Graduate Institute of Public Health, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City, 40402, Taiwan.
Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City, 40402, Taiwan.
Sci Rep. 2021 Feb 16;11(1):3882. doi: 10.1038/s41598-021-83346-2.
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.
儿童营养不良是马拉维的一个主要健康问题。我们评估了马拉维产妇自主权与儿童发育迟缓之间的关系。我们利用了来自 2010 年和 2015/16 年马拉维人口与健康调查（MDHS）的全国代表性汇总横断面数据，其中包括 7348 对母婴（母亲 28.1±6.8 岁，年龄范围 15-49 岁；儿童 27.6±16.7 个月，年龄范围 0-59 个月）。产妇自主权综合评分反映了决策权、对家庭暴力的容忍度和经济独立性。营养结果测量指标为发育迟缓（身高年龄 z 评分＜-2）。逻辑回归评估了产妇自主权与发育迟缓之间的关联，优势分析评估了相关因素的相对重要性。从两次调查综合来看，39.2%的儿童发育迟缓。发育迟缓率从 2010 年的 45.0%下降到 2015/16 年的 34.6%；同时，产妇自主权得到改善，与发育迟缓明显相关（优势比 aOR=0.81，95%置信区间 CI=0.71，0.93；p=0.002）。然而，这种关联可能是由其他与改善儿童营养相关的因素介导的，包括产妇教育和家庭财富，这些因素以及儿童年龄，在优势分析中与发育迟缓相关。同期的干预性计划也可能有助于减少两次调查之间的发育迟缓，从而缓和产妇自主权的影响。
