The Influence of Women's Autonomy: Mothers from Scheduled Castes/Tribes and Backward Populations

Background/Purpose:  

 Malnourishment, stunting, and wasting rates in India are among the world’s highest, resulting in excess of more than one million child deaths in India annually.   According to UNICEF, malnutrition is defined as a child measuring at least 2 standard deviations below the median weight-for-height for age of the reference population.  Rates of malnutrition are over-represented in Scheduled Castes and Scheduled Tribes (ST/SC), marginalized peoples who make up over 24% of India’s population.  Although significant disparities exist among the different tribes residing in different regions, some tribes exhibit lower fertility, high literacy rate, high work participation rate, rejection of child marriage, and social and cultural traditions that value the economic worth of women.  Empowerment theory is a lens through which to view and understand how people lacking equal access to and control over valued resources can achieve power through community participatory processes; therefore, it was used as a guiding framework for the study.  This research was undertaken to understand the relationship between SC/ST women’s autonomy and child malnutrition. 

Methods:

This study used data from the 2005-2006 National Family Health Survery-3, which was conducted by 18 research organizations in 29 Indian states. The sample consisted of 19,640 women between the ages of 15-49 (mean age=26.87).  Autonomy was measured using five items concerning women’s say on healthcare, financial decisions, and visits to family and relatives.  Malnutrition was assessed using a standardized (z-score) score for the child’s weight-for height for their specific age. Age, religion, education level, and place of residence (urban or rural) were used as covariates.  Structural Equation Modeling (SEM) was used to test how women’s autonomy impacts children’s malnutrition in SC/ST tribes in India. 

Results:

The measurement model was a good fit, X²(5,N=19640)=249.64, p<.001, CFI=.99, RMSEA=.05, 90% CI [.45,.55], and indicated that all five autonomy variables were good indicators of women’s autonomy.  Autonomy was negatively related to malnutrition (such that malnutrition decreases as autonomy increases) when controlling for covariates related to malnutrition.  Older aged, less educated, urban, and poorer mothers had more malnourished children.

Conclusion and Implications:

Our findings suggest that women’s autonomy is an important factor in children’s malnutrition within scheduled castes and tribes. However, the influence of demographic variables such as mother’s age, wealth, education and place of residence cannot be ignored. Although India has many public nutrition and social safely programs integrated within its state health system, it lacks a comprehensive nutrition strategy. Our results shed light on the fact that women’s autonomy plays a significant role in children’s lives. Therefore, in a patriarchal society with a culturally embedded caste system, context-specific strategies to increase women’s autonomy must be sought.  Historically, social workers recognize that marginalized populations need to be empowered.  International social work efforts should be targeted toward initiatives that increase women’s autonomy.