Skip to main content
Top
Published in: BMC Pediatrics 1/2024

Open Access 01-12-2024 | Nutrition | Research

Women empowerment and childhood stunting: evidence from rural northwest Ethiopia

Authors: Emebet Gashaw Wassie, Mesfin Wogayehu Tenagashaw, Tenaw Yimer Tiruye

Published in: BMC Pediatrics | Issue 1/2024

Login to get access

Abstract

Background

Women are often the primary caregivers of children, and as such, their empowerment could influence the nutritional status of their children. However, the role of maternal empowerment on the nutritional status of children in Ethiopia is largely unknown.

Aim

To determine the association of women’s empowerment with childhood stunting in rural northwest Ethiopia.

Methods

A community-based cross-sectional study was conducted among 582 mothers with children aged 6–59 months. A multistage sampling technique was used to select the study participants. Binomial logistic regression analyses were used to assess whether women’s empowerment (categorized as low, moderate and high) and its five dimensions (household decision-making, educational status, cash earnings, house/land ownership, and membership in community groups) were associated with stunting in children. Odds ratios with 95% CI were estimated, and statistical significance was declared at a p-value of < 0.05.

Results

A total of 114 (19.6%), 312 (53.6%), and 156 (26.8%) participants had low, moderate, and high empowerment levels, respectively. In addition, 255 (43.8%) mothers had children who were stunted (too short for their age). In the adjusted models, mothers with moderate empowerment (AOR 0.60, 95% CI: 0.35, 0.97) and high empowerment (AOR 0.56, 95% CI: 0.37, 0.86) had lower odds of having stunted children compared to mothers with low empowerment. Mothers who had a secondary education or higher (AOR 0.57, 95% CI: 0.35, 0.93), owned a house or land (AOR 0.64, 95% CI: 0.44, 0.94) and were members of community groups (AOR 0.54, 95% CI: 0.36, 0.80) were less likely to have stunted children.

