Is mother’s financial autonomy associated with stunting among children aged 7–35 months: An empirical study from India

Stunting depicts chronic deprivation and is a huge public health problem in several developing countries. Considering the sociocultural and sociodemographic factors of India, we aimed to examine the relationship between maternal autonomy and stunting among children <35 months. We have used the data from the latest round of National Family health survey conducted in 2015–16. The main exposure variable was women’s autonomy which are represented in our study by the four dimensions- decision-making, physical mobility, financial autonomy, attitudes towards domestic violence, the main predictor variable was stunting among children. Chi-square analysis, univariate and multivariable binary logistic regression analysis were performed to find the association of childhood stunting and women’s autonomy. The results were reported at 5% level of significance. All the autonomy variables have shown a significant association with child stunting at 5% level of significance. The unadjusted odds of stunting were found to be significant with respect to all the four dimensions of autonomy variables except physical autonomy. However, after adjusting for other explanatory factors attenuated these relationships and made them statistically insignificant except for women’s economic autonomy (AOR = 0.91; 95% C.I.-(0.85, 0.98)) which was found to be significantly affecting the child’s status of stunting. Our study reinforces that maternal autonomy is a significant predictor of childhood stunting. Hence, we recommend that policy makers, while designing interventions and policies, must address the socioeconomic inequalities at the community level while devising ways to improve women’s empowerment. As it has far-reaching consequences on the nutrition status of the upcoming generations.

Infant and young child feeding practices and its associated factors among mothers of under two years children in a western hilly region of Nepal

Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. Nepal government has developed and implemented different programs to improve infant and young child feeding practice. However, the practice remains poor and is a major cause of malnutrition in Nepal. This study aims to identify infant and young child feeding practices and its associated factors among mothers of children aged less than two years in western hilly region of Nepal. A descriptive cross-sectional study was carried out among 360 mothers of under two years’ children in Syangja district. A semi structural questionnaire was used. Data was entered in EpiData and analyzed using IBM SPSS version 21. Descriptive statistics were used to report the feeding practices and other independent variables. Bivariate and multivariate logistic regression model was used to establish the factors associated with infant and young child feeding practices. The prevalence of breastfeeding, timely initiation of breastfeeding, exclusive breastfeeding, timely initiation of complementary feeding, minimum dietary diversity, minimum meal frequency and minimum acceptable diet (MAD) were 95.6%, 69.2%, 47.6%, 53.3%, 61.5%, 67.3% and 49.9% respectively. Normal delivery (AOR 6.1, 95% CI 1.2–31.3) and higher maternal autonomy (AOR 5.2, 95% CI 1.8–14.6) were significantly associated with exclusive breastfeeding. Similarly, crop production and food security (AOR 3.8, 95% CI 1.9–7.7), maternal knowledge on MAD (AOR 2.5, 95% CI 1.0–6.2) and maternal autonomy (AOR 4.2, 95% CI 2.1–8.4) were significantly associated with minimum acceptable diet. Factors such as maternal education, maternal health services utilization, maternal knowledge, and maternal autonomy were associated with infant and young child feeding practices, which warrants further attention to these factors to reduce malnutrition.

Influence of Maternal Autonomy Support on Social Withdrawal in Young Children: The Moderated Mediation Effect of Executive Function and Behavioral Inhibition

Objectives: This study investigated the relationship between maternal autonomy support and social withdrawal, executive function, and behavioral inhibition in young children. Specifically, it examined how behavioral inhibition moderates the mediating effect of executive function on the relationship between maternal autonomy support and social withdrawal in young children.Methods: Participants were 273 3-to 4-year-old children and their mothers. The data obtained were analyzed using descriptive statistics, frequency analysis, Cronbach’s α, and Pearson correlation analysis with SPSS 20.0. Meanwhile, the PROCESS Macro 3.5 software was used for analyzing the moderating effect, mediating effect, and moderated mediation effect.Results: Our findings indicated that, first, maternal autonomy support and executive function, social withdrawal, and behavioral inhibition in young children were significantly correlated. Second, executive function had a partial mediating effect on the relationship between maternal autonomy support and social withdrawal in young children. Third, the behavioral inhibition had a moderating effect on the relationship between maternal autonomy support and executive function. Last, the findings verified that the mediating effect of executive function on the relationship between maternal autonomy support and social withdrawal was moderated by behavioral inhibition.Conclusion: These results indicate that improving executive function and reducing social withdrawal through maternal autonomy support can promote positive development in young children, even when behavioral inhibition is high. Thus, they can be used to highlight the importance of parenting behaviors in shaping young children’s temperament. Furthermore, the results could provide a framework for parental education programs and early intervention programs for reducing social withdrawal in children.

