Feeding patterns and nutrition status of children aged 0–24 months in Rwanda: a secondary data analysis of Rwanda DHS 2019–2020

Undernutrition among children under five remains a major global public health concern. In Rwanda, 33% of children under five are stunted despite extensive nutrition programs. Limited evidence exists examining how infant and young child feeding (IYCF) patterns relate to nutritional outcomes among children aged 0–24 months using population-based data. This study assessed feeding patterns and their association with nutritional status among children aged 0–24 months in Rwanda. Secondary analysis of the 2019–2020 Rwanda Demographic and Health Survey included 1,581 children aged 0–24 months with complete anthropometric and IYCF indicators data. IYCF practices were assessed using WHO/UNICEF indicators. Nutritional status indicators (stunting, wasting, underweight) were calculated using WHO 2006 Child Growth Standards. Multivariable logistic regression identified independent predictors of child malnutrition. Among 1,581 children, the prevalence of stunting was 28%, underweight 6.6%, and wasting 1.6%. Breastfeeding practices were strong (early initiation 85.5% and exclusive breastfeeding 81.4%), but complementary feeding remained inadequate (34.2% met minimum dietary diversity, 46% minimum meal frequency, and 22.4% minimum acceptable diet). Independent predictors included rural residence, low household wealth, single maternal status, male sex, and low birth weight for stunting; male sex, low birth weight, and recent diarrhea for underweight; recent fever and paradoxically meeting the minimum acceptable diet for wasting. This study’s findings underscore the need for integrated interventions improving complementary feeding, healthcare access, childhood illness prevention, and targeted support for high-risk children to reduce stunting, underweight, and wasting in Rwanda.