Perceived Determinants of Childhood Stunting in Rwanda: Insights from Parents and Frontline Workers

Background Childhood stunting remains a pervasive public health concern. Understanding the perceptions of parents and frontline workers regarding childhood stunting is essential in designing culturally appropriate intervention. The purpose of this study was to investigate the viewpoints of frontline workers and Rwandan parents regarding the determinants of childhood stunting. Methods We conducted a qualitative study using ten focus groups discussions and sixteen key informant interviews among 83 parents and frontline workers all from five districts scatted in Rwanda. We used NVivo 14, to conduct thematic analysis with open coding. Results There was inadequate knowledge about stunting: most respondents knew only visible signs of stunting. The key perceived determinants included poverty, poor children and maternal feeding practices, family conflict and behavioral resistance. Inconsistent adherence to recommended practices such as vegetable gardening and hygiene were attributed to limited program ownership hence poor feeding practices and increased rate of stunting. Participants also mentioned systemic barriers, poor management in the selection of beneficiaries and assistance distribution, as well as limited access to essential health and nutrition services. Conclusion Childhood stunting in Rwanda is influenced by a complex interplay of individual, household, and structural determinants. Addressing stunting requires community-driven and multisectoral interventions that aim to improve maternal and child nutrition, reduce socioeconomic vulnerabilities, and strengthen service delivery and program accountability.