The effect of social restrictions, loss of social support, and loss of maternal autonomy on postpartum depression in 1 to 12-months postpartum women during the COVID-19 pandemic

Background: This study focuses on postpartum women, who are one of the most vulnerable populations during the COVID-19 pandemic, aiming to reveal mental health consequences of social restrictions, loss of social support, or loss of autonomy. Methods: A cross-sectional study for postpartum women was conducted in October 2020 (N = 600). The Edinburgh Postpartum Depression Scale (EPDS) was used to measure postpartum depression. The prevalence ratios were estimated by log-binomial regression models, adjusting for age, education, household income, residence area, parity, the timing of delivery, and a prior history of depression. Results: The prevalence of postpartum depression was 28.7% (EPDS ≥), 18.6% (≥11), and 13.1% (≥13). Social restrictions including cancellation of home visits by health care professionals, or cancellation of infant checkups or vaccinations, loss of support during pregnancy or after delivery including loss of opportunities to consult with health care professionals or friends, or cancellation of parents or other family member visits to support, and loss of autonomy about delivery or breastfeeding, were associated with postnatal depression. Conclusion: About 30% of women who delivered and raised a baby during the COVID-19 pandemic had postpartum depression, which is much higher than a pre-pandemic meta-analysis. COVID-19 related social restrictions or loss of social support from healthcare professionals, family, and friends were significantly associated with postpartum depression. Also, loss of maternal autonomy in delivery and breastfeeding is associated with postpartum depression. The results indicate that both formal and informal support should not be limited to prevent postpartum depression during the pandemic.

The Delayed Effect of Parental Control on the Adaptation of Men and Women in Adulthood

Parental control is an integral part of parent-child relations and a traditional tool of socialization. However, numerous negative effects of parental intervention in the child’s inner world are known. This study clarifies the delayed effects of parental control and a detached parenting style. 270 men and women are aged 35-44 years filled in the questionnaires of hardiness, the sovereignty of the psychological space, and perceived behavior by the father and mother. The results confirmed the prevalence of parental control, especially its manifestations on the part of mothers about daughters. In adult women's lives, mothers' directiveness correlates with hostility and violation of personal boundaries as regards the body, personal territory, things, habits, social connections, and values; men noted maternal interference in the formation of sovereign habits and values. At the same time, parental non-involvement is widespread; the autonomy of fathers about children is significantly greater than mothers. Correlation analysis confirmed the assumption that parental directivity/autonomy determines the hardiness and sense of integrity of personal boundaries in adulthood. The effect of parental control in adulthood depends on the gender of the children and the parents. Maternal control is a strong negative factor for daughters, while maternal autonomy positively correlates with indicators of hardiness. Paternal control was a neutral factor for daughters. For sons, the directivity of father and mother contributes to the formation of resilience. The conclusion was made about the need for differentiation of positive and negative effects of parental control, taking into account gender positions.

