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Childhood stunting is highly clustered in Northern Province of Rwanda : A spatial analysis of a population-based study

Ndagijimana, Albert ; Nduwayezu, Gilbert LU orcid ; Kagoyire, Clarisse LU ; Elfving, Kristina LU ; Umubyeyi, Aline ; Mansourian, Ali LU and Lind, Torbjörn (2024) In Heliyon 10(2).
Abstract

Background: In Northern Province, Rwanda, stunting is common among children aged under 5 years. However, previous studies on spatial analysis of childhood stunting in Rwanda did not assess its randomness and clustering, and none were conducted in Northern Province. We conducted a spatial-pattern analysis of childhood undernutrition to identify stunting clusters and hotspots for targeted interventions in Northern Province. Methods: Using a household population-based questionnaire survey of the characteristics and causes of undernutrition in households with biological mothers of children aged 1–36 months, we collected anthropometric measurements of the children and their mothers and captured the coordinates of the households. Descriptive... (More)

Background: In Northern Province, Rwanda, stunting is common among children aged under 5 years. However, previous studies on spatial analysis of childhood stunting in Rwanda did not assess its randomness and clustering, and none were conducted in Northern Province. We conducted a spatial-pattern analysis of childhood undernutrition to identify stunting clusters and hotspots for targeted interventions in Northern Province. Methods: Using a household population-based questionnaire survey of the characteristics and causes of undernutrition in households with biological mothers of children aged 1–36 months, we collected anthropometric measurements of the children and their mothers and captured the coordinates of the households. Descriptive statistics were computed for the sociodemographic characteristics and anthropometric measurements. Spatial patterns of childhood stunting were determined using global and local Moran's I and Getis-Ord Gi* statistics, and the corresponding maps were produced. Results: The z-scores of the three anthropometric measurements were normally distributed, but the z-scores of height-for-age were generally lower than those of weight-for-age and weight-for-height, prompting us to focus on height-for-age for the spatial analysis. The estimated incidence of stunting among 601 children aged 1–36 months was 27.1 %. The sample points were interpolated to the administrative level of the sector. The global Moran's I was positive and significant (Moran's I = 0.403, p < 0.001, z-score = 7.813), indicating clustering of childhood stunting across different sectors of Northern Province. The local Moran's I and hotspot analysis based on the Getis-Ord Gi* statistic showed statistically significant hotspots, which were strongest within Musanze district, followed by Gakenke and Gicumbi districts. Conclusion: Childhood stunting in Northern Province showed statistically significant hotspots in Musanze, Gakenke, and Gicumbi districts. Factors associated with such clusters and hotspots should be assessed to identify possible geographically targeted interventions.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Child, LMICs, Rwanda, Spatial, Stunting, Sub-saharan africa, Undernutrition, spatial analysis
in
Heliyon
volume
10
issue
2
article number
e24922
publisher
Elsevier
external identifiers
  • pmid:38312557
  • scopus:85183022200
ISSN
2405-8440
DOI
10.1016/j.heliyon.2024.e24922
language
English
LU publication?
yes
additional info
Funding Information: This study was funded by the Swedish International Development Cooperation Agency (SIDA) , grant number (SIDA Contribution no 11277 ), especially for data collection. Publisher Copyright: © 2024 The Authors
id
be69cf40-ebb3-4569-9cac-74b2e4d981e3
date added to LUP
2024-02-06 10:04:31
date last changed
2024-04-22 17:07:40
@article{be69cf40-ebb3-4569-9cac-74b2e4d981e3,
  abstract     = {{<p>Background: In Northern Province, Rwanda, stunting is common among children aged under 5 years. However, previous studies on spatial analysis of childhood stunting in Rwanda did not assess its randomness and clustering, and none were conducted in Northern Province. We conducted a spatial-pattern analysis of childhood undernutrition to identify stunting clusters and hotspots for targeted interventions in Northern Province. Methods: Using a household population-based questionnaire survey of the characteristics and causes of undernutrition in households with biological mothers of children aged 1–36 months, we collected anthropometric measurements of the children and their mothers and captured the coordinates of the households. Descriptive statistics were computed for the sociodemographic characteristics and anthropometric measurements. Spatial patterns of childhood stunting were determined using global and local Moran's I and Getis-Ord Gi* statistics, and the corresponding maps were produced. Results: The z-scores of the three anthropometric measurements were normally distributed, but the z-scores of height-for-age were generally lower than those of weight-for-age and weight-for-height, prompting us to focus on height-for-age for the spatial analysis. The estimated incidence of stunting among 601 children aged 1–36 months was 27.1 %. The sample points were interpolated to the administrative level of the sector. The global Moran's I was positive and significant (Moran's I = 0.403, p &lt; 0.001, z-score = 7.813), indicating clustering of childhood stunting across different sectors of Northern Province. The local Moran's I and hotspot analysis based on the Getis-Ord Gi* statistic showed statistically significant hotspots, which were strongest within Musanze district, followed by Gakenke and Gicumbi districts. Conclusion: Childhood stunting in Northern Province showed statistically significant hotspots in Musanze, Gakenke, and Gicumbi districts. Factors associated with such clusters and hotspots should be assessed to identify possible geographically targeted interventions.</p>}},
  author       = {{Ndagijimana, Albert and Nduwayezu, Gilbert and Kagoyire, Clarisse and Elfving, Kristina and Umubyeyi, Aline and Mansourian, Ali and Lind, Torbjörn}},
  issn         = {{2405-8440}},
  keywords     = {{Child; LMICs; Rwanda; Spatial; Stunting; Sub-saharan africa; Undernutrition; spatial analysis}},
  language     = {{eng}},
  month        = {{01}},
  number       = {{2}},
  publisher    = {{Elsevier}},
  series       = {{Heliyon}},
  title        = {{Childhood stunting is highly clustered in Northern Province of Rwanda : A spatial analysis of a population-based study}},
  url          = {{http://dx.doi.org/10.1016/j.heliyon.2024.e24922}},
  doi          = {{10.1016/j.heliyon.2024.e24922}},
  volume       = {{10}},
  year         = {{2024}},
}