Sociodemographic and Environmental Factors for Ill Health in Rwanda: Results from the 2016 Integrated Household Living Conditions Survey

A quarter of deaths are due to environmental factors worldwide, in Africa, and in Rwanda. Integrated Household Living Conditions Surveys (EICV) assess the living conditions of households. We sought to increase evidence on environmental factors in Rwanda.

We used a cross-sectional design to analyze the fifth EICV 5 conducted from October 2016 to October 2017, and conducted a multiple logistic regression to assess the prevalence of illness and environmental factors associated with disease in Rwanda.

One-third of participants reported illness. Females (OR 1.26, 95% CI 1.22-1.33), over 65 years (OR 3.75, 95% CI 3.30-4.26), and affiliation with military medical insurance (OR=1.60, 95% CI: 1.14-2.23, p=0.006) indicated greater odds of disease. Using unimproved water sources (OR=1.47, 95% CI: 1.20-1.79, p<0.001), firewood for lighting (OR=1.28, 95% CI: 1.06-1.53, p=0.008), unimproved sanitation services (OR=1.72, 95% CI: 1.28-2.31, p<0.001), and occurrence of an environmental shock (OR=1.18, 95% CI: 1.18-1.39, p<0.001) showed higher odds of disease.

Biological and social factors contribute to poorer health among females. Increased illness with age may be explained by aging-related changes. Higher odds of disease among military personnel might be due to the nature of their work. Increased odds of disease associated with non-improved drinking water sources reflect the drinking water ladder. We confirmed the harmful effects of wood consumption, the increased risk of illness across the sanitation ladder, and the association between environmental shocks and poor health.

Increased access to improved water sources, high-level sanitation services, and clean energy, reinforced disaster preparedness, and longitudinal studies are needed.