Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-28T01:29:47.337Z Has data issue: false hasContentIssue false
  • English
  • Français

Women's input into household decisions and their nutritional status in three resource-constrained settings

Published online by Cambridge University Press:  02 January 2007

Michelle J Hindin
Michelle J Hindin*
Affiliation:
The Johns Hopkins Bloomberg School of Public Health, Department of Population and Family Health Sciences, 615 N. Wolfe Street, Baltimore, MD 21205, USA
*
*Corresponding author: Email mhindin@jhsph.edu
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objective

To understand the role of women's input into household decisions as a possible factor contributing to women's undernutrition in settings where HIV/AIDS and drought have constrained household resources.

Design and setting

Three cross-sectional surveys of non-pregnant women in partnerships without a birth in the last 3 months were analysed. Factors associated with chronic energy deficiency (CED), defined as body mass index of < 18.5 kg m−2, were assessed among 1920 women in Zimbabwe, 2870 women in Zambia and 6219 women in Malawi.

Results

Prevalence of CED was 4.2% in Zimbabwe, 13.5% in Zambia and 6.7% in Malawi. In Malawi, women with less input into decisions were more likely to have CED. After multivariable adjustment, each additional decision made by the partner increased the odds of CED in Malawi by 1.08 (95% confidence interval (CI) 1.02–1.15); each additional decision made by the woman decreased the odds of CED by 0.90 (95% CI 0.88–0.97). Malawian women with all the final say or with partners with no final say had significantly more CED than expected (odds ratio (OR) = 2.88, 95% CI 1.42–5.83 and OR = 1.64, 95% CI 1.06–2.52, respectively), and removing these points increased the magnitude and significance of the linear trends. In Zambia, the relationship was found for urban women only and no associations were found in Zimbabwe.

Conclusions

Input into household decisions may be a key factor in the cycle of drought and CED. Women with both low input and CED may lose productive capacity, putting them at greater risk of food insecurity and potentially HIV/AIDS in high prevalence settings.

Keywords

WomenDecision-makingChronic energy deficiencyHIV/AIDSDroughtAfrica
Type
Research Article
Information
Public Health Nutrition , Volume 9 , Issue 4 , June 2006 , pp. 485 - 493
Copyright
Copyright © The Authors 2006

