A Redaction by ARPS Media with Authors: Professor Haddy Tunkara-Bah & Professor Jainaba Sey-Sawo
Abstract Background
The study examines the link between women’s empowerment and child undernutrition in The Gambia, analyzing GDHS 2019–20 data for children under 5, focusing on stunting and underweight. Key findings include:
– 17% of children were stunted and 12% underweight.
– Women with no education had higher odds of having undernourished children (51% for stunting, 52% for underweight) compared to those with primary or higher education.
– Thin mothers had increased odds of having stunted (44%) and underweight (69%) children.
– Acceptance of wife beating correlated with higher odds of stunting (69%) and underweight (66%).
– Women from poorer households had greater odds of undernutrition (69% for underweight, 83% for stunting) than those from wealthier households.
– The analysis utilized StataSE software and controlled for confounding variables.
1. Introduction
In 2015, global leaders set a goal to reduce chronic malnutrition in children under five by 40% by 2025, but only three regions achieved a 50% decline in stunting from 1990 to 2015. Women’s empowerment is essential for improving child nutrition and health, but in The Gambia, patriarchal societal structures hinder women’s access to education, employment, and decision-making. Research indicates that maternal education and income positively impact child nutrition. Despite governmental efforts to empower women, challenges such as child marriage persist, negatively affecting women’s opportunities and contributing to malnutrition and higher child mortality rates.
1.1 Research Question
The research investigates the link between women’s empowerment and the rates of stunting and underweight in children under 5 in The Gambia. It will assess women’s empowerment through factors such as education level, decision-making ability, employment status, attitudes towards domestic violence, and the age at first marriage and childbirth.
1.2 Conceptual Framework
The relationship between women’s empowerment and child nutrition in The Gambia, highlighting the following main points:
– Women’s empowerment positively influences child nutrition through various factors.
– Wealthier households provide more nutritious food, while poverty limits women’s work opportunities.
– Maternal nutritional status (BMI) and partner characteristics impact child nutrition as confounding variables.
– The study focuses on individual indicators of women’s empowerment due to the absence of standardized measures.
– Further disaggregated analyses of empowerment indexes are needed to understand their relationship with child nutrition outcomes better.
2. Data and Methods
2.1 Data
The analysis utilized data from The Gambia’s Demographic and Health Survey (GDHS), which employed a nationally representative sample through a two-stage sampling process. This involved selecting enumeration areas and then households. The survey focused on women aged 15 to 49 who were married or living with partners and had children under age 5. The unit of analysis was the child, examining the mothers’ characteristics and health-related information for children born in the last five years, including issues like stunting and underweight.
2.2. Variables
2.2.1 Dependent Variables
The nutritional status of children is evaluated using two indicators:
– Stunting: Determined by the height-for-age Z-score (HAZ), stunted children have a HAZ below -2 standard deviations from the median.
– Underweight: Assessed through the weight-for-age Z-score (WHZ), where underweight children have a WHZ below -2 SD from the median.
These indicators are used to identify children with growth retardation issues.
2.2.2 Women’s Empowerment Variables
The measurement of women’s empowerment using five indicators: educational level, employment status, decision-making, age at first marriage, and acceptance of wife beating. Decision-making is assessed based on who makes significant household decisions, with scores of 2-3 indicating empowerment and 0-1 indicating lack of empowerment. Acceptance of wife beating is evaluated through respondents’ agreement with justifications for it. Women’s educational levels are categorized as either educated (primary level and above) or non-educated (no primary education), while employment status is determined by work history in the past year.
2.2.3 Other Variables
The relationship between maternal empowerment and child undernutrition can be influenced by several key factors, including:
– Mother’s parity (number of living children).
– Child’s age, sex, and birth order.
– Mother’s educational level (no education/primary vs. above).
– Husband/partner employment status (employed vs. not employed).
– Mother’s nutritional status (BMI: normal, thin, overweight, or obese).
– Residential area (rural vs. urban).
– Household wealth index (classified as poor, middle, or rich).