The impact of child health interventions and risk factors on child survival in Kenya, 1993–2014: a Bayesian spatio-temporal analysis with counterfactual scenarios

Background During the millennium development goals period, reduction in under-five mortality (U5M) and increases in child health intervention coverage were characterised by sub-national disparities and inequities across Kenya. The contribution of changing risk factors and intervention coverage on the sub-national changes in U5M remains poorly defined. Methods Sub-national county-level data on U5M and 43 factors known to be associated with U5M spanning 1993 and 2014 were assembled. Using a Bayesian ecological mixed-effects regression model, the relationships between U5M and significant intervention and infection risk ecological factors were quantified across 47 sub-national counties. The coefficients generated were used within a counterfactual framework to estimate U5M and under-five deaths averted (U5-DA) for every county and year (1993–2014) associated with changes in the coverage of interventions and disease infection prevalence relative to 1993. Results Nationally, the stagnation and increase in U5M in the 1990s were associated with rising human immunodeficiency virus (HIV) prevalence and reduced maternal autonomy while improvements after 2006 were associated with a decline in the prevalence of HIV and malaria, increase in access to better sanitation, fever treatment-seeking rates and maternal autonomy. Reduced stunting and increased coverage of early breastfeeding and institutional deliveries were associated with a smaller number of U5-DA compared to other factors while a reduction in high parity and fully immunised children were associated with under-five lives lost. Most of the U5-DA occurred after 2006 and varied spatially across counties. The highest number of U5-DA was recorded in western and coastal Kenya while northern Kenya recorded a lower number of U5-DA than western. Central Kenya had the lowest U5-DA. The deaths averted across the different regions were associated with a unique set of factors. Conclusion Contributions of interventions and risk factors to changing U5M vary sub-nationally. This has important implications for targeting future interventions within decentralised health systems such as those operated in Kenya. Targeting specific factors where U5M has been high and intervention coverage poor would lead to the highest likelihood of sub-national attainment of sustainable development goal (SDG) 3.2 on U5M in Kenya.

Barriers and facilitators to exclusive breastfeeding practices in a disadvantaged community in southern Zimbabwe: A maternal perspective

Background: Despite the well-documented significance of EBF in developing countries, many poor communities still present with the highest percentage of disease burden resulting from suboptimal breastfeeding. Objectives: To identify the maternal perception on barriers and facilitators to EBF in Gwanda District, Zimbabwe. Methods: Five focused group discussions were conducted using 40 purposively-selected mothers while eight in-depth key informant interviews were also conducted. The qualitative data collected were analyzed using thematic network analysis. The themes were used in interpreting the perceived barriers and facilitators of EBF. Results: The study identified individual, socio-cultural, health service-related and environmental factors as the basic themes influencing maternal infant feeding choice. These were grouped into two organizing themes, namely, barriers and facilitators of EBF which were summarized into one global theme: EBF intention. Facilitating factors were maternal autonomy, self-efficacy, knowledge of EBF definition, maternal diet, support and sourcing information from healthcare workers. Poor infant feeding practices, affordability of alternative infant feeding options, ritualistic/symbolic infant preparations, family conflicts, increased workload and hot climate were barriers to EBF. Conclusion: To increase in uptake of EBF in the study area required comprehensive multiple stakeholder interventions incorporating the mothers, influential family members, religion and traditional advisors, and healthcare workers.

Higher maternal autonomy is associated with reduced child stunting in Malawi

Child undernutrition is a major health problem in Malawi. We assessed the association between maternal autonomy and child stunting in Malawi. We utilized nationally representative pooled cross-sectional data from the 2010 and 2015/16 Malawi Demographic and Health Surveys (MDHS), which included 7348 mother (28.1 ± 6.8 years, range 15–49 years)—child (27.6 ± 16.7 months, range 0–59 months) pairs. Maternal autonomy composite scores captured decision-making power, tolerance of domestic violence, and financial independence. The nutritional outcome measure was stunting (height-for-age z score < – 2). Logistic regression assessed associations between maternal autonomy and stunting, and dominance analysis evaluated the relative importance of the associated factors. From the two surveys combined, 39.2% were stunted. Stunting decreased from 45.0% in 2010 to 34.6% in 2015/16; concurrently, maternal autonomy improved and was evidently associated with stunting (aOR = 0.81, 95% CI = 0.71, 0.93;p = 0.002). However, this association was probably mediated by other factors associated with improved child nutrition, including maternal education and family wealth, which, along with child age, were associated with stunting in the dominance analysis. Concurrent interventional programs may also have contributed to the decrease in stunting between the surveys, thus moderating the effect of maternal autonomy.