References

1Southern African Development Community (SADC) Food, Agriculture and Natural Resources (FANR) Vulnerability Assessment Committee (VAC). Towards Identifying Impacts of HIV/AIDS on Food Security in Southern Africa and Implications for Response: Findings from Malawi, Zambia and Zimbabwe. Harare, Zimbabwe: SADC FANR VAC, 2003.Google Scholar
2The Joint United Nations Programme on HIV/AIDS (UNAIDS). UNAIDS Fact Sheet: HIV/AIDS and Food Security, 09 2003 [online]. Available at http://www.unaids.org/html/pub/publications/fact-sheets03/fs_food_security_2003_en_doc.htmGoogle Scholar
3Grinspoon, S, Mulligan, K. Weight loss and wasting in patients infected with human immunodeficiency virus. Clinical Infectious Diseases 2003; 36(Suppl. 2): S69–78.CrossRefGoogle ScholarPubMed
4Salomon, J, De, TP, Melchior, JC. Nutrition and HIV infection. British Journal of Nutrition 2002; 87(Suppl. 1): S111–9.CrossRefGoogle ScholarPubMed
5Wanke, CA, Silva, M, Ganda, A, Fauntleroy, J, Spiegelman, D, Knox, TA, et al. Role of acquired immune deficiency syndrome-defining conditions in human immunodeficiency virus-associated wasting. Clinical Infectious Diseases 2003; 37(Suppl. 2): S81–4.CrossRefGoogle ScholarPubMed
6Morris, JT, Lewis, S. Mission Report: Lesotho, Malawi, Zambia, and Zimbabwe 22–29 January 2003. New York: United Nations, 10 02 2003.Google Scholar
7Rukuni, M. Africa: addressing growing threats to food security. Journal of Nutrition 2002; 132(11): 3443S–8S.CrossRefGoogle ScholarPubMed
8Focusing on health in the crisis in Zimbabwe. Lancet 2002; 359(9305): 455.CrossRefGoogle Scholar
9United Nations Development Programme (UNDP). Human Development Report 2004: Cultural Liberty in Today's Diverse World. New York: UNDP, 2005.Google Scholar
10Zachariah, R, Spielmann, MP, Harries, AD, Salaniponi, FM. Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Transactions of the Royal Society of Tropical Medicine and Hygiene 2002; 96(3): 291–4.CrossRefGoogle ScholarPubMed
11Niyongabo, T, Henzel, D, Ndayishimyie, JM, Melchior, JC, Ndayiragije, A, Ndihokubwayo, JB, et al. Nutritional status of adult inpatients in Bujumbura, Burundi (impact of HIV infection). European Journal of Clinical Nutrition 1999; 53(7): 579–82.CrossRefGoogle ScholarPubMed
12Gittinger, JP. Household Food Security and The Role of Women. Report No. 96. New York: World Bank, 1990.Google Scholar
13James, WP, Ferro-Luzzi, A, Waterlow, JC. Definition of chronic energy deficiency in adults. Report of a working party of the International Dietary Energy Consultative Group. European Journal of Clinical Nutrition 1988; 42(12): 969–81.Google ScholarPubMed
14Abbas, JD. Gender asymmetries in intrahousehold resource allocation in Sub-Saharan Africa: some policy implications for land and labor productivity. In: Haddad, L, Hoddinott, J, Alderman, H, eds. Intrahousehold Resource Allocation in Developing Countries: Models, Methods and Policy. Baltimore, MD: The Johns Hopkins University Press, 1997, 249–62.Google Scholar
15Hindin, MJ. Women's power and anthropometric status in Zimbabwe. Social Science & Medicine 2000; 51(10): 1517–28.CrossRefGoogle ScholarPubMed
16Bindon, JR, Vitzthum, VJ. Household economic strategies and nutritional anthropometry of women in American Samoa and highland Bolivia. Social Science & Medicine 2002; 54(8): 1299–308.CrossRefGoogle ScholarPubMed
17Baqui, AH, Arifeen, SE, Amin, S, Black, RE. Levels and correlates of maternal nutritional status in urban Bangladesh. European Journal of Clinical Nutrition 1994; 48(5): 349–57.Google ScholarPubMed
18Posel, DR. Intra-family transfers and income-pooling: a study of remittances in Kwazulu-Natal. South African Journal of Economics 2001; 69(3): 501–28.CrossRefGoogle Scholar
19Rose, D, Charlton, KE. Quantitative indicators from a food expenditure survey can be used to target the food insecure in South Africa. Journal of Nutrition 2002; 132(11): 3235–42.CrossRefGoogle ScholarPubMed
20Lemke, S, Vorster, HH, van Rensburg, NS, Ziche, J. Empowered women, social networks and the contribution of qualitative research: broadening our understanding of underlying causes for food and nutrition insecurity. Public Health Nutrition 2003; 6(8): 759–64.CrossRefGoogle ScholarPubMed
21Central Statistical Office, Zimbabwe/Macro International Inc. Zimbabwe Demographic and Health Survey 2000. Calverton, MD: National Statistics Office, Central Board of Health/ORC Macro, 2001.Google Scholar
22National Statistical Office, Malawi/ORC Macro. Malawi Demographic and Health Survey 2000. Zomba, Malawi/Calverton, MD: National Statistics Office/ORC Macro, 2001.Google Scholar
23Central Statistical Office, Zambia/Central Board of Health, Zambia/ORC Macro. Zambia Demographic and Health Survey 2001–2002. Calverton, MD: Central Statistical Office/Central Board of Health/ORC Macro, 2004.Google Scholar
24Hindin, MJ, Adair, LS. Who's at risk? Factors associated with intimate partner violence in the Philippines. Social Science & Medicine 2002; 55(8): 1385–99.CrossRefGoogle ScholarPubMed
25Jewkes, R. Intimate partner violence: causes and prevention. Lancet 2002; 359(9315): 1423–9.CrossRefGoogle ScholarPubMed
26Koenig, MA, Ahmed, S, Hossain, MB, Khorshed Alam Mozumder, AB. Women's status and domestic violence in rural Bangladesh: individual- and community-level effects. Demography 2003; 40(2): 269–88.CrossRefGoogle ScholarPubMed
27Messer, E. Intra-household allocation of food and health care: current findings and understandings – introduction. Social Science & Medicine 1997; 44(11): 1675–84.CrossRefGoogle ScholarPubMed
28Scrimshaw, SCM. Combining quantitative and qualitative methods in the study of intra-household resource allocation. In: Rogers, BL, Schlossman, NP, eds. Intra-household Resource Allocation: Issues and Methods for Development Policy and Planning. Tokyo: United Nations University Press, 1990; 86–98.Google Scholar
29Laier, JK, Davies, S, Milward, K, Kennan, J. Gender, Household Food Security and Coping Stratagies. Report No. 14. Brighton: Institute of Development Studies, 1996.Google Scholar