Women's empowerment and nutritional status of children: new evidence for Bangladesh

OBJECTIVES: This study examines aspects of women's empowerment related to the nutritional status of under-five children in Bangladesh, including their age-appropriate food intake and access to healthcare during acute respiratory tract infection (ARI).

DESIGN: Three waves of the Bangladesh Demographic Health Survey (BDHS) data (2011, 2014 and 2017-2018) were pulled and utilised to construct three domains of the Survey-Based Women's Empowerment Index, such as social independence, intrinsic agency and instrumental agency. The height-for-age Z (HAZ), weight-for-age Z (WAZ) and weight-for-height Z (WHZ) scores were used to measure the nutritional status of offspring. Two variables were generated to measure age-appropriate food intake and treatment-seeking from medically trained providers (MTP) at the commencement of ARI. Generalised structural equation modelling was performed to develop pathways between women's empowerment and children's nutritional status.

SETTINGS: Data were collected from eight administrative divisions in Bangladesh.

PARTICIPANTS: A total of 18 706 married women aged 15-45 years residing with their husbands and having at least one under-five child.

RESULTS: Women's social independence was positively associated with HAZ (0·25 (95 % CI: 0·22, 0·28)), WAZ (0·21 (0·18, 0·24)) and WHZ (0·06 (0·02, 0·09)). Intrinsic agency positively influenced HAZ (0·03 (0·02, 0·04)) and WAZ (0·02 (0·01, 0·02)). Both social independence and intrinsic agency promoted appropriate feeding, while instrumental agency had a negative effect on food consumption (-0·0026 (-0·005, -0·0002)). Both age-appropriate food intake and seeking treatment from MTP during recent ARI episodes improved nutritional outcomes of offspring.

CONCLUSION: Maternal social independence and intrinsic agency enhance the nutritional status, food consumption and healthcare access of offspring in Bangladesh.