Impacts of in Utero Exposure to Weather Shocks on Nutritional Outcomes of Children under Five in Rwanda

Abstract

Child undernutrition remains a major public health challenge in many developing countries, including Rwanda, where environmental and climatic factors can adversely affect maternal and child health. This study analyzes the impact of in utero exposure to weather shocks on the nutritional outcomes of children under five years of age in Rwanda. The findings indicate that adverse weather conditions experienced during pregnancy are associated with poorer nutritional indicators among children, highlighting the importance of climate-resilient health and nutrition interventions. The study provides evidence for policymakers to strengthen maternal and child nutrition programs in the context of increasing climate variability. This study investigated the association between in utero exposure to weather shocks and nutritional outcomes among children under five years in Rwanda. The study used nationally representative data from the 2019–2020 Rwanda Demographic and Health Survey (RDHS) combined with Climate Physical Risk Index (CPRI) indicators to assess the effects of prenatal exposure to climatic shocks on child nutrition. The analytical approach included the use of multivariable Ordinary Least Squares (OLS) and logistic regression models, which controlled for key socioeconomic and demographic factors such as maternal education, household wealth, child sex, residence, household size, and region. The study analyzed data from 3,821 children under five years of age using Ordinary Least Squares (OLS) and logistic regression models. Nutritional outcomes were measured using Height-for-Age Z-score (HAZ), Weight-for-Age Z-score (WAZ), Weight-for-Height Z-score (WHZ), and binary indicators for stunting, underweight, and wasting. The findings revealed that exposure to High Temperature Days (HTD) during gestation significantly reduced Height-for-Age Z-scores and increased the probability of stunting among children. The effects were more pronounced among male children and those residing in rural areas. Household wealth, maternal education, and place of residence significantly influenced child nutritional outcomes. Children from wealthier households and mothers with higher educational attainment demonstrated better nutritional outcomes compared to children from poorer households. The findings highlighted the importance of integrating climate-sensitive nutrition and maternal health interventions into Rwanda’s public health policies. These results emphasize the need for strengthened climate adaptation strategies within maternal and child health programs to mitigate the long-term effects of prenatal weather shocks on child development. The study concluded that climate change and prenatal weather shocks posed a significant threat to child growth and development in Rwanda.