Associations between women's empowerment and children's health status in Ethiopia.

Yacob Abrehe Zereyesus,Mellissa H. Withers,Solomon Zena Walelign,Solomon Kibret Abreha

doi:10.1371/journal.pone.0235825

Abstract

Although women's empowerment has gained attention over the last two decades, our understanding of the associations between different dimensions of women's empowerment and different children's health outcomes is limited. This study aims to measure the extent of women's empowerment and to examine its associations with the children's health status in Ethiopia. Data were obtained from the 2016 Ethiopian Demographic and Health Survey (EDHS). The sample is restricted to a sub-sample of 10,641 women from 15 to 49 years old and their children under the age of five years. We used children's height-for-age and weight-for-height Z-scores and pneumonia and anemia experience as indicators of children's health outcome. Women's empowerment is measured by five indices reflecting their participation in decision-making, attitudes towards wife-beating by husband, barriers to health care access, asset ownership, and socio-economic variables. These indicators of empowerment were constructed using exploratory and confirmatory factor analysis. A Multiple Indicators Multiple Causes (MIMIC) model was employed to examine the relationship between women's empowerment and latent child health outcomes, after controlling for relevant covariates. Results suggests that enhancing women's empowerment in the household in terms of their socio-economic status (i.e., increasing women's access to education, information, media, and promoting saving) was associated with less likelihood of the children's being stunted or wasted (p<0.05). Higher women's empowerment in terms of household decision-making power were also associated with better children's health status measured by the children's experience of pneumonia and anemia (p<0.05). All aspects of women's empowerment are not related with children's health indicators. Women's empowerment dimensions related with child health have a varying degree of association with the different children's health indicators. Gender-specific policies focusing on increasing women's access to education, media, information, and promoting saving and their participation in the household decision making are some of the strategies for improving their children's health and wellbeing.

Highlights

Ensuring better child health outcomes remains a global public health challenge due to the prevalence of children’s vulnerability to malnutrition and exposure to infectious diseases, in developing countries [1,2]
We refer some studies and the studies indicated that implementing the Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) analyses using a full sample and split sample leads to similar results as far as methodological explanations can account for cases in which EFA and CFA lead to different conclusions based on the same sample
39% of women reported that distance to a health facility was not a big problem

Summary

Introduction

Ensuring better child health outcomes remains a global public health challenge due to the prevalence of children’s vulnerability to malnutrition and exposure to infectious diseases, in developing countries [1,2]. Child health has featured in the international development agenda of the last 20 years Best examples for this are the adoption of the Millennium Development Goals (MDGs) and Sustainable Development Goals (SDGs) by the United Nations in 2000 and 2015, respectively. Both MDGs and SDGs have been dedicated to promoting healthy lives and well-being for all children, MDG-4 which aims to reduce child mortality and SDG-3 which aims to end preventable deaths of newborns and under-5 children by 2030 [3,4]. In SSA, 1 out of dies before the child’s fifth birthday, times higher than in high-income countries, where in high-income countries, that number was 1 in 185 [5]

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Discussion

Conclusion