Anthropometric Failure and Associated Factors Among 6–59 Month Children Living in Gicumbi District

ABSTRACT Background Childhood anthropometric failure remains a global public health problem. In Rwanda, malnutrition is a leading cause of child illness and death. Yet, more than an assessment of undernutrition using a conventional index is needed to conclude the overall prevalence of undernutrition among children aged 6–59 months; therefore, this study aims to assess undernutrition using the Composite Index of Anthropometric Failure (CIAF) and its determinants on children under 5 years of age in Gicumbi District, Northern Province, Rwanda. Methods A community‐based cross‐sectional study was employed among 366 mother–child pairs selected using a cluster sampling technique, followed by a systematic random sampling technique to select study participants. A pretested structured questionnaire was used to collect data. WHO Anthro software was used to calculate height for age, weight for age, and weight for height. Both bivariable and multivariable binary logistic regressions were used to identify factors associated with undernutrition. Results The overall prevalence of anthropometric failure among children under 59 months was 37.2%, significantly associated with female children who were 49.4% less likely to experience anthropometric failure (AOR = 0.506, confidence interval CI: 0.288–0.891, p = 0.018). Children below two had an increased risk (AOR = 1.556, CI: 1.04–2.31, p = 0.03). No livestock increased failure odds by 2.5 times (AOR = 2.50, CI: 1.059–5.921, p = 0.037). One daily meal doubled the failure risk (AOR = 2.05, CI: 1.09–3.87, p = 0.025). Conclusion Anthropometric failure affected nearly one‐third of children under five. Age, sex, livestock ownership, marital status, and meal frequency were significantly associated with CIAF. Multi‐sectoral nutrition interventions and further research on unassessed factors are recommended.