Coming up short: Women's empowerment and stunting in children 6 to 23 months in Sierra Leone Open Access
Maguiraga, Fodie (2014)
Published
Abstract
Background: Sierra Leone has some of the world's highest rates of maternal and child under-nutrition. Worldwide, many studies indicate that low status of women and gender inequality are factors that increase maternal and child malnutrition. CARE's Window of Opportunity project (2009-2012) initiated nutrition specific interventions to improve the nutritional status of children under two years of age. The objective of this study was to assess the relationship between women's empowerment (encouraged through women's civic and community group participation) in the household and stunting among children 6 to 23 months of age.
Methods: Cross sectional data were collected using a sample of 585 women with children 6 to 23 months in the intervention areas of the program. Data were analyzed using SPSS20. Anthropometric data were calculated using the World Health Organization's software, Anthro. The independent variable, stunting, was defined as length for age Z-scores <-2sd from the standard population. Model variables included women's empowerment, child sex, maternal age, maternal education and civic group participation. A logistic regression was run to assess the association between stunting and women's empowerment measured by their participation in the household decision-making.
Results: The mean age of children was 12.7 months (sd. =4.9). 52.2 percent of children were girls and 47.8 percent boys. Overall, 15 percent of children were stunted. The level of stunting was 10 percent among women who participated in household decision-making and 16 percent among those who did not participate in the household decision-making. Bivariate association showed that the women's empowerment index was significantly associated with stunting (unadjusted OR=.56; 95% CI=0.28, 1.13). Multivariate association confirmed the bivariate results (adjusted OR=0.51, CI=0.244, 1.059)
Conclusion: Women who participated in the household decision-making alone or jointly with their husbands, were considered as empowered and were less likely to have stunted children compared to women who did not participate in shared household decision-making. Public health interventions that aim to influence stunting among children 6 to 23 months should consider implementing programming aimed at increasing women's participation in household decision-making.
Table of Contents
Acknowledgments. 1
List of Tables and Figures. 3
List of Acronyms. 4
CHAPTER I: INTRODUCTION.. 5
Problem statement. 7
Purpose of the project. 7
CHAPTER II: LITERATURE REVIEW... 8
Defining Women's empowerment and gender. 9
Women's empowerment, an overview of definitions. 9
Defining gender and its relation to women's health. 14
Gender, women's empowerment and maternal and child nutrition. 16
Women's empowerment and women's nutrition. 19
Women's empowerment and nutrition of children under two. 21
Measuring women's empowerment. 23
Conceptual framework. 27
Women's empowerment and child nutritional status in Sierra Leone. 29
State of malnutrition in Sierra Leone (SLDHS, 2008). 33
Critical evaluation of gap in the knowledge. 35
Overview of CARE's Window of Opportunity Program.. 35
Research question and hypothesis. 37
CHAPTER III: METHODOLOGY, MEASURES AND MODEL DEVELOPMENT. 38
Survey Design, Area and Tools. 38
Survey Design. 38
Survey Area and Sampling. 39
Survey Tools. 39
Training of Enumerators. 40
Data Collection. 41
Data Management and Analysis. 41
Variables and Measures. 41
Statistical Model 44
Modeling strategy. 45
CHAPTER IV: RESULTS. 46
Description of Population. 46
Bivariate Analysis. 48
Bivariate Association. 49
Multivariate association. 49
CHAPTER V: DISCUSSION.. 51
Maternal age. 52
Sex of the child. 53
Maternal education. 53
Civic and community groups participation. 54
Limitations. 55
CHAPTER VI: CONCLUSION.. 56
Recommendations for future researches and nutrition programming. 57
REFERENCES 58About this Master's Thesis
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