Are children in female-headed households at a disadvantage? An analysis of immunization coverage and stunting prevalence: in 95 low- and middle-income countries

Wendt, Andrea; Hellwig, Franciele; Saad, Ghada E; Faye, Cheikh; Mokomane, Zitha; Boerma, Ties; Barros, Aluísio J D; Victora, César G.

doi:10.1016/j.ssmph.2021.100888

Cited by 16 publications

(17 citation statements)

References 48 publications

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“…Household headship characteristics of gender and education were essential factors for stunting. This result differs from a prior study that showed that even after adjusting for family wealth, education, and residence, there were no changes in stunting prevalence based on household headship [ 45 ]. Most female-headed households regard themselves as vulnerable and less stable livelihoods [ 46 ] because of their often lower earnings and restricted access to vital services [ 45 ].…”

Section: Discussioncontrasting

confidence: 99%

Family Household Characteristics and Stunting: An Update Scoping Review

et al. 2023

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Stunting remains a public health concern in developing countries. Factors related to stunting have been categorized using various frameworks. Family plays an important role in providing nutrients for children; however, no review specifies this aspect for identifying family characteristics related to stunting. This study aimed to identify family household characteristics related to stunting among children aged less than 5 years. A scoping review was undertaken with sources from PubMed, CINAHL, and Scopus, using the keywords “family characteristics” AND “growth”. Inclusion criteria were (1) correlational study; (2) published between 2018 and 31 July 2022; (3) families with children under the age of 5 years; and (4) independent variable any measure of stunting factors from family and household factors. Of 376 articles, only 20 met the inclusion criteria of the study. The family household characteristics included individual factors (sex age, history of diarrhea, and birthplace), family factors (family headship, primary caregiver/mother, social-cultural orientation, and family system factors), and environmental factors. Various child variables, family factors, and environmental factors (the type of home, floor type, water access, source of drinking water, and household electricity) were identified as being associated with stunting. Therefore, these factors should be evaluated to prevent and control stunting, and they should be incorporated into health programs targeting stunting.

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Section: Discussioncontrasting

confidence: 99%

Family Household Characteristics and Stunting: An Update Scoping Review

et al. 2023

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“…Although studies assessing the relationship between FHH and birth registration are scarce, other studies exploring associations with child health and nutrition outcomes also showed high variability in the results [ 4 , 22 , 31 ]. There are at least two main explanations for the lack of consistent results.…”

Section: Discussionmentioning

confidence: 99%

“…The frequencies of some subgroups were small in many countries, and our final typology was restricted to three categories: (a) male-headed household (MHH); (b) FHH with any adult male; (c) FHH without a male. This typology is described in detail in a previous publication [ 12 , 22 ].…”

Section: Methodsmentioning

confidence: 99%

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Birth registration coverage according to the sex of the head of household: an analysis of national surveys from 93 low- and middle-income countries

et al. 2022

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Background Within-country inequalities in birth registration coverage (BRC) have been documented according to wealth, place of residence and other household characteristics. We investigated whether sex of the head of household was associated with BRC. Methods Using data from nationally-representative surveys (Demographic and Health Survey or Multiple Indicator Cluster Survey) from 93 low and middle-income countries (LMICs) carried out in 2010 or later, we developed a typology including three main types of households: male-headed (MHH) and female-led with or without an adult male resident. Using Poisson regression, we compared BRC for children aged less than 12 months living the three types of households within each country, and then pooled results for all countries. Analyses were also adjusted for household wealth quintiles, maternal education and urban-rural residence. Results BRC ranged from 2.2% Ethiopia to 100% in Thailand (median 79%) while the proportion of MHH ranged from 52.1% in Ukraine to 98.3% in Afghanistan (median 72.9%). In most countries the proportion of poor families was highest in FHH (no male) and lowest in FHH (any male), with MHH occupying an intermediate position. Of the 93 countries, in the adjusted analyses, FHH (no male) had significantly higher BRC than MHH in 13 countries, while in eight countries the opposite trend was observed. The pooled analyses showed t BRC ratios of 1.01 (95% CI: 1.00; 1.01) for FHH (any male) relative to MHH, and also 1.01 (95% CI: 1.00; 1.01) for FHH (no male) relative to MHH. These analyses also showed a high degree of heterogeneity among countries. Conclusion Sex of the head of household was not consistently associated with BRC in the pooled analyses but noteworthy differences in different directions were found in specific countries. Formal and informal benefits to FHH (no male), as well as women’s ability to allocate household resources to their children in FHH, may explain why this vulnerable group has managed to offset a potential disadvantage to their children.

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“… 36 Nevertheless, some studies were unable to verify this association. 37 Our results of an interaction between female head of household and other modifiable factors might be an indicator for researchers and policymakers to explore women empowerment in practice.…”

Section: Discussionmentioning

confidence: 88%