Investigation of the underlying causes of malnutrition among children in the Nyabihu and Ngororero districts of Rwanda: a cross-sectional descriptive survey design.

Introduction: malnutrition remains a critical public health challenge in Rwanda, particularly in rural districts like Nyabihu and Ngororero, where children face chronic undernutrition despite ongoing national interventions. This study investigates the underlying causes of malnutrition among children in Nyabihu and Ngororero districts. Methods: using a structured questionnaire, data were gathered from 46 parents to assess household income, nutrition knowledge, dietary practices, sanitation, and access to health services. Independent t-tests, MANOVA, and Chi-square tests were utilized to examine relationships between variables. Results: most households earn less than 50,000 RWF per month, reflecting widespread poverty. Significant gender-based disparities were observed in engagement with community malnutrition programs, with women (M= 0.96, SD= 0.19) demonstrating significantly higher involvement than males (M= 0.58, SD= 0.42), t (46) = 2.45, p= 0.017. Despite general awareness of principles of balanced diets, this knowledge is not translating into practice. Most households reported poor dietary diversity and inadequate intake of proteins, dairy, fruits, and vegetables, leading to deficiencies in essential nutrients. Alarmingly, a large proportion of children are not benefiting from available nutrition interventions. Perceptions of malnutrition varied significantly by gender (p= 0.013) and occupation (p= 0.036), though not by age (p= 0.119). Conclusion: the study highlights the urgent need for targeted, multisectoral strategies that address both knowledge-practice gaps and systemic barriers. In addition to improving food availability, integrated interventions focusing on maternal education, dietary diversity, hygiene, and equitable access to healthcare services are crucial for achieving sustainable improvements in child nutrition.