Conclusion

High women empowerment was significantly associated with a lower likelihood of childhood stunting. The findings suggest a need to look beyond the direct causes of stunting and incorporate targeted strategies for empowering women into child nutrition programs.
Literature
2.
go back to reference WHO Multicentre Growth Reference Study Group. WHO child growth standards: length/heightfor-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006. WHO Multicentre Growth Reference Study Group. WHO child growth standards: length/heightfor-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006.
3.
go back to reference Fanzo J, Hawkes C, Udomkesmalee E, Afshin A, Allemandi L, Assery O et al. 2018 Global Nutrition Report: Shining a light to spur action on nutrition. 2018. Fanzo J, Hawkes C, Udomkesmalee E, Afshin A, Allemandi L, Assery O et al. 2018 Global Nutrition Report: Shining a light to spur action on nutrition. 2018.
4.
go back to reference UNICEF, WHO, World Bank. Levels and trends in child Malnutrition. eSocialSciences; 2018. UNICEF, WHO, World Bank. Levels and trends in child Malnutrition. eSocialSciences; 2018.
5.
go back to reference Central Statistical Agency (CSA). [Ethiopia], ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2017. Central Statistical Agency (CSA). [Ethiopia], ICF. Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA: CSA and ICF; 2017.
6.
go back to reference Engle P, Menon P, Haddad L. Care and nutrition: concepts and measurement. World Dev. 1999;27(8):1309–37.CrossRef Engle P, Menon P, Haddad L. Care and nutrition: concepts and measurement. World Dev. 1999;27(8):1309–37.CrossRef
7.
go back to reference Santoso MV, Kerr RB, Hoddinott J, Garigipati P, Olmos S, Young SL. Role of women’s empowerment in Child Nutrition outcomes: a systematic review. Advances in nutrition (Bethesda. Md). 2019;10(6):1138–51. Santoso MV, Kerr RB, Hoddinott J, Garigipati P, Olmos S, Young SL. Role of women’s empowerment in Child Nutrition outcomes: a systematic review. Advances in nutrition (Bethesda. Md). 2019;10(6):1138–51.
8.
go back to reference Karim N, Picard M, Gillingham S, Berkowitz L. Building capacity to measure long-term impact on women’s empowerment: CARE’s women’s empowerment Impact Measurement Initiative. Gend Dev. 2014;22(2):213–32.CrossRef Karim N, Picard M, Gillingham S, Berkowitz L. Building capacity to measure long-term impact on women’s empowerment: CARE’s women’s empowerment Impact Measurement Initiative. Gend Dev. 2014;22(2):213–32.CrossRef
9.
go back to reference Siddhanta A, Chattopadhyay A. Role of women’s empowerment in determining child stunting in Eastern India and Bangladesh. Social Sci Spectr. 2017;3(1):38–51. Siddhanta A, Chattopadhyay A. Role of women’s empowerment in determining child stunting in Eastern India and Bangladesh. Social Sci Spectr. 2017;3(1):38–51.
10.
go back to reference Rahman MM, Saima U, Goni MA. Impact of maternal household decision-making autonomy on child nutritional status in Bangladesh. Asia Pac J Public Health. 2015;27(5):509–20.CrossRefPubMed Rahman MM, Saima U, Goni MA. Impact of maternal household decision-making autonomy on child nutritional status in Bangladesh. Asia Pac J Public Health. 2015;27(5):509–20.CrossRefPubMed
11.
go back to reference Na M, Jennings L, Talegawkar SA, Ahmed S. Association between women’s empowerment and infant and child feeding practices in sub-saharan Africa: an analysis of demographic and health surveys. Public Health Nutr. 2015;18(17):3155–65.CrossRefPubMedPubMedCentral Na M, Jennings L, Talegawkar SA, Ahmed S. Association between women’s empowerment and infant and child feeding practices in sub-saharan Africa: an analysis of demographic and health surveys. Public Health Nutr. 2015;18(17):3155–65.CrossRefPubMedPubMedCentral
12.
go back to reference Barrios PL. Relationship between household structure, maternal autonomy and undernutrition in Brazilian children. Rutgers University-Graduate School-New Brunswick; 2012. Barrios PL. Relationship between household structure, maternal autonomy and undernutrition in Brazilian children. Rutgers University-Graduate School-New Brunswick; 2012.
13.
