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Karen P. Menendez, MPH¹, Subrato K. Mondal, MA, MPS, PhD², Michael J. McQuestion, MS, MPH, PhD¹, Kaliprasad Pappu, MBBS, MCommH², and Michele L. Dreyfuss, MPH, PhD³. (1) Department of Population & Family Health Sciences, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W4510, Baltimore, MD 21205, 443-676-9996, kmenende@jhsph.edu, (2) Research, Monitoring and Evaluation Team, Child In Need Institute, 357A Ashok Nagar, Road No-5, Ranchi, India, (3) Department of Population & Family Health Sciences, Johns Hopkins Bloomber School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205

Malnutrition is highly prevalent among Indian women. Food availability, intra-household food allocation, and cultural beliefs all play a role in women's dietary intake. Less is known about the role of women's autonomy. Using data from 3,536 women ages 15-49 in Jharkhand State, India, this study examined how women's decision-making autonomy was associated with dietary intake. Autonomy was assessed by women's reports of household decision-making power in 3 domains, and summary indices created (range 0-3). Dietary intake was measured by a one week food frequency recall. Multinomial logistic regression was used to estimate the association of women's decision-making autonomy and diet. Among women, 5-10% made decisions alone, 15-29% jointly, and 63-72% said their husbands made decisions. Vegetables were the most commonly (97%) and dairy products (24%) and fruits (19%) were the least commonly consumed foods. Pulses, dairy products, and meat/fish/eggs were consumed regularly (≥2 times/wk) by 63%, 16%, and 45% of women, respectively. In multivariate models adjusting for education, family type, religion, caste, afternoon rest, and a wealth index, women who made 1+ household decisions alone were more likely to regularly consume pulses (AOR=1.49; CI: 1.22-1.82) and meat/fish/eggs (AOR=1.52; CI: 1.27-1.83), and women who made 1+ decisions jointly were less likely to regularly consume pulses (AOR=0.81; CI: 0.70-0.95), dairy products (AOR=0.59; CI: 0.48-0.73), and meat/fish/eggs (AOR=0.73; CI: 0.63-0.84) compared to those whose husbands made 1+ decisions alone. These findings indicate women's decision-making autonomy in rural Indian households is strongly associated with disparities in women's diets.

Learning Objectives:

• 1. List the categories of decision-making autonomy and the frequency of their occurrence among women in Jharkhand State, India.
• 2. Describe general dietary intake patterns in this population.
• 3. Recognize that household decision-making autonomy may play a role in determining dietary intake among Indian women.

Keywords: Food and Nutrition, Women's Health

Presenting author's disclosure statement:

Any relevant financial relationships? No