Women's autonomy, household structure, and maternal-child nutrition in Haiti

Studies in both developed and developing countries suggest that women's status or autonomy within the household can affect important health outcomes, including fertility, child survival, and nutritional outcomes. Few studies of women's status and maternal-child health have examined how women's status may vary based on household composition, including whether the woman is married and whether her partner resides in the same home. Such considerations are particularly important in countries such as Haiti, where although 68% of women with young children are married or in union, over one-third of these married mothers have a spouse residing outside the home. This study explores the relationship between women's decision-making autonomy, household structure, and women's and children's nutritional status in Haiti, using data from 3,114 mother-child dyads in the 2005 Haiti Demographic and Health Survey. Descriptive analysis indicated that nearly 25% of children under age five were stunted or wasted, and 16% of mothers were underweight. Multivariate linear and logistic regression analyses examined 1) child height-for-age, 2) child weight-for-height, and 3) maternal BMI. Regression results indicate that after controlling for household socioeconomic factors, women's decision-making autonomy remains a strong predictor of both child and maternal nutritional status. Household structure moderates this relationship; greater decision-making autonomy predicts lower maternal and child malnutrition in single-parent households (both single mothers and married mothers whose spouse resides elsewhere), but not for two-parent co-residential households. The results from this study suggest that research, programs, and policies addressing malnutrition in Haiti and other developing country contexts should not limit their focus to women's status and development, but rather should be extended to include family characteristics and household structure.