Women’s empowerment is associated with maternal nutrition and low birth weight: Evidence from Bangladesh Demographic Health Survey

Abstract

Background The burden of maternal malnutrition and low birth weight (LBW) incurs enormous economic costs due to their adverse consequences. Women’s empowerment is believed to be one of the key factors for attaining maternal and child health and nutritional goals. Our objective was to investigate the association of women’s empowerment with maternal malnutrition and LBW.Methods We used nationally representative data from the Bangladesh Demographic Health Survey for 2011 and 2014. We analysed 27,357 women and 9,234 mother-child pairs. A women’s empowerment index (WEI) was constructed using principal component analysis. We estimated odds ratios as the measure of association between the WEI and the outcome measures using generalized estimating equations to account for the cluster level correlation.Results The overall prevalence of maternal malnutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal malnutrition and LBW with a dose-response relationship. The adjusted odds of having a LBW baby was 32% [AOR (95% CI):0.68 (0.57, 0.82)] lower in the highest quartile of the WEI relative to the lowest quartile. Household wealth significantly modified the effect of the WEI on maternal nutrition.; in the highest wealth quintile, the odds of maternal malnutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of malnutrition was only 18% [AOR (95% CI): 0.82 (0.67, 1.00)] lower comparing the highest WEI quartile with the lowest WEI quartile. However, the absolute differences in prevalence of malnutrition between the highest and lowest WEI quartiles were similar across wealth quintiles (6-8%).Conclusions This study used a comprehensive measure of women’s empowerment and provides strong evidence that low levels of women’s empowerment is associated with maternal malnutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved population health.