28 个撒哈拉以南非洲国家的妇女赋权与儿童人体测量失败：按性别不平等指数进行的跨级别互动

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health Pub Date : 2024-03-03 DOI:10.1016/j.ssmph.2024.101651

Yun-Jung Eom , Hyejun Chi , Sohee Jung , Jinseo Kim , Joshua Jeong , S.V. Subramanian , Rockli Kim

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引用次数: 0

摘要

s:儿童营养不良仍然是一个重大的全球健康问题，尤其是在撒哈拉以南非洲地区（SSA）。鉴于母亲在儿童早期健康和发展中扮演的重要角色，我们研究了个人层面的妇女赋权和国家层面的性别不平等指数（GII）与撒哈拉以南非洲儿童营养不良的共同关系。我们汇总了 28 个撒哈拉以南非洲国家最近的人口与健康调查。对于 137,699 名 5 岁以下儿童，营养不良的定义是人体测量失败（发育迟缓、体重不足、消瘦）。妇女赋权采用基于调查的妇女赋权（SWPER）指数的三个领域进行评估：对暴力的态度、社会独立性和决策；国家层面的性别不平等采用联合国开发计划署的 GII 进行测量。在对社会人口协变量进行调整后，对 SWPER 和 GII 及其交互作用与儿童人体测量不合格及其交互作用的共同关联性进行了三级逻辑回归研究。总体而言，32.9%的儿童发育迟缓，17.6%的儿童体重不足，6.7%的儿童消瘦。在 SWPER 各个领域赋权水平较低的母亲，其子女发育迟缓的几率较高（对暴力的态度：OR=1.15; 95% - 0.5）：OR=1.15；95% CI，1.11-1.19；社会独立性：OR=1.21；95% CI，1.17-1.25；决策：OR=1.16；95% CI，1.12-1.20），体重不足和消瘦的结果一致。与妇女赋权无关，国家级全球信息基础设施增加了体重不足（ORs=1.46；95% CI，1.15-1.85 至 1.50；95% CI，1.18-1.90）和消瘦（ORs=1.56；95% CI，1.24-1.97 至 1.61；95% CI，1.27-2.03）的概率。在发育迟缓和体重不足方面，妇女赋权与国家级 GII 之间存在显著的交互作用（P<0.05）。在性别不平等现象较为严重的撒哈拉以南非洲国家，提高妇女的社会独立性和决策权尤其可以降低其子女的人体测量失败风险。旨在加强妇女赋权的政策和干预措施应考虑每个国家的性别不平等程度。

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Women’s empowerment and child anthropometric failures across 28 sub-Saharan African countries: A cross-level interaction by Gender Inequality Index

Background

Child undernutrition remains a major global health issue, particularly in sub-Saharan Africa (SSA). Given the important role mothers play in early childhood health and development, we examined how individual-level women’s empowerment and country-level Gender Inequality Index (GII) are jointly related with child undernutrition in SSA.

Methods

We pooled recent Demographic and Health Surveys from 28 SSA countries. For 137,699 children <5 years old, undernutrition was defined using anthropometric failures (stunting, underweight, wasting). Women’s empowerment was assessed using three domains of Survey-based Women’s EmPowERment (SWPER) index: attitude to violence, social independence, and decision-making; and country-level gender inequality was measured using GII from United Nations Development Programme. Three-level logistic regression was conducted to examine the joint associations of SWPER and GII as well as their interactions with child anthropometric failures, after adjusting for sociodemographic covariates.

Results

Overall, 32.85% of children were stunted, 17.63% were underweight, and 6.68% had wasting. Children of mothers with low-level of empowerment for all domains of SWPER had higher odds of stunting (attitude to violence: OR=1.15; 95% CI, 1.11-1.19; social independence: OR=1.21; 95% CI, 1.17-1.25; decision-making: OR=1.16; 95% CI, 1.12-1.20), and consistent results were found for underweight and wasting. Independent of women’s empowerment, country-level GII increased the probability of underweight (ranging ORs=1.46; 95% CI, 1.15-1.85 to 1.50; 95% CI, 1.18-1.90) and wasting (ranging ORs=1.56; 95% CI, 1.24-1.97 to 1.61; 95% CI, 1.27-2.03). Significant interaction was found between women’s empowerment and country-level GII for stunting and underweight (p<0.05).

Conclusions

In SSA countries with greater gender inequality, improving women’s social independence and decision-making power in particular can reduce their children’s risk of anthropometric failures. Policies and interventions targeted at strengthening women's empowerment should consider the degree of gender inequality in each country.

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来源期刊

Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

2.10%

发文量

298

审稿时长

101 days

期刊介绍： SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.