Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
Center for Research on Environment, Health and Population Activities, Kathmandu, Nepal.
Matern Child Nutr. 2022 Jul;18(3):e13374. doi: 10.1111/mcn.13374. Epub 2022 May 25.
Women's nutritional status remains poor in South Asia, impacting maternal and infant health outcomes. Women's household status is also low, as evidenced by eating behaviours. We started with triadic qualitative interviews with newly married women, husbands and mothers-in-law to explore the link between women's status and eating patterns, followed by longitudinal data from a cohort of 200 newly married women in rural Nepal to measure associations over time. Quantitative data were collected every 6 months for 18 months (four rounds of data) between 2018 and 2020. Interviews suggested that household relationships, women's status, and how much and what types of food she was given were intricately linked. Using mixed effects logistic regression models, we explore the association between markers of changing women's status (becoming pregnant, giving birth and working outside the home) on two outcomes (eating last always/usually and achieving minimum dietary diversity). We also explore for interaction between women's status and household food insecurity. Pregnancy increases women's dietary diversity, but this is not sustained post-partum. Women who work outside the home are less likely to eat last in the household. Food insecurity is associated with both the order of household eating and dietary diversity. Interactions between food insecurity and giving birth suggested that women who give birth in food insecure households are more likely to eat last in the household. Changes in women's household status are associated with some improvements in dietary diversity and order of household eating, but the associations are not long-lasting and depend on food security status.
南亚女性的营养状况仍然很差，影响到母婴健康状况。女性的家庭地位也很低，这从她们的饮食习惯就可以看出。我们首先对新婚妇女、丈夫和婆婆进行了三方定性访谈，以探讨妇女地位与饮食习惯之间的联系，然后对尼泊尔农村的 200 名新婚妇女进行了队列纵向研究，以衡量随着时间的推移的关联。2018 年至 2020 年期间，每 6 个月收集一次定量数据，共收集了 18 个月（四轮数据）。访谈表明，家庭关系、妇女地位以及她得到多少和什么类型的食物之间存在着错综复杂的联系。我们使用混合效应逻辑回归模型，探索了女性地位变化（怀孕、分娩和外出工作）的两个结果（最后一个吃饭/通常吃饭和达到最低饮食多样性）之间的关联。我们还探索了女性地位和家庭粮食不安全之间的相互作用。怀孕增加了妇女的饮食多样性，但产后这种情况不会持续。外出工作的妇女在家中最后一个吃饭的可能性较小。粮食不安全与家庭饮食顺序和饮食多样性都有关。粮食不安全与分娩之间的相互作用表明，在粮食不安全家庭中分娩的妇女更有可能在家中最后一个吃饭。妇女家庭地位的变化与饮食多样性和家庭饮食顺序的一些改善有关，但这种关联不会持久，取决于粮食安全状况。
