Abstract
Undernutrition in children remains a major global health issue and the prevalence of undernutrition in children under age five in the Democratic Republic of the Congo (DRC) is among the highest in the world. Both biological and socioeconomic factors contribute to undernutrition, and the literature reports an association between women’s empowerment and lower rates of child undernutrition in sub-Saharan Africa. However, the relationship between women’s decision-making power and child undernutrition is less understood. The objective of this study was to evaluate the association between women’s decision-making power and stunting/wasting in their children under age five in the DRC. This study used cross-sectional data from the 2013–2014 DRC Demographic and Health Survey, from which a sample of 3,721 woman-child pairs were identified. Women were classified as having decision-making power in five decision-making dimensions if they participated in the decision either alone or jointly with their husband or partner or someone else. Child height-for-age and weight-for-height Z-scores were used to determine stunting and wasting, respectively, according to the World Health Organization Child Growth Standards. Multivariate regression analyses demonstrated that none of the five dimensions of decision-making power were associated with stunting or wasting in children. Further research that evaluates women’s decision-making power with more detailed, relevant and context-specific measures is warranted to more accurately investigate women’s decision-making power and undernutrition in children.
Highlights
UndernutritionUndernutrition remains a major global health issue, accounting for 45% of deaths in children under age five who are at the highest risk of becoming undernourished [1]
The following inclusion criteria were used to select the final sample: women who were living with a husband or with a partner as if they were married at the time of the survey, and their youngest child aged 6–59 months had complete anthropometric data
The stunted group was observed to have a higher proportion of male children (p < 0.01), children greater than one year of age (p < 0.001), children whose mothers were without higher education (p < 0.001), children whose mothers were between 35 and 49 years old (p = 0.02), and children with a preceding birth interval of < 24 months (p < 0.01)
Summary
Undernutrition remains a major global health issue, accounting for 45% of deaths in children under age five who are at the highest risk of becoming undernourished [1]. An indicator of chronic undernutrition, refers to a child who is too short for their age and is associated with prolonged food insecurity or persistent illness. Wasting is an indicator of acute undernutrition, and refers to a child who is too thin for their height [2] and reflects acute food shortages or illnesses. The World Health Organization (WHO) reports that stunting prevalence over 30% is considered severe and wasting prevalence over 5% indicates food insecurity [2]. Children who are stunted may suffer severe irreversible physical and cognitive damage [2, 9], and children who are wasted have an increased risk of death if they do not receive timely treatment [2]
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