Associations between women’s empowerment and child development, growth, and nurturing care practices in sub-Saharan Africa: A cross-sectional analysis of demographic and health survey data

Abstract

Background Approximately 40% of children 3 to 4 years of age in low- and middle-income countries have suboptimal development and growth. Women’s empowerment may help provide inputs of nurturing care for early development and growth by building caregiver capacity and family support. We examined the associations between women’s empowerment and child development, growth, early learning, and nutrition in sub-Saharan Africa (SSA). Methods and findings We pooled data on married women (15 to 49 years) and their children (36 to 59 months) from Demographic and Health Surveys that collected data on child development (2011 to 2018) in 9 SSA countries (N = 21,434): Benin, Burundi, Cameroon, Chad, Congo, Rwanda, Senegal, Togo, and Uganda. We constructed a women’s empowerment score using factor analysis and assigned women to country-specific quintile categories. The child outcomes included cognitive, socioemotional, literacy–numeracy, and physical development (Early Childhood Development Index), linear growth (height-for-age Z-score (HAZ) and stunting (HAZ <−2). Early learning outcomes were number of parental stimulation activities (range 0 to 6) and learning resources (range 0 to 4). The nutrition outcome was child dietary diversity score (DDS, range 0 to 7). We assessed the relationship between women’s empowerment and child development, growth, early learning, and nutrition using multivariate generalized linear models. On average, households in our sample were large (8.5 ± 5.7 members) and primarily living in rural areas (71%). Women were 31 ± 6.6 years on average, 54% had no education, and 31% had completed primary education. Children were 47 ± 7 months old and 49% were female. About 23% of children had suboptimal cognitive development, 31% had suboptimal socioemotional development, and 90% had suboptimal literacy–numeracy development. Only 9% of children had suboptimal physical development, but 35% were stunted. Approximately 14% of mothers and 3% of fathers provided ≥4 stimulation activities. Relative to the lowest quintile category, children of women in the highest empowerment quintile category were less likely to have suboptimal cognitive development (relative risk (RR) 0.89; 95% confidence interval (CI) 0.80, 0.99), had higher HAZ (mean difference (MD) 0.09; 95% CI 0.02, 0.16), lower risk of stunting (RR 0.93; 95% CI 0.87, 1.00), higher DDS (MD 0.17; 95% CI 0.06, 0.29), had 0.07 (95% CI 0.01, 0.13) additional learning resources, and received 0.16 (95% CI 0.06, 0.25) additional stimulation activities from their mothers and 0.23 (95% CI 0.17 to 0.29) additional activities from their fathers. We found no evidence that women’s empowerment was associated with socioemotional, literacy–numeracy, or physical development. Study limitations include the possibility of reverse causality and suboptimal assessments of the outcomes and exposure. Conclusions Women’s empowerment was positively associated with early child cognitive development, child growth, early learning, and nutrition outcomes in SSA. Efforts to improve child development and growth should consider women’s empowerment as a potential strategy.

Exploring Future Research Agenda for Rural Mother’s Empowerment: A Study at the Intersection of Bibliometric and Systematic Literature Review

“…Education is also associated with empowerment, as a mother’s education is associated with children’s nutritional and health-related aspects (Imai et al, 2014), such as anaemia (Sunguya et al, 2020). Furthermore, women’s empowerment is associated with children’s early learning (Bliznashka et al, 2021).…”

Community Empowerment with Stunting Risk Factors Based on Home visit Approach: Scoping Review

“…Empowerment of related families through education provided to individuals, groups, and in the community and monitored through home visits has been proven to be able to provide behavioral changes in families (Islam et al, 2018). Mothers who have a high level of education have sufficient knowledge so that they can influence childcare patterns and understand how to improve children's nutritional status in preventing stunting (Bliznashka et al, 2021). This is in line with research that said that the level of a mother's education greatly affects health status, especially in improving the nutritional status of children (Ogechi, 2014).…”

“…Empowerment of women can improve a person's socioeconomic status so that he can fulfill the nutritional adequacy given to children in preventing stunting. Women's ability to participate in empowerment can affect children's nutritional status (Bliznashka et al, 2021). Empowerment of women is a form of distribution aimed at improving living standards and nutrition, reducing poverty, and urbanization.…”

Understanding the interaction between stunting and women’s autonomy

“…Menciptakan lingkungan tanpa kekerasan pada perempuan akan mewujudkan derajat kesehatan perempuan yang lebih baik yang pada gilirannya berdampak signifikan pada pertumbuhan anaknya (Mekonnen et al, 2021). Sebaliknya, anak yang dilahirkan oleh ibu yang berdaya di dalam aspek gender, otonomi dan pendidikan, memiliki peluang untuk lebih sehat baik fisik maupun non-fisiknya (Bliznashka et al, 2021).…”