Stunting Among Children Under Five Years with Disabilities in Bugesera District, Rwanda: Prevalence and Associated Factors

Abstract

Background Global burden of disease report shows that 49.8 million children under the age of five worldwide suffer from disabilities together with other difficulties. The most prevalent of these problems is stunting, which negatively impacts children's physical health, growth, mental development, and resilience to disease. This heightened burden is attributed to inadequate food intake, exacerbating their nutritional status and worsening their overall well-being, particularly in developing countries like Rwanda. Thus, the primary objective of this study was to evaluate the prevalence of stunting and its associated factors among disabled children under the age of five in Bugesera district, Rwanda. Method This was a cross-sectional descriptive study. A multistage sampling technique was applied where the first eight sectors out of 15 were randomly selected then participants were selected using a simple random technique based on probability proportion to size (PPS) in each sector. Weight was obtained using a standard electronic balance scale while height was measured using a wooden height board and children less than 24 months lengths were obtained in recumbent position. Height for age was classified according to WHO z-score standards with the help of the zscore06 stata function. Independent factors including sociodemographic and socio-economic factors were obtained through an administered questionnaire. The description of independent variables was done using frequencies and percentages. The chi-square (χ 2 ) test was applied to determine the associated factors of stunting among children with disabilities. Multivariable logistic regression analysis was performed to test the strength of the association. The significance level was set at 5%. Results In total 265 children were recruited and the majority were aged between 25-59 months and more than half 59.66% were males. The prevalence of stunting among disabled children under the age of five was 44.91%. The factors positively associated with stunning after running multiple logistic regression were: age 25-59 months (aOR = 4.18 [95% CI: 1.71 - 10.23]), incomplete child immunization (aOR = 4.4 [95% CI: 1.16 - 16.69]), and rural residence (aOR = 3.08 [95% CI: 1.05 - 8.99]. However, the father’s education in primary school was a protective factor compared to those with no education ([aOR=0.52 [95% CI: 0.30- 0.90]). Conclusion The prevalence of stunting among under-five children with disabilities is high and being in preschool age, incomplete child immunization, and living in rural are associated with high risk of stunting among these children. There is a need to address stunting among disabled children through a strong program on Page 3/23 parental education about nutritional guidance and support, as well as providing high-quality healthcare including child full immunization.