Water, sanitation, and hygiene practices mediate the association between women's empowerment and child length-for-age z-scores in Nepal.

In Nepal, more than one-third of children are stunted. Prior studies have shown that women's empowerment in agriculture is associated with child (<2 years) length-for-age z-scores (LAZ) in Nepal. This study tests whether child dietary diversity (DD) and household water, sanitation, and hygiene (WASH) facilities and practices mediate the associations between women's empowerment and LAZ. With a cross-sectional dataset of 4,080 households from 240 rural communities across 16 districts of Nepal, we used ordinary least squares regression models to first estimate the associations between women's empowerment and LAZ for children 6 to 24 months (n = 1,402; our previous published analysis included all children <24 months of age), using the Women's Empowerment in Agriculture Index's Five Domains of Empowerment subindex. We used standardized structural equation models to test whether child DD and/or household WASH mediated the association between women's empowerment and child LAZ. Overall, women's empowerment was positively associated with child LAZ (β = 0.24, P = 0.03), as found in our previous analyses. In the mediation analysis, women's empowerment was positively associated with WASH (β = 0.78, P < 0.001), and in turn child LAZ (β = 0.09, P < 0.001). Women's empowerment was not associated with DD, but DD was associated with LAZ (β = 0.06, P = 0.05). Empowered women had better WASH practices than nonempowered women, which translated into higher child LAZ. Child DD was not a mediating factor in the association between women's empowerment and child LAZ. More research is needed to explore other pathways by which women's empowerment may affect child nutrition outcomes

Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

Islam MM, Alam M, Tariquzaman M, et al. Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model. BMC Public Health. 2013;13(1): 11.BACKGROUND: Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable. METHODS: The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model. RESULTS: The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother's education, father's education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman. CONCLUSIONS: Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh

Association Between Women's Empowerment and Maternal and Child Nutrition in Kalalé District of Northern Benin.

BackgroundEvidence on effectiveness of women's empowerment (WE) to reduce undernutrition is limited in sub-Sahara Africa, and few studies incorporate multidimensional measures of WE.ObjectiveTo examine whether a WE status, in sum and across leadership, decision-making, mobility, economic security, male involvement in housework, and nonfamily group domains, is associated with women and their children nutritional status in Kalalé district of northern Benin.MethodsData were obtained from the 2014 Solar Market Garden baseline study: 767 paired reproductive-age women aged 15 to 49 years and children 6 to 59 months old. Exploratory principal component (cross-validate with confirmatory) factor analysis was first conducted to identify the structure of empowerment. Then, using a new survey-based index, regression analysis was conducted to examine associations between WE measures and maternal dietary diversity score (DDS) and body mass index (BMI), as well as their child's DDS, height-for-age z score (HAZ), weight-for-height z score (WHZ), and weight-for-age z score (WAZ).ResultsPositive associations were observed between women's composite empowerment, leadership, maternal DDS and BMI, and female child's DDS. However, opposite signs were found between economic security and child's DDS. Mobility was positively associated with female children's WHZ and male children's HAZ and WAZ, while decision-making was correlated with male child's WHZ and female children's WAZ.ConclusionsWomen's empowerment can be associated with undernutrition. Efforts to improve nutrition may benefit from empowerment initiatives that promote women's self-confidence and decision-making in Benin. However, additional qualitative and longitudinal research may enhance understanding of WE in the present area

Agriculture’s role in the Indian enigma: help or hindrance to the crisis of undernutrition?

In recent decades India has achieved one of the fastest economic growth rates in the world, yet its progress against both child and adult undernutrition has been sluggish at best. While this Indian variant of the so-called Asian enigma presents many puzzles, one of the puzzles pertains to agriculture's role. Many researchers and policymakers have high expectations of agriculture's potential to reduce undernutrition, despite a lack of substantive evidence. In this paper we assess this tenuous evidence base by exploring two key channels by which agricultural production conditions can influence nutritional outomes: a food consumption pathway and a maternal employment-time use pathway. We conclude with an appraisal of some possible entry points for pro-nutrition agricultural policies