Prevalence Trends and Associated Factors of the Double Burden of Malnutrition Among Rwandan Women of Childbearing Age: Evidence From Demographic Health Surveys, 2010-2020.

Abstract

Background: Double burden of malnutrition (DBM) is a significant public health concern among women of reproductive age globally. Overweight or obesity is more prevalent than underweight, leading to an increased risk of noncommunicable diseases and childbirth complications, contributing to maternal and infant mortality. The study aimed to assess prevalence trends and factors associated with DBM among Rwandan women.

Methods: The cross-sectional study used data from the Rwanda Demographic and Health Survey (RDHS) conducted in 2010 and 2020. It involved 20,926 women who were not pregnant and aged 15-49, with newborns at least 2 months old at the time of the survey. The analysis adjusted for sampling weights. BMI was calculated according to World Health Organization (WHO) classifications, and the study involved sociodemographic variables and household characteristics. Data analysis used descriptive statistics, chi-square tests, and multivariable binary logistic regression with 95% confidence intervals (CIs) at a significance level of p ≤ 0.05.

Results: Underweight among women decreased from 6.75% to 5.57%. Overweight/Obesity rose from 17.81% to 27.42%; normal nutrition declined from 75.44% to 67.01%. Women aged 20-24 had lower odds of being underweight; those aged 44-49 had higher odds (aOR: 2.929; CI: 1.661-5.164; p < 0.0001). Never-married (aOR: 1.803; CI: 1.230-2.644; p = 0.003) and widowed/divorced women (aOR: 1.836; CI: 1.183-2.848; p = 0.007) had higher odds. Adventists were less likely (aOR: 0.580). The poorer and poorest categories showed higher odds of underweight (poorest OR: 2.353; CI: 1.356-4.082; p = 0.002). Overweight/Obesity increased with age, marital status, religion, occupation, and urban residence. Richest group aOR: 3.572 (CI: 2.600-4.907; p < 0.001); TV aOR: 1.365 (CI: 1.086-1.716; p = 0.008); radio aOR: 1.177 (CI: 1.018-1.361; p = 0.027).

Conclusion: DBM is rising among Rwandan women. Overweight or obesity, driven by socioeconomic factors, requires targeted interventions, awareness campaigns, empowerment, and further research to inform effective public health policies.