Enhancing pathways from agriculture-to-nutrition
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Date
2021-12-03
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Kamuzu University of Health Sciences
Abstract
Study TitleType of research study:
Women’s empowerment in nutrition and maternal nutrition outcomes: examination of linkages and identification
of strategies for optimising outcomes among beneficiaries of a feeding trial in a rural agro-based community in
Malawi
The proposed study is a cross-survey that determines associations between Women’s empowerment and
maternal nutrition outcomes in a rural Malawian community. Consensus exists that addressing malnutrition, a
problem of public health significance in Malawi, will require a combination of both nutrition specific and
sensitive interventions. Women’s empowerment, alone, or through the agriculture impact pathway, has generated
considerable interest within various sectors, nutrition inclusive, despite limited evidence of its impacts on
nutrition. The proposed study to be conducted in Kasungu District under Wimbe Traditional Authority, involves
research to this effect.
Problem:
The nature, strength, and direction of associations between women’s empowerment and nutrition outcomes
seems to vary widely and is ambiguous. No local research has assessed comprehensively associations between
women’s empowerment and maternal nutrition or attempted to measure women’s empowerment in the realm of
nutrition. Using a measure closely related to nutrition, the proposed study will provide data on the status of
women’s empowerment and propose actions to facilitate nutrition empowerment and outcomes. This ambiguity
largely stems from differences in the measures used for women’s empowerment. This is further compounded by
a lack of local data in the field to inform actions. No research in Malawi has attempted to measure women’s
empowerment in the realm of nutrition or assessed comprehensively associations between women’s
empowerment and maternal nutrition. This study, therefore, will not only add to the body of knowledge in the
relevant fields, but will generate evidence with policy and programmatic implications. proposes research which
can support and guide national strategies and policies in these dimensions.
Objectives:
Broadly, the study seeks to identify strategies for optimising maternal nutrition outcomesdetermine the status of
nutritional empowerment among women of reproductive age in a rural Malawian community using a novel
index, the Women’s Empowerment in Nutrition Index (WENI) and assess its associations with nutrition
outcomes. Specific study objectives are; (i) to determine the level and extent to whichstatus of nutritional women
are empowered in nutrition using a novel index,empowerment in the study population the Women’s
Empowerment in Nutrition Index (WENI); (ii) to measure determine associations between the WENI and the
Body Mass Index (BMI), Mid Upper Arm Circumference, and, dietary diversity of women in the study area; (iii)
to examine assess the effect of provision of a staple food (maize flour) on dietary diversity, and intakes of energy,
protein, iron and folate; and, (iv) to examine assess changes in dietary quality (diversity) among the WRA 2
years after participation in a feeding trial.
Methodology:
The study combines a cross sectional survey designed to collect and measure status of women’s empowerment
in nutrition and its associations with maternal nutrition outcomes, and, secondary analysis of data from an
intervention study, the “Alleviating Hidden Hunger with Agronomy (AHHA)” conducted within the Geo
Nutrition project (reference: P.05/18/2393). The analysis of the AHHA data will measure changes in diversity
and intakes of energy, protein, iron, and folate following receipt of a staple food (maize flour). The changes in
diversity over time will also be assessed to see to what extent benefits, if any, are sustained over time. For the
WENI survey, face-to-face interviews will be conducted with women who participated in the AHHA study
(n=180), guided by a semi-structured interviewer administered questionnaire. Microsoft Excel, IBM SPSS
Statistics version 25, will be used in the data entry and analyses phase respectively. In addition to general
descriptive statistics, Fischer’s LSD test and the Dunnett’s test will be used to examine assess changes in nutrient
intakes. To test for associations between women’s empowerment in nutrition and nutrition outcomes, chi-square
analyses will be used. Multivariate logistic regression will be employed to identify specific empowerment
domains closely related to nutrition outcomes. This study is part of a Doctoral Research for Ms Zione
Kalumikiza.
Expected Findings and Dissemination.
The study is expected to measure the level of women’s empowerment in nutrition and identify areas of
disempowerment, which provides a basis for the type of interventions needed to improve nutrition and health of
women in similar contexts. By investigating associations between women’s empowerment in nutrition and
maternal nutrition outcomes, the study helps to understand the extent to which the empowerment index (WENI)
can be used as a predictor of nutritional status hence its application in both nutrition programming and
assessments. Variations are expected in empowerment across the different domains with most participants
demonstrating empowerment in the knowledge domain as opposed to resources and control domains. This is
largely because women are the main targets for nutrition education and are less often provided with resource
support or linkages to institutions. In addition, rural communities often favour males on control of resources.
Overall, this study will identify specific areas of disempowerment and provide a basis for the type of
interventions needed to improve nutrition and health of women in similar contexts. It will further help to
understand the extent to which the empowerment index (WENI) can be used as a predictor of nutritional status
hence its application in both nutrition programming and assessments. We further test the influence of
empowerment in a single domain-dimension (food/maize flour provision) and hope this generates evidence for
informing the design of similar nutrition-sensitive interventions for better impact. Finally, the study will explore
whether dietary changes resulting from the AHHA intervention are sustained over time. Taken together, this
study will identify barriers to nutrition empowerment and thus propose actions to facilitate nutrition
empowerment and outcomes. The study, therefore, will not only add to the body of knowledge about nutrition
and empowerment, but generate evidence with policy and programmatic implications.
Study findings will be presented to the scientific community through publications in peer reviewed journals and
presentations at national and international conferences. The Kasungu local council and concerned Traditional
Authority will also be presented with key findings from this research. A copy of the thesis and all published work from this study will be shared with the College of Medicine Library, the College of Medicine Research
Ethics Committee, and other relevant committees in line with requirements by the College of Medicine.
Description
Keywords
Research Subject Categories::SOCIAL SCIENCES