Child Nutritional Status, Feeding Practices and Women's Autonomy in Rural Andhra Pradesh, India Public Deposited

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  • March 20, 2019
  • Shroff, Monal R.
    • Affiliation: Gillings School of Global Public Health, Department of Nutrition
  • Childhood under-nutrition is a prevalent public health issue through out the developing world. In recent surveys, such as the one carried out by the National Nutrition Monitoring Bureau, India, poor dietary intakes (energy, protein and micro-nutrients) and nutrition status was evident among 0-3 year old children, even in families where the adults meet their daily dietary requirements (NNMB, 2001). This indicates that availability of food may not be the only necessarily cause of under-nutrition among the under three-year-olds in such families. Further, recent research postulates the linkage between women's autonomy and child health, particularly in countries such as India where mothers play a vital role in childcare. This dissertation investigates the influence of maternal autonomy on child feeding and child nutritional status in a sequence of three essays. In the first essay, using logistic regression, we examine the overall effect of mother's autonomy on child stunting using a secondary dataset from the state of Andhra Pradesh (AP) in India. In particular we examine the influence of indicators of autonomy on child stunting. Our results show financial independence and not needing permission to go to the local market have a positive impact in reducing child stunting. In the second essay, we further investigate the role of woman's autonomy on feeding behavior through a set of qualitative interviews, conducted among a sample of 43 mothers in 3 rural villages of Andhra Pradesh, India. In particular, we explored the perception and beliefs regarding women's autonomy and environmental factors such as income and family structure and their influence on infant feeding practices. We find that not only does mother's autonomy play a role in the woman seeking information through formal health care system for a her to introduce foods and liquids to the infant, but the family structure and the cultural norms surrounding the mother-child environment also plays an important role in child feeding practices. In our third essay, using structural equation modeling approach, we examine the impact of seven latent dimensions of maternal autonomy on infant feeding practice. Our results indicate that mothers with higher autonomy [indicated by financial autonomy and decrease experience of domestic violence] are more likely to breastfeed 3-5 month old infants. Mothers in joint family households are more likely to have infants with poor growth. Overall, these results suggest that improving certain dimensions of maternal autonomy will have a positive impact on infant care and growth outcomes in rural settings of India. Future research should consider autonomy as a multi-dimensional concept to examine the influence of individual dimension of autonomy on health behaviors and health outcomes.
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  • Bentley, Margaret
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