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

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          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 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 are 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.

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          Outcomes in young adulthood for very-low-birth-weight infants.

          Elaine Borawski, Lydia Cartar, Mark Schluchter … (2002)
          Very-low-birth-weight infants (those weighing less than 1500 g) born during the initial years of neonatal intensive care have now reached young adulthood. We compared a cohort of 242 survivors among very-low-birth-weight infants born between 1977 and 1979 (mean birth weight, 1179 g; mean gestational age at birth, 29.7 weeks) with 233 controls from the same population in Cleveland who had normal birth weights. We assessed the level of education, cognitive and academic achievement, and rates of chronic illness and risk-taking behavior at 20 years of age. Outcomes were adjusted for sex and sociodemographic status. Fewer very-low-birth-weight young adults than normal-birth-weight young adults had graduated from high school (74 percent vs. 83 percent, P=0.04). Very-low-birth-weight men, but not women, were significantly less likely than normal-birth-weight controls to be enrolled in postsecondary study (30 percent vs. 53 percent, P=0.002). Very-low-birth-weight participants had a lower mean IQ (87 vs. 92) and lower academic achievement scores (P<0.001 for both comparisons). They had higher rates of neurosensory impairments (10 percent vs. <1 percent, P<0.001) and subnormal height (10 percent vs. 5 percent, P=0.04). The very-low-birth-weight group reported less alcohol and drug use and had lower rates of pregnancy than normal-birth-weight controls; these differences persisted when comparisons were restricted to the participants without neurosensory impairment. Educational disadvantage associated with very low birth weight persists into early adulthood.
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            Measuring inequality with asset indicators

            David J. McKenzie (2005)
            Article 0 comments Cited 157 times – based on 0 reviews     Review now
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              Global Burden of Maternal and Child Undernutrition and Micronutrient Deficiencies

              Tahmeed Ahmed, Muttaquina Hossain, Kazi Sanin (2013)
              Maternal and child undernutrition and micronutrient deficiencies affect approximately half of the world’s population. These conditions include intrauterine growth restriction (IUGR), low birth weight, protein-energy malnutrition, chronic energy deficit of women, and micronutrient deficiencies. Although the rates of stunting or chronic protein-energy malnutrition are increasing in Africa, the absolute numbers of stunted children are much higher in Asia. The four common micronutrient deficiencies include those of iron, iodine, vitamin A, and zinc. All these conditions are responsible directly or indirectly for more than 50% of all under-5 deaths globally. According to more recent estimates, IUGR, stunting and severe wasting are responsible for one third of under-5 mortality. About 12% of deaths among under-5 children are attributed to the deficiency of the four common micronutrients. Despite tremendous progress in different disciplines and unprecedented improvement with many health indicators, persistently high undernutrition rates are a shame to the society. Human development is not possible without taking care to control undernutrition and micronutrient deficiencies. Poverty, food insecurity, ignorance, lack of appropriate infant and young child feeding practices, heavy burden of infectious illnesses, and poor hygiene and sanitation are factors responsible for the high levels of maternal and child undernutrition in developing countries. These factors can be controlled or removed by scaling up direct nutrition interventions and eliminating the root conditions including female illiteracy, lack of livelihoods, lack of women’s empowerment, and poor hygiene and sanitation.
              Article 0 comments Cited 113 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Alamgir Kabir: a.kabir@unsw.edu.au
                Journal
                Journal ID (nlm-ta): BMC Womens Health
                Journal ID (iso-abbrev): BMC Womens Health
                Title: BMC Women's Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1472-6874
                Publication date (Electronic): 5 May 2020
                Publication date PMC-release: 5 May 2020
                Publication date Collection: 2020
                Volume: 20
                Electronic Location Identifier: 93
                Affiliations
                [1 ]GRID grid.1005.4, ISNI 0000 0004 4902 0432, Centre for Primary Health Care and Equity, Faculty of Medicine, , University of New South Wales, ; Level 3, AGSM Building, Sydney, NSW 2052 Australia
                [2 ]GRID grid.1005.4, ISNI 0000 0004 4902 0432, School of Public Health and Community Medicine, Faculty of Medicine, , University of New South Wales, ; Sydney, NSW Australia
                [3 ]GRID grid.412656.2, ISNI 0000 0004 0451 7306, Department of Statistics, , University of Rajshahi, ; Rajshahi, Bangladesh
                [4 ]Asian Institute of Disability and Development, Dhaka, Bangladesh
                [5 ]Kala-azar Elimination Program, Dhaka, Bangladesh
                [6 ]GRID grid.1003.2, ISNI 0000 0000 9320 7537, School of Public Health, , The University of Queensland, ; Brisbane, Australia
                [7 ]Sexual Reproductive Health and Rights Team, CARE USA, Patna, India
                [8 ]GRID grid.482157.d, ISNI 0000 0004 0466 4031, Women and Babies Research, , Kolling Institute, Northern Sydney Local Health District, ; St Leonards, NSW 2065 Australia
                [9 ]GRID grid.1013.3, ISNI 0000 0004 1936 834X, The University of Sydney Northern Clinical School, ; Sydney, NSW Australia
                [10 ]GRID grid.493834.1, National Centre for Immunisation Research and Surveillance, ; Westmead, NSW Australia
                Article
                Publisher ID: 952
                DOI: 10.1186/s12905-020-00952-4
                PMC ID: 7201548
                PubMed ID: 32370781
                SO-VID: 950155e7-e671-4f0c-8caa-9f45da0bb305
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 30 August 2019
                Date accepted : 15 April 2020
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: women’s empowerment,maternal nutrition,low birth weight,principal component analysis,bangladesh,demographic health survey
                Data availability:
                ScienceOpen disciplines: Obstetrics & Gynecology
                Keywords: women’s empowerment, maternal nutrition, low birth weight, principal component analysis, bangladesh, demographic health survey

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