What empowerment indicators are important for food consumption for women? Evidence from 5 sub-Sahara African countries

Onah, Michael Nnachebe; Horton, Susan; Hoddinott, John

doi:10.1371/journal.pone.0250014

Cited by 18 publications

(19 citation statements)

References 57 publications

(78 reference statements)

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“…The influence of gender roles and empowerment on diets has been investigated in three studies ( 45 , 50 , 61 ). One study among women across five African countries explored the relationship between women's empowerment and the consumption of vegetables and combined FV.…”

Section: Resultsmentioning

confidence: 99%

“…One study among women across five African countries explored the relationship between women's empowerment and the consumption of vegetables and combined FV. Results showed that women's autonomy and input in production decisions were positively associated with the consumption of dark green leafy vegetables, as well as with the consumption of vitamin A-rich FV, while leadership opportunities measured as “women are comfortable speaking in public” was associated only with combined FV consumption (e.g., other fruit and vegetables), but not with dark green leafy vegetables or combined FV (e.g., other vitamin A-rich FV) ( 61 ). In one study in urban Ethiopia, “husband's encouragement,” which was described as a social support within the household, was positively associated with women's combined FV consumption ( 45 ).…”

Section: Resultsmentioning

confidence: 99%

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Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

et al. 2023

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In order to achieve the Sustainable Development Goals, considerable dietary shifts, including an increase in the consumption of fruit and vegetables (FV) will be required. However, worldwide consumption of FV is far below international recommendations, including in many low- and middle-income countries (LMICs), particularly in Africa. Understanding what, where, when, and how people choose to eat requires an understanding of how individuals are influenced by factors in their social, physical, and macro-level environments. In order to develop effective interventions to increase fruit and vegetable consumption, the factors influencing consumer behavior need to be better understood. We conducted a rapid review to assess and synthesize data on individual, social, physical, and macro-level factors that enable or constrain fruit and vegetable consumption and purchase among adults living in sub-Saharan Africa. Our conceptual framework is based on a socio-ecological model which has been adapted to settings in LMICs and Africa. We systematically searched four electronic databases including Scopus, Medline (PubMed), PsycInfo, and African Index Medicus, and screened Google Scholar for gray literature. We included a total of 52 studies and narratively summarized the existing evidence for each identified factor across the different levels. We found that most studies assessed demographic factors at the individual level including household or family income, socio-economic status and education. Furthermore we identified a variety of important factors that influence FV consumption, in the social, physical, and macro environment. These include women's empowerment and gender inequalities, the influence of neighborhood and retail food environment such as distance to market and price of FV as well as the importance of natural landscapes including forest areas for FV consumption. This review identified the need to develop and improve indicators both for exposure and outcome variables but also to diversify research approaches.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

et al. 2023

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“…The results also illustrated that intrinsic agency has a significant effect on families with low household wealth, while resources have a significant effect on families with high household wealth. Two studies utilizing the Demographic and Health Surveys (DHS) data in different countries found that improving intrinsic agency for women in low socioeconomic status was associated with better childhood nutrition [ 53 , 63 ]. Enabling resources, thus, tend to make a difference in women who belong to a higher wealth status, which could explain why the disparity between women and their husbands is larger in those of higher socioeconomic status compared to those of lower socioeconomic status.…”

Section: Discussionmentioning

confidence: 99%

Women’s Empowerment and Children’s Complete Vaccination in the Democratic Republic of the Congo: A Cross-Sectional Analysis

