Women's Empowerment, Household Dietary Intake, and Individual Dietary Intakes in Urban Bangladesh: Repeated Cross‐Sectional Study
Authors: Sinharoy Sheela Selin , Waid Jillian , Ali Masum , Yount Kathryn M , Thilsted Shakuntala Haraksingh , Webb‐Girard Amy 
Published: November 2023

Objective

We aimed to assess how women's resources for empowerment influence their household‐ and individual‐level food consumption and quantify possible pathways through women's agency.

Methods

We analyzed data collected from 598 households in 30 poor neighborhoods of Dhaka, Bangladesh. Data collectors visited each household three times, in rounds between February 2015 and February 2016, as part of a study of urban food consumption and intra‐household distribution. We defined resources for empowerment as grades of schooling (less than secondary versus any secondary). To measure women's agency, we used exploratory and confirmatory factor analysis to identify two latent factors for decision‐making and voice with husband. We measured household food frequency as the number of times any household member consumed a given food group (of nine groups) in the prior seven days. Of the three components of food security (availability, access, and utilization), household food frequency measures the utilization component, when controlling for household wealth as a proxy for access. We measured women's individual dietary diversity using a quantitative 24‐hour recall, with data categorized into ten food groups using the Minimum Dietary Diversity for Women (MDDW‐10) scale. The household and individual consumption variables were each averaged across the three survey rounds, to capture dietary practices over one year, accounting for seasonal and other variation. We used structural equation modeling to estimate indirect effects, direct effects, and total effects, adjusting for household wealth and clustering.

Results

In adjusted models, women's secondary schooling was directly and positively associated with household food frequency (β=2.91, p<0.001) and women's dietary diversity (β=0.219, p=0.001) scores but not with decision‐making agency nor voice with husband (p=0.49 and p=0.052, respectively). Neither decision‐making agency nor voice with husband was associated with household food frequency (p=0.20 and p=0.52, respectively). While decision‐making agency was directly positively associated with women's dietary diversity (β=0.62, p=0.001) there was no significant association between voice with husband and women's dietary diversity (p=0.54). Household food consumption was directly and positively associated with women's dietary diversity (β=0.051, p<0.001).

Conclusions

Our study is the first to examine how selected resources for women's empowerment were associated with household‐ and individual‐level dietary patterns in urban Bangladesh, directly and indirectly through aspects of women's agency. We observed positive associations of secondary schooling with household food consumption and women's dietary diversity; however, this relationship did not appear to operate through the dimensions of women's agency measured here. Neither dimension of women's agency was associated with household consumption, but decision‐making agency was associated with women's dietary diversity. Thus, household consumption and wealth being equal, women with more decision‐making agency may improve their own dietary diversity in this urban context. Future research should explore the influence of other resources for women's empowerment to understand potential pathways of influence on women's dietary diversity. Research is also needed on how other domains of women's agency influence food security and nutrition in urban poor populations.

Support or Funding Information

Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), WorldFish, and Laney Graduate School of Emory University