Maternal Education Mitigates the Negative Effects of Higher Income on the Double Burden of Child Stunting and Maternal Overweight in Rural Mexico

Abstract

Globally, the rate at which maternal overweight and obesity increase with rising wealth is higher than the accompanying decline in the prevalence of child stunting, resulting in the double burden of malnutrition. The positive association between household wealth and child linear growth is larger in households with a more educated mother. However, whether a similar positive and synergistic association between maternal education and household wealth is observed for maternal body weight is unknown. Our objective was to assess the potential protective role of maternal education in the etiology of the double burden of malnutrition (stunted child with an overweight mother). We used data on 1547 nonpregnant mothers (aged 18-49 y) and their children (aged 0-5 y) collected in a cross-sectional survey in 235 rural communities in southern Mexico. Child height-for-age Z-score and maternal body weight were regressed on household wealth, women's schooling, and the interaction between both, controlling for relevant covariates. A similar model was used for the prevalence of double-burden pairs (stunted child with an overweight mother). In mothers with less than primary school, a doubling in wealth was not associated with improved child's height but was associated with an increase in mother's weight (3.7%, P < 0.01). In mothers who had completed primary school, the reverse was found: a doubling in wealth score was associated with improved child height-for-age Z-score (0.32 SD, P < 0.01) but not with mother's weight. As a result, a 100% increase in wealth among households with less schooled mothers was associated with a 4.5 percentage point increase (P < 0.05) in double-burden pairs; in households with mothers with primary schooling or more, it was not associated with the occurrence of double-burden pairs. Maternal schooling effectively mitigated the negative effects of household wealth on the prevalence of double-burden households in rural Mexico. Where maternal schooling is low, poverty reduction must be accompanied by effective behavior change communication to prevent child stunting and to protect women from unhealthy weight gain.

Dietary Diversity at 6 Months of Age Is Associated with Subsequent Growth and Mediates the Effect of Maternal Education on Infant Growth in Urban Zambia

“…In addition to the implementation of policies to increase the level of formal education among women, IYCF education programs should be targeted toward women with little formal education, because higher maternal nutrition knowledge has been demonstrated to partially compensate for low education in some contexts (39,49). Although it was not evident from our middle-income study setting, it should be noted that the beneficial influence of maternal knowledge or formal education on child growth is understood to be dependent on a minimum level of access to resources (39,(50)(51)(52)(53). Nonetheless, our findings support the growing interest in increasing maternal educational attainment as a potential intervention toward improving child health outcomes (18,(54)(55)(56).…”

Women’s Empowerment Mitigates the Negative Effects of Low Production Diversity on Maternal and Child Nutrition in Nepal

“…In Benin, Reed, Habicht, and Niameogo (1996) find that the effect of maternal schooling was insignificant in the lowest stratum, positive and significant in the intermediate socioeconomic stratum, and weakly positive in the best socioeconomic category. In Mexico, Leroy et al (2014) find that maternal schooling mitigates the potentially negative association between increasing wealth and maternal weight, while fostering the positive association between household wealth and child linear growth. Evidence from Bangladesh suggests that the effect of women's empowerment varies with wealth: Sraboni et al (2014), using the WEAI, have shown that the positive effect of different dimensions of women's empowerment on calorie availability and dietary diversity is greater for smaller landowners, that is, for less well-off households.…”

“…The literature on maternal education and nutrition suggests that socioeconomic status and maternal education interact (see Leroy, Habicht, Gonzalez De Cossio, & Ruel, 2014 and resources cited therein), although the direction of interaction may vary across socioeconomic status. In Benin, Reed, Habicht, and Niameogo (1996) find that the effect of maternal schooling was insignificant in the lowest stratum, positive and significant in the intermediate socioeconomic stratum, and weakly positive in the best socioeconomic category.…”

Riwayat Berat Badan Lahir dengan Kejadian Stunting pada Anak Usia Bawah Dua Tahun

“…Selain itu, dengan penghasilan yang rendah, ibu tidak mampu untuk melindungi dan menjaga keseimbangan berat badan ketika hamil. 31 Hasil penelitian Djaali dan Eryando, 32 menemukan bahwa anak yang terlahir dengan berat badan yang rendah memiliki ibu dengan tingkat pendidikan yang rendah pula. Berbeda dengan hasil penelitian yang dilakukan oleh Nurcahyani dan Trihandini, 33 anak yang dilahirkan dengan berat lahir yang rendah disebabkan karena ibunya masih belum berkeinginan untuk hamil sebelumnya.…”