Wang

et al. 2021

Vaccines

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(1) Background: The empowerment of women contributes to better child health and wellness. This study aimed to examine the association between women’s empowerment and complete vaccination of children, as recommended in the National Expanded Program on Immunization (EPI) in the Democratic Republic of the Congo (DRC). (2) Methods: In this cross-sectional study, a principal component analysis (PCA) was conducted on data from the Multiple-Indicator Cluster Survey 6 (MICS-6) to determine the dimensions of women’s empowerment. Logistic regression analysis was used to assess the association between women’s empowerment and complete vaccination of children stratified by household wealth. In total, 3524 women with children aged 12–23 months were included in the study. (3) Results: Women’s empowerment was defined by three dimensions, namely intrinsic agency, enabling resources, and social independence. Children of women with high levels of empowerment had higher odds of complete vaccination, with values of 1.63 (p = 0.002) and 1.59 (p = 0.012) for intrinsic agency and enabling resources of the empowerment, respectively, compared to the children of women with low levels of empowerment; however, social independence failed to be associated with the vaccination status of children. After stratification by household wealth, the OR of complete vaccination was higher in women from middle-income households with high levels of intrinsic agency (OR: 2.35, p = 0.021) compared to women from poor households with high levels of intrinsic agency (OR: 1.92, p = 0.004). (4) Conclusions: Higher levels of women’s empowerment, especially intrinsic agency and enabling resources, were associated with complete vaccination in children in the DRC. Household wealth status influenced the associations. The empowerment of women is crucial in promoting the complete vaccination of children and providing equal access to vaccines.

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“…For instance, studies have found that a unit increase in empowerment scores across different domains is associated with increases in the probability of improved dietary diversity and nutrition outcomes (10,48,49) however, such associations might matter for a narrower list of food items. While Onah et al (13) using quantitative means found varied associations between empowerment domains and the consumption of specific food groups for women, this study goes further by qualitatively examining the socio-economic nuances that inform some of these varied quantitative associations.…”

Section: Discussionmentioning

confidence: 82%

“…Numerous studies have utilised the MDD-W measure to find a strong link between improved dietary diversity and health outcomes (6,(9)(10)(11) . Evidence also suggests that there are many determinants of improved dietary diversity for women with different contextual factors playing an important role in women's food consumption (9,12,13) .…”

mentioning

confidence: 99%

Qualitative exploration of the dynamics of women’s dietary diversity. How much does economic empowerment matter?

Onah

Hoddinott

Horton

2021

Public Health Nutr.

Self Cite

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Objective: This study qualitatively examined dietary diversity among married women of reproductive age who engaged in two socioeconomic activities to explore the dynamics of food availability, access, costs, and consumption. Design: Qualitative in-depth interviews. The food groups in the MDD-W were used to explore women’s dietary diversity. In-depth interviews were used to develop a roster of daily food consumption over a week. We explored food items that were considered expensive and frequency of consumption, food items that women require permission to consume, and frequency of permission sought and the role of economic empowerment. Data analysis followed an inductive-deductive approach to thematic analysis. Setting: Rural and peri-urban setting in Enugu State, Nigeria. Participants: Thirty-eight married women of reproductive age across two socioeconomic groupings (women who work only at home and those who worked outside their homes) were recruited in April 2019. Results: Economic empowerment improved women’s autonomy in food purchase and consumption. However, limited income restricted women from full autonomy in consumption decisions and access. Consumption of non-staple food items, especially flesh proteins, would benefit from women’s economic empowerment, whereas staple food items would not benefit so much. Dietary diversity is influenced by food production and purchase where factors including seasonal variation in food availability, prices, contextual factors that influence women’s autonomy, and income are important determinants. Conclusion: With limited income, agency and access to household financial resources coupled with norms that restrict women’s income earning, women continues to be at risk to not achieving adequate dietary diversity.

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What empowerment indicators are important for food consumption for women? Evidence from 5 sub-Sahara African countries

Cited by 18 publications

References 57 publications

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

Factors affecting fruit and vegetable consumption and purchase behavior of adults in sub-Saharan Africa: A rapid review

Women’s Empowerment and Children’s Complete Vaccination in the Democratic Republic of the Congo: A Cross-Sectional Analysis

Qualitative exploration of the dynamics of women’s dietary diversity. How much does economic empowerment matter?

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