Bivariate binary logistic regression analysis on undernutrition and anemia among under-five children in Rwanda; evidence from 2019/20 Rwanda demographic health survey

AbstractBackground:In low and middle-income countries such as Rwanda, undernutrition and anemia were major causes of death and morbidity among children under the age of five. Thus, this study aims to conduct a bivariate binary logistic regression model by accounting for the possible dependency of childhood undernutrition and anemia.Methods:The data came from the DHS program's measurement. A total of 3,206 under-five children were involved in this study. A single composite index measure was calculated for stunting, wasting, and underweight using principal component analysis. A bivariate binary logistic regression model is used to assess the association between undernutrition and anemia given the effect of other predictors.Results:Among 3,206 under-five children considered in this study, 1482 (46.2%) and 658 (20.5%) children were agonized by anemia and undernutrition, respectively. Nearly half of the children (48.8%) were female and 83.0% lived in rural areas. Children from urban areas were 0.663 and 0.751 times less likely to be undernourished and anemic, respectively, as compared to children from rural areas, and multiple birth children were more likely to be undernourished and anemic as compared to single-birth children. Children from families with an improved water source were 0.681 and 0.581 times less likely to be anemic and undernourished, respectively, as compared to children from families without an improved water source. The estimated odds of children who had diarrhea were 1.134 and 1.052 times anemic and undernourished, respectively, as compared to children who had no diarrhea.Conclusion:The prevalence of both undernutrition and anemia was high in Rwanda. The following determinants are statistically associated with both childhood undernutrition and anemia: place of residence; source of drinking water; maternal anemia; being a twin; birth size of children; diarrhea; fever; and child age. Policy measures that reduce the burden of undernutrition and anemia can be applied to increase access to health care through providing vital services. Besides, it is better to strengthen the strategies of early recognition and organization of maternal anemia to decrease the prevalence of childhood undernutrition and anemia.