…”

Pooled prevalence and its determinants of stunting among children during their critical period in Ethiopia: A systematic review and meta-analysis

“…From random effects model estimate, the pooled odds of developing stunting was higher among children who received less than four food score than children who provided greater than four varieties of food items which is similar to a study in Rwanda [ 19 , 20 ]. If Children did not feed the recommended diversified food in their life window, it is inevitable to be exposed for stunted growth, development, morbidity and mortality.…”

“…Several studies indicated that various factors contribute to the developments of stunting in less than 24 months children. For example, maternal age [ 14 , 15 ], maternal education [ 16 ], child age [ 17 ], having more than one child under 2 years of age in the household [ 18 ], minimum dietary diversity, consumption of animal sourced food, child’s sex [ 19 ], diarrhea, respiratory infection [ 20 ], lower wealth quintile [ 21 ], household dietary diversity, early initiation of complementary feeding [ 22 ] are some of the associated factors.…”

Prevalence of child stunting in Sub-Saharan Africa and its risk factors

“…In addition, knowledge about the benefits of breastfeeding is key to ensuring proper nutrition in the first months of life. Targeting these practices enables families to provide diverse and nutritious foods for their children and to make more health-promoting prioritizations when necessary [56]. Climate change is an external factor that threatens food security, exacerbating any negative effect of poor household wealth or improper feeding practices.…”