2.3. Statistical Analysis
The analyses were cluster-adjusted and sample-weighted for population representation. Descriptive statistics, cross-tabulations, and a Chi-square test were used for bivariate analysis of women’s empowerment and confounding variables. Multiple logistic regressions assessed relationships between women’s empowerment and other factors. Preliminary tests for normality, linearity, multicollinearity, and homogeneity of variance were conducted, excluding variables with a VIF of 5 or more and selecting one variable for pairs with a correlation coefficient of 0.7 or above. Obesity and normal weight were excluded due to high VIF values. Statistical significance was set at p-values less than 0.05, with data analysis performed using Stata SE version 17.
3. Results
3.1 Characteristics of Respondents
A study of 7,123 women aged 15 to 49, who were married or living with partners and had children under 5, revealed several key findings:
– Most women were aged 25 to 34 (54.2%) and employed (54.2%).
– 39% experienced early sexual debut (ages 8 to 16), and 51.3% had their first child between the ages of 12 and 19.
– Most had a normal BMI (51.4%), and 69% had 1 to 2 living children under age 5.
– A significant portion (58.1%) accepted wife beating in certain situations, while 90% felt empowered to make family planning and financial decisions.
– Most lived in urban areas (64.1%) with a high wealth index (45.5% classified as rich).
– Among children, 62.5% were aged 0 to 2, 61.3% were male, with 17% and 12% stunting and underweight rates, respectively.
– Most husbands/partners were illiterate (55.1%), but nearly all were employed (96.4%).
3.2 Bi-variate Analysis Result
The bi-variate analysis identifies several key factors associated with stunting and underweight in children under 5 years old. Significant factors include the number of living children, household wealth, maternal thinness, acceptance of wife beating, birth order, and education level of the mother’s partner. Stunting is linked to place of residence and child age, while underweight is associated with maternal age at first sex and maternal overweight/obesity. There is no significant association found between maternal education, employment status, decision-making, and child underweight or stunting.
3.3 Multiple Logistic Regression Result
– Women with no education have significantly higher odds of having stunted (51%) and underweight (52%) children compared to those with primary or higher education.
– Mothers classified as thin have increased odds of having stunted (OR = 1.44) and underweight (OR = 1.69) children.
– Acceptance of wife beating is linked to higher odds of having stunted (69%) and underweight (66%) children.
– Women from poor households have greater odds of having stunted (83%) and underweight (69%) children compared to middle or affluent households; middle-class women also have higher odds of stunting (OR = 1.79) than those from wealthy families.
– Employment status, age at first sex and birth, and decision-making are not significantly associated with stunting and underweight in children under age 5.
4. Discussion
Using DHS data, this study in The Gambia explored the connection between children’s undernutrition and women’s empowerment indicators. Key findings revealed that low maternal education and acceptance of wife-beating are linked to child stunting and being underweight, with illiterate mothers at higher risk of having undernourished children. Approximately 48% of Gambian women lack education, which affects both their well-being and their children’s health. The research also highlighted the prevalence of wife beating as a cultural norm that contributes to gender inequalities and intimate partner violence, negatively impacting maternal and child health. Additionally, low household wealth was associated with increased risks of underweight and stunted children. The study emphasizes the need for improving women’s education and status to enhance child health outcomes.
5. Strengths and Limitations Of The Study
This study uses nationally representative data to explore the link between women’s empowerment and children’s nutritional status in The Gambia. The findings offer insights for policy on child nutrition, but the cross-sectional design limits causal conclusions. Notably, infant feeding variables were omitted to preserve sample size. Future research should focus on path analyses to investigate the specific impacts of different dimensions of women’s empowerment on child undernutrition, notably underweight and stunting.
6. Conclusion
The study examines the link between women’s empowerment and child undernutrition in The Gambia, noting that maternal nutrition and poverty significantly impact children’s health. It points out that women’s disempowerment has detrimental effects on both children and society. The research advocates for enhancing women’s empowerment to improve child health outcomes and urges further investigation into the direct impact of women’s empowerment on children’s nutritional status.
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Read how women’s empowerment impacts child nutrition in The Gambia, with low education, acceptance of wife beating, and poverty linked to higher rates of stunting and underweight in children under 5, based on GDHS 2019–20 data.
