Empowered Women Raise Healthy Children
A study of Child Malnutrition in Burkina Faso
Research Question:
How does a mother’s agency and access to health systems affect their child’s nutritional health?
Theory behind this study:
- Gender divisions of labor, gender norms and identities, access to and control over resources, and limited autonomy and bargaining positions within the family and community limit poor women’s ability to use health-care services including during pregnancy or delivery (Afsana et al. 2007).
- Research has consistently demonstrated a strong correlation between women's education and child health, but there is a lack of research on confounding effects of wealth and social privilege. I wanted to take that a step further and analyze social privilege in the context of gender norms and women’s ability to make autonomous decisions for their children.
- In many developing countries, women have decreased autonomy and decreased capital from lack of education and productive employment which add to their decreased ability to bargain for their children’s health needs in their household. A lack of resources and a lack of ability to bargain for them may lead to decreased childhood nutrition and decreased use of health services, which in turn negatively affects child health, growth, and development.
Measuring Malnutrition:
Since the endorsement of the community‐based management of acute malnutrition in 2007 in Burkina Faso, implementing agencies have widely adopted the use of MUAC as one of several new approaches that can be used to target resources to the most severely malnourished children and improve program efficiency and coherency. (Isanaka et al., 2019)
According to UNICEF, a MUAC measurement under 11.5cm in children indicates severe undernutrition and under 12.5cm indicates acute undernutrition. Measurements between 12.5 and 13.5cm refers to “at risk” of acute undernutrition.
In the PMA2017 survey, MUAC scores were collected in centimeters. For the purpose of this study, each child's MUAC was categorized as either "severely malnourished", "acutely malnourished", "at risk", or "not at risk" according to UNICEF definitions.
Rural communities suffer from unmet healthcare needs and child malnutrition.
In this map, a comparison of malnutrition in children 6-23 months in Burkina Faso and the associated Livelihood Zones are shown. Malnutrition was estimated by integrating spatially referenced health data from IPUMS PMA. The Livelihood Zones were applied using spatial data from USAID’s Famine Early Warning Systems Network (FEWS NET).
Having access to healthcare services can be a very important tool for ensuring health in children. All the mothers who have never used a health care service lived in rural communities. This could be solved by empowering the mother to have means to seek the services, or by bringing expanding services to rural areas.
Here you can see that the average Middle Upper Arm Circumference, shown on the y-axis, is higher in urban settings than in rural settings.
Compared to the capital region, Ouagadougou, children in all other parts of Burkina Faso experience malnutrition at higher rates.
Measuring Empowerment:
Mother’s empowerment was determined by assigning each mother a value of 0-4, based on their household wealth, education status, employment status, and marital status.
Most mothers fall in the first 2 categories of empowerment: 0 or 1. This means that most mothers don't receive any education, do not have employment outside of the home, and do not fall within the the top 4 or 5 wealth quintiles. It is hypothesized that most mothers with an empowerment score of 1 are solely married.
Mother's empowerment is an important indicator of their child's nutritional status.
This study finds that children are less likely to be malnourished if their mother is more empowered** and mothers who are more empowered are more likely to use health care services that support their child’s wellbeing***
*=0.5, **=0.01, ***=0.001
Likelihood of Preventing Malnutrition by Empowerment Variable. From this model, increasing household wealth would be the most effective way to prevent child malnutrition, followed by mother's attainment of employment outside the home and mother's educational attainment.
Purchasing food together prevents malnutrition.
This study finds that children are less likely to be malnourished if both of their parental figures make decisions on food purchasing**
*=0.5, **=0.01, ***=0.001
Less children experience malnutrition if both parents make decisions about food purchasing together, as compared to only the primary caretaker.
Questions? Comments?
Feel free to contact me directly!
Kassandra Fate | fatex008@umn.edu
Data Sources
IPUMS Performance Monitoring for Action Burkina Faso Nutrition - household Survey 2017 (N = 40,139)
Famine Early Warning System Network Burkina Faso Livelihood Zone 2014
References
Afsana K, Rashid SM, Chowdhury AMR et al. (2007) Promoting maternal health: gender equity in Bangladesh. British Journal of Midwifery, 15(11): 721
Isanaka, S., Hanson, K. E., Frison, S., Andersen, C. T., Cohuet, S., & Grais, R. F. (2019). MUAC as the sole discharge criterion from community‐based management of severe acute malnutrition in Burkina Faso. Maternal & Child Nutrition, 15(2), e12688.
