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

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 27357 women and 9234 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 sociofamilial 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%).

Prevalence and associated factors of underweight, overweight and obesity among women of reproductive age group in the Maldives: Evidence from a nationally representative study

“…However, in our study, we could not find any significant relationship between overweight and obesity and the wealth quintile covariate. Nevertheless, being in the higher wealth index tier reduced the likelihood of being underweight, which bolsters the impact of economic solvency in mitigating the burden of undernourishment, as reported in neighboring countries [56][57][58]. Perhaps, other factors like pattern of age, education level, physical activity, dietary habit or genetic influence overrode the effect of wealth quintile in predicting the risk of being overweight/obese in our sample population.…”

Dietary Patterns and Determinants of Pregnant and Lactating Women From Marginalized Communities in India: A Community-Based Cross-Sectional Study

“…Congruent to our findings, another study found in a randomized controlled intervention trial that pregnant and lactating women who received nutrition-related counseling had a higher likelihood of consuming a diverse diet (42). This spotlights the fact that women's empowerment (employment) is a key driver for attaining maternal and child health and nutritional goals (43).…”

Incomes, employment and gender roles: understanding women's intrahousehold decision-making participation in Nicaragua

“…Contrarily to previous research using decision-making indicators to construct autonomy or empowerment measures (Allendorf, 2007;Kabir et al, 2020;Seymour & Peterman, 2018), we do not order the decision-making outcomes given the lack of information to determine whether sole compared to joint decision-making translates into more decision-making power (see Bernard, Doss, Hidrobo, Hoel, & Kieran, 2020;Mabsout, 2011 for arguments and evidence where joint decisions may represent better bargaining outcomes for women compared to sole decisions). Therefore, the model choice probability of each alternative j is estimated using multinomial logistic regressions (MNL) [3], a popular method to estimate unordered categorical dependent variables.…”

“…Previous findings indicate that decision-making may vary across different domains (Bonilla et al, 2017; deleted for blind review) or by types of decisions (joint vis-a-vis independent decisions) (Kafle, Michelson, & Winter-Nelson, 2019). However, joint or additive measures of decision-making are still broadly used, usually merging sole and joint decisions, particularly in studies using decision-making to approximate autonomy, status or empowerment (Allendorf, 2007;Kabir et al, 2020;Seymour & Peterman, 2018).…”