Predictors of early childhood undernutrition in Nigeria: the role of maternal autonomy

Public Health Nutr. 2019 Aug;22(12):2279-2289. doi: 10.1017/S1368980019000818. Epub 2019 May 21.

Abstract

Objective: To investigate the relationship between maternal autonomy and various indices of child undernutrition among children aged <2 years in Nigeria, considering the cultural context and sociodemographic factors.

Design: Population-based, cross-sectional study. Associations between various indices of maternal autonomy and child undernutrition (specifically stunting, underweight and wasting) were determined using weighted bivariate and multivariable logistic regression modelling.

Setting: 2013 Nigerian Demographic Health Survey.

Participants: Children aged between 3 and 24 months (n 7532).

Results: Overall, 31·4 % (n 2270), 29·8 % (n 2060) and 25·0 % (n 1755) of children in the sample were stunted, underweight and wasted, respectively. Women with acceptance of domestic violence (low autonomy) were approximately 18 and 14 % less likely to have stunted (OR = 0·82; 95 % CI 0·71, 0·94) and underweight children (OR = 0·86; 95 % CI 0·75, 0·99), respectively. Similarly, women with low power in their couple relations were 17 % less likely to have children who were wasted (OR = 0·83; 95 % CI 0·72, 0·97). Sociodemographic predictors of all indices of undernutrition included maternal education and Hausa ethnicity. Additionally, stunting was predicted by lack of exclusive breast-feeding, low income and being of Fulani ethnicity; wasting by having mothers with low BMI; and underweight by breast-feeding initiation within 1 h hour of birth, polygamous homes, mothers with low BMI and being of Fulani ethnicity.

Conclusions: Women with acceptance of domestic violence and low power in couple relations were found to be less likely to have children with indices of undernutrition. This unexpected finding calls for future exploratory research, and policies and interventions that target at-risk subgroups.

Keywords: Maternal autonomy; Stunting; Undernutrition; Underweight; Wasting.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Child Nutrition Disorders / epidemiology*
  • Child Nutrition Disorders / etiology*
  • Child, Preschool
  • Cross-Sectional Studies
  • Demography
  • Domestic Violence / statistics & numerical data
  • Family Relations
  • Female
  • Growth Disorders / epidemiology
  • Growth Disorders / etiology
  • Health Surveys
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Mothers / psychology*
  • Mothers / statistics & numerical data
  • Nigeria / epidemiology
  • Personal Autonomy*
  • Risk Factors
  • Socioeconomic Factors
  • Thinness / epidemiology
  • Thinness / etiology
  • Wasting Syndrome / epidemiology
  • Wasting Syndrome / etiology