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

Abstract

KEYWORDSWomen's empowerment, maternal nutrition, low birth weight, principal component analysis, Bangladesh, demographic health survey 2 Abstract Background : The burden of maternal undernutrition 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 undernutrition 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 with five groups of indicators: a) education, b) access to socio-familial decision making, c) economic contribution and access to economic decision making, d) attitudes towards domestic violence and e) mobility. 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 undernutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal undernutrition 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 undernutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of undernutrition 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 undernutrition 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 undernutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved public health. Background About half of the world's population is affected by maternal and child under-nutrition [1, 2]. Undernourishment of women in reproductive age is more common in South Asia than any other region [3]. In the South Asian region, prevalence of maternal undernutrition varies between 10 and 40% [1]. Particularly in Bangladesh, the prevalence of undernutrition among females is much higher than any other developing country, [3] with more than 30% women of reproductive age reported to be malnourished [4]. Maternal under-nutrition has persistently been reported to be a major contributor to morbidity, mortality and poor birth outcomes including low birth weight (LB...

Education as Predictor of Low Birth Weight among Female Worker in Indonesia

“…A high level of education is one of the outputs of women's empowerment. Better education has an impact on maternal nutrition and reduces the incidence of LBW 16,17 . Several previous studies have informed that a good level of education is a major predictor of performance in the health sector 18,19 .…”