Women\u2019s economic empowerment, participation in decision-making and exposure to violence as risk indicators for early childhood caries

Morenike Oluwatoyin Folayan,Mary Obiyan,Arheiam Arheiam,Hamideh Daryanavard,Maha El Tantawi,Ola B Al-Batayneh,Rosa Amalia,Robert Schroth,Ana Vukovic,Balgis Gaffar

doi:10.1186/s12903-020-1045-5

Abstract

ObjectivesIn view of the association between early childhood caries (ECC])and maternal social risk factors, this study tried to determine if there were associations between indicators of processes, outputs and outcomes of women’s empowerment, and the prevalence of ECC.MethodsIn this ecological study, indicators measuring the explanatory variables - economic empowerment, decision-making and violence against women - were selected from the Integrated Results and Resources Framework of the UN-Women Strategic Plan 2018–2021 and WHO database. Indicators measuring the outcome variables - the prevalence of ECC for children aged 0 to 2 years, and 3 to 5 years - were extracted from a published literature. The general linear models used to determine the association between the outcome and explanatory variables were adjusted for economic level of countries. Regression estimates (B), 95% confidence intervals and partial eta squared (η2) were calculated.ResultsCountries with more females living under 50% of median income had higher prevalence of ECC for 3 to 5-year olds (B = 1.82, 95% CI = 0.12, 3.52). Countries with higher percentage of women participating in their own health care decisions had higher prevalence of ECC for 0 to 2-year-olds (B = 0.85, 95% CI = 0.03, 1.67). Countries with higher percentage of women participating in decisions related to visiting family, relatives and friends had higher prevalence of ECC for 3 to 5-year-olds (B = 0.67, 95% CI = 0.03, 1.32). None of the indicators for violence against women was significantly associated with the prevalence of ECC.ConclusionEmpowerment of women is a welcome social development that may have some negative impact on children’s oral health. Changes in policies and norms are needed to protect children’s oral health while empowering women.

Highlights

Childhood caries (ECC) is a non-communicable disease with both biological and social constructs
Global level indicators of women’s economic empowerment, decision-making ability, exposure to violence and Early childhood caries (ECC) prevalence Table 2 provides an overview of the data available for the study
It shows that the number of countries with available data varied: only a fifth of the 193 United Nation countries (20.2%, n = 39) had data about the percentage of females living below 50% of median income while 90.7% (n = 175) countries had data on homicides per 100,000 female

Summary

Introduction

Childhood caries (ECC) is a non-communicable disease with both biological and social constructs It affects more than 621 million children worldwide [1,2,3], and negatively impacts the general health and wellbeing of children [4, 5]. There is extensive literature highlighting the biological etiology and risk indicators for ECC [5,6,7] and a few on the family related risk factors Maternal factors such as age and marital status [8] psychosocial status [9, 10], knowledge of oral health [10, 11] and oral health behavior [12, 13] are risk factors for ECC. Maternal empowerment is associated with increased mobility that improves social networking [26, 27], access to health information [16, 28, 29] and access to food and medicines [30, 31]

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