go back to reference Mashal T, Takano T, Nakamura K, Kizuki M, Hemat S, Watanabe M, et al. Factors associated with the health and nutritional status of children under 5 years of age in Afghanistan: family behaviour related to women and past experience of war-related hardships. BMC Public Health. 2008;8(1):301.CrossRefPubMedPubMedCentral Mashal T, Takano T, Nakamura K, Kizuki M, Hemat S, Watanabe M, et al. Factors associated with the health and nutritional status of children under 5 years of age in Afghanistan: family behaviour related to women and past experience of war-related hardships. BMC Public Health. 2008;8(1):301.CrossRefPubMedPubMedCentral
14.
go back to reference Kathmandu N. Women’s Empowerment and Spousal Violence in Relation to Health Outcomes in Nepal. 2013. Kathmandu N. Women’s Empowerment and Spousal Violence in Relation to Health Outcomes in Nepal. 2013.
15.
go back to reference Arulampalam W, Bhaskar A, Srivastava N. Does greater autonomy among women provide the key to better child nutrition? 2016. Arulampalam W, Bhaskar A, Srivastava N. Does greater autonomy among women provide the key to better child nutrition? 2016.
16.
go back to reference Ickes SB, Wu M, Mandel MP, Roberts AC. Associations between social support, psychological well-being, decision making, empowerment, infant and young child feeding, and nutritional status in Ugandan children ages 0 to 24 months. Matern Child Nutr. 2018;14(1). Ickes SB, Wu M, Mandel MP, Roberts AC. Associations between social support, psychological well-being, decision making, empowerment, infant and young child feeding, and nutritional status in Ugandan children ages 0 to 24 months. Matern Child Nutr. 2018;14(1).
17.
go back to reference Smith LC, Ramakrishnan U, Ndiaye A, Haddad LJ, Martorell R. The importance of women’s status for child nutrition in developing countries. 2023. Smith LC, Ramakrishnan U, Ndiaye A, Haddad LJ, Martorell R. The importance of women’s status for child nutrition in developing countries. 2023.
19.
go back to reference Beyene H. Final report national assessment: Ethiopia gender equality and the knowledge society. Los Angeles, CA: Wisat, Women in Global Science & Technology; 2015. Beyene H. Final report national assessment: Ethiopia gender equality and the knowledge society. Los Angeles, CA: Wisat, Women in Global Science & Technology; 2015.
20.
go back to reference Kuche D, Moss C, Eshetu S, Ayana G, Salasibew M, Dangour AD, et al. Factors associated with dietary diversity and length-for-age z-score in rural Ethiopian children aged 6–23 months: a novel approach to the analysis of baseline data from the sustainable undernutrition reduction in Ethiopia evaluation. Matern Child Nutr. 2020;16(1):e12852.CrossRefPubMed Kuche D, Moss C, Eshetu S, Ayana G, Salasibew M, Dangour AD, et al. Factors associated with dietary diversity and length-for-age z-score in rural Ethiopian children aged 6–23 months: a novel approach to the analysis of baseline data from the sustainable undernutrition reduction in Ethiopia evaluation. Matern Child Nutr. 2020;16(1):e12852.CrossRefPubMed
21.
go back to reference Yimer F, Tadesse F. Women’s empowerment in agriculture and dietary diversity in Ethiopia. 2019;3(1437). Yimer F, Tadesse F. Women’s empowerment in agriculture and dietary diversity in Ethiopia. 2019;3(1437).
22.
go back to reference Bahir Dar City Administration Health Bureau. Health report 2018. Bahir Dar City Administration Health Bureau. Health report 2018.
23.
go back to reference Gelu A, Edris M, Derso T, Abebe Z. Undernutrition and associated factors among children aged 6–59 months living in slum areas of gondar city, northwest Ethiopia: a cross-sectional study. Pediatr Health Med Ther. 2018;9:81.CrossRef Gelu A, Edris M, Derso T, Abebe Z. Undernutrition and associated factors among children aged 6–59 months living in slum areas of gondar city, northwest Ethiopia: a cross-sectional study. Pediatr Health Med Ther. 2018;9:81.CrossRef
24.
go back to reference Akombi B, Agho K, Hall J, Wali N, Renzaho A, Merom D, Stunting. Wasting and underweight in Sub-saharan Africa: a systematic review. Int J Environ Res Public Health. 2017;14(8):863.CrossRefPubMedPubMedCentral Akombi B, Agho K, Hall J, Wali N, Renzaho A, Merom D, Stunting. Wasting and underweight in Sub-saharan Africa: a systematic review. Int J Environ Res Public Health. 2017;14(8):863.CrossRefPubMedPubMedCentral
25.
go back to reference FDRE Ministry of Health (FMoH). National strategy for infant and young child feeding. Ethiopia: Addis Ababa; 2004. FDRE Ministry of Health (FMoH). National strategy for infant and young child feeding. Ethiopia: Addis Ababa; 2004.
26.
