Joshi Supriya, Acharya Yubraj
Department of Agricultural Economics, Sociology and Education, The Pennsylvania State University, University Park, Pennsylvania, United States of America.
Department of Health Policy and Administration, The Pennsylvania State University, University Park, Pennsylvania, United States of America.
PLOS Glob Public Health. 2022 Jul 20;2(7):e0000355. doi: 10.1371/journal.pgph.0000355. eCollection 2022.
There is limited empirical evidence from low-income countries on the effects of women's seclusion during menstruation on children's health. The objective of the current study was to examine the association between women's extreme seclusion during menstruation and their children's nutritional status and health in Nepal. Using nationally representative data from the 2019 Multiple Indicator Cluster Survey, we examined the relationship between mother's exposure to extreme forms of seclusion during menstruation and anthropometric measures of nutritional status and health outcomes among children ages 5-59 months (n = 6,301). We analyzed the data in a regression framework, controlling for potential confounders, including province fixed effects. We assessed extreme seclusion during menstruation based on women's exposure to chhaupadi, a practice in which women are forced to stay away from home-in separate huts or animal sheds-during menstruation and childbirth. Mothers' exposure to extreme seclusion during menstruation was associated with 0.18 standard deviation lower height-for-age z-scores (HAZ) (p = 0.046) and 0.20 standard deviation lower weight-for-age z-scores (WAZ) (p = 0.007) among children. Analysis by the place of seclusion showed that the negative association was stronger when women stayed in animal sheds-0.28 SD for HAZ (p = 0.007) and 0.32 SD for WAZ (p<0.001)-than when they stayed in separate huts. Extreme seclusion was associated with higher incidence of acute respiratory symptoms but not with incidence of diarrhea, irrespective of the place of seclusion. Women's extreme seclusion during menstruation in Nepal has profound implications on the physical health of their children. Additional research is needed to ascertain potential mechanisms.
来自低收入国家的关于女性经期隔离对儿童健康影响的实证证据有限。本研究的目的是检验尼泊尔女性经期极端隔离与其子女营养状况和健康之间的关联。利用2019年多指标类集调查的全国代表性数据，我们研究了母亲在经期遭受极端隔离形式与5至59个月儿童营养状况的人体测量指标及健康结果之间的关系（n = 6301）。我们在回归框架中分析数据，控制潜在的混杂因素，包括省份固定效应。我们根据女性是否接触“查乌帕迪”来评估经期极端隔离情况，“查乌帕迪”是一种习俗，即女性在经期和分娩期间被迫离家，住在单独的小屋或牲畜棚里。母亲在经期遭受极端隔离与子女身高别年龄标准差分数（HAZ）降低0.18（p = 0.046）以及年龄别体重标准差分数（WAZ）降低0.20（p = 0.007）相关。按隔离地点分析表明，当女性住在牲畜棚时，这种负相关更强——HAZ降低0.28标准差（p = 0.007），WAZ降低0.32标准差（p<0.001）——而住在单独小屋时则不然。无论隔离地点如何，极端隔离与急性呼吸道症状的较高发病率相关，但与腹泻发病率无关。尼泊尔女性经期极端隔离对其子女的身体健康有深远影响。需要进一步研究以确定潜在机制。
