Does communal women empowerment mitigate the risk of acute respiratory infection among under-five children in Pakistan?

Abstract

ObjectivesGrowing evidence has associated solid/polluted fuel (PF) burning with higher risks of acute respiratory infection (ARI) among under-five children. However, higher usage of PF contributed to upsurge communal air pollution, which may further aggravate ARI. Instead, women empowerment may mitigate the risk of ARI by shifting towards cleaner fuels.This study aimed to estimate the mitigating impact of community-level women empowerment on ARI among under-five children in Pakistan. In addition, the study also aimed to explore the mitigating impact pathway of empowered women community. Study designA cross-sectional study design was used to collect data under 2018 Pakistan Demographic and Health Survey. MethodsRetrieved data used in the analysis comprised 12,295 surviving under-five children suffering from cough coinciding with short and rapid breathing and fever from 561 communities. Because of hierarchical structure of the data, two-level mixed-effects logistic regression was used to compute unbiased odds ratios. ResultsApproximately 58% of total households used PF as a primary fuel, and PF usage by more than 50% of households led to 129 polluted communities. About 19% of children suffered from symptoms of ARI within 2 weeks preceding the survey. After adjusting for individual, household and communal attributes, the odds of suffering from ARI were 1.156 times higher among children from polluted households than their counterparts. The odds of ARI were aggravated to 1.333 for highly polluted communities. Women empowerment mitigated the risk of ARI by odds of 0.708 and 0.671 at individual level and communal levels, respectively. After shifting towards cleaner fuels, highly women empowered community-mitigated ARI risk by odds of 0.765. ConclusionsUnder-five children of highly polluted communities were at higher risk of ARI, while highly women empowered communities mitigated the risk by shifting towards cleaner fuels. We suggest interventional efforts towards empowering poor women in mitigating ARI.