go back to reference Fall CHD, Sachdev HS, Osmond C, Restrepo-Mendez MC, Victora C, Martorell R, et al. Association between maternal age at Childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Glob Health. 2015;3(7):e366–e77.CrossRefPubMed Fall CHD, Sachdev HS, Osmond C, Restrepo-Mendez MC, Victora C, Martorell R, et al. Association between maternal age at Childbirth and child and adult outcomes in the offspring: a prospective study in five low-income and middle-income countries (COHORTS collaboration). Lancet Glob Health. 2015;3(7):e366–e77.CrossRefPubMed
27.
go back to reference Efevbera Y, Bhabha J, Farmer PE, Fink G. Girl child marriage as a risk factor for early childhood development and stunting. Soc Sci Med. 2017;185:91–101.CrossRefPubMed Efevbera Y, Bhabha J, Farmer PE, Fink G. Girl child marriage as a risk factor for early childhood development and stunting. Soc Sci Med. 2017;185:91–101.CrossRefPubMed
28.
go back to reference Woldemicael G, Tenkorang EY. Women’s autonomy and maternal health-seeking behavior in Ethiopia. Matern Child Health J. 2010;14(6):988–98.CrossRefPubMed Woldemicael G, Tenkorang EY. Women’s autonomy and maternal health-seeking behavior in Ethiopia. Matern Child Health J. 2010;14(6):988–98.CrossRefPubMed
29.
go back to reference WHO Expert Committee. Physical status: the use and interpretation of anthropometry. Volume No 854. WHO Technical Report Series; 1995. pp. 217–50. WHO Expert Committee. Physical status: the use and interpretation of anthropometry. Volume No 854. WHO Technical Report Series; 1995. pp. 217–50.
30.
go back to reference Solomon D, Aderaw Z, Tegegne TK. Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. Int J Equity Health. 2017;16(1):181.CrossRefPubMedPubMedCentral Solomon D, Aderaw Z, Tegegne TK. Minimum dietary diversity and associated factors among children aged 6–23 months in Addis Ababa, Ethiopia. Int J Equity Health. 2017;16(1):181.CrossRefPubMedPubMedCentral
31.
go back to reference Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian SV. The association of parental education with childhood undernutrition in low- and middle-income countries: comparing the role of paternal and maternal education. Int J Epidemiol. 2017;46(1):312–23.PubMed Vollmer S, Bommer C, Krishna A, Harttgen K, Subramanian SV. The association of parental education with childhood undernutrition in low- and middle-income countries: comparing the role of paternal and maternal education. Int J Epidemiol. 2017;46(1):312–23.PubMed
32.
go back to reference Regassa N, Tsegaye G. Women’s status among households in Sothern Ethiopian: Survey of Autonomy and Power. Hum Social Stud. 2016;5(1):30–50.CrossRef Regassa N, Tsegaye G. Women’s status among households in Sothern Ethiopian: Survey of Autonomy and Power. Hum Social Stud. 2016;5(1):30–50.CrossRef
33.
go back to reference Clouston SA, Manganello JA, Richards M. A life course approach to health literacy: the role of gender, educational attainment and lifetime cognitive capability. Age Ageing. 2017;46(3):493–9.PubMed Clouston SA, Manganello JA, Richards M. A life course approach to health literacy: the role of gender, educational attainment and lifetime cognitive capability. Age Ageing. 2017;46(3):493–9.PubMed
34.
go back to reference Batool SA, Batool SS. Impact of Education on Women’s Empowerment: Mediational Role of Income and Self-Esteem. J Res Reflections Educ (JRRE). 2018;12(1). Batool SA, Batool SS. Impact of Education on Women’s Empowerment: Mediational Role of Income and Self-Esteem. J Res Reflections Educ (JRRE). 2018;12(1).
35.
go back to reference Jones R, Haardörfer R, Ramakrishnan U, Yount KM, Miedema S, Girard AW. Women’s empowerment and child nutrition: the role of intrinsic agency. SSM - Population Health. 2019;9:100475.CrossRefPubMedPubMedCentral Jones R, Haardörfer R, Ramakrishnan U, Yount KM, Miedema S, Girard AW. Women’s empowerment and child nutrition: the role of intrinsic agency. SSM - Population Health. 2019;9:100475.CrossRefPubMedPubMedCentral
Metadata
Title
Women empowerment and childhood stunting: evidence from rural northwest Ethiopia
Authors
Emebet Gashaw Wassie
Mesfin Wogayehu Tenagashaw
Tenaw Yimer Tiruye
Publication date
01-12-2024
Publisher
BioMed Central
Keyword
Nutrition
Published in
BMC Pediatrics / Issue 1/2024
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-023-04500-5

Other articles of this Issue 1/2024

BMC Pediatrics 1/2024 Go to the issue