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妇女决策自主权及其与喂养方式和产后生长的关系。

Women's decision-making autonomy and its relationship with child feeding practices and postnatal growth.

机构信息

School of Allied Health Sciences, University for Development Studies, P.O. Box TL 1883, Tamale, Ghana.

出版信息

J Nutr Sci. 2020 Aug 27;9:e38. doi: 10.1017/jns.2020.30. eCollection 2020.

Abstract

Childhood stunting remains a global public health concern. Little has been documented on the effect of women's decision-making autonomy on child growth in settings where decision-making at the household and community levels is largely dominated by men. To assess the relationship between maternal autonomy and child growth, we analysed data from a cross-sectional study of 422 mothers and their youngest child aged 6-24 months in the Bawku West District of Ghana. The dimensions of women's autonomy measured were decision-making power, freedom of mobility and financial autonomy. We then compared how each dimension was associated with the likelihood of stunting and wasting. The important predictors of child growth and dietary intake as measured by the mean length-for-age -score (LAZ) and minimum acceptable (MAD) diet, respectively, were determined using multivariable regression models. The overall composite index of women autonomy (CIWA) showed that 52⋅8 % of women were of high autonomy and half of them had higher autonomy regarding their own and their children's health. After adjusting (multiple regression analysis) for potential confounders, the mean LAZ of children born to women of high autonomy was significantly higher than LAZ of children born to women of low autonomy (β = 0⋅132; 95 % CI 0⋅19, 0⋅95; = 0⋅004). Similarly, high women's autonomy was a significant independent predictor of meeting MAD (AOR = 1⋅59; CI 1⋅09, 2⋅34). Of all, the dimensions of women's autonomy measured in this study, health care autonomy better predicted child growth and dietary intake. Based on the findings, nutrition policies and interventions that enhance women's decision-making autonomy could have a positive impact on child growth outcomes.

摘要

儿童发育迟缓仍然是全球公共卫生关注的问题。在家庭和社区层面的决策主要由男性主导的情况下,关于妇女决策自主权对儿童成长影响的记录很少。为了评估母亲自主权与儿童成长之间的关系,我们分析了来自加纳博克西西部区 422 名母亲及其 6-24 个月大的最小子女的横断面研究数据。衡量妇女自主权的维度包括决策权、行动自由和财务自主权。然后,我们比较了每个维度与发育迟缓的可能性的关系。使用多变量回归模型确定了作为衡量儿童生长和饮食摄入的重要预测指标的年龄别身长 - 评分(LAZ)和最低可接受(MAD)饮食的平均值。妇女自主权的综合指数(CIWA)表明,52.8%的妇女具有高度自主权,其中一半妇女对自己和子女的健康拥有更高的自主权。在调整了潜在混杂因素后(多元回归分析),高度自主权的妇女所生儿童的平均 LAZ 明显高于自主权较低的妇女所生儿童的 LAZ(β=0.132;95%CI 0.19, 0.95;=0.004)。同样,妇女自主权高是满足 MAD 的独立显著预测因素(AOR=1.59;95%CI 1.09, 2.34)。在所有衡量的妇女自主权维度中,医疗自主权更好地预测了儿童的生长和饮食摄入。基于这些发现,增强妇女决策自主权的营养政策和干预措施可能会对儿童成长结果产生积极影响。

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