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Women's decision-making autonomy and dietary intake in Jharkhand State, India

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:

Keywords: Food and Nutrition, Women's Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Nutritional Status: The Influence of Poverty, Equity, and Autonomy

The 134th Annual Meeting & Exposition (November 4-8, 2006) of APHA