Association of Basic Maternal Factors and Maternal Autonomy with Malnourishment among Children 6-36 Months Old in an Urban Slum in Bangalore, India

BACKGROUND: Child malnutrition is a significant problem in many developing countries with much of the burden falling on economically and historically underprivileged societies. Chronic undernutrition leads to decreased height for age (stunting) and contributes to reduced intellectual capacity, morbidity, and mortality. Acute undernutrition results in decreased weight for height (wasting) and can decrease a child's reserve for fighting illnesses and thriving. Recent attention on psychosocial dynamics has encouraged researchers to focus on maternal factors and its effect on child malnourishment. OBJECTIVE: Maternal autonomy - the freedom and ability to control the resources available to the mother to care for her child - are likely important factors influencing child health outcomes, especially in an economically disadvantaged, culturally segregated slum society.
METHODS: To examine this relationship in an urban slum in Karnataka, India, a cross-sectional observational study was conducted on 199 mother-child dyads. Anthropometric measurements were collected from children between 6-36 months of age. A 34 question survey uncovering issues of basic maternal factors, decision-making abilities, and domestic violence was administered to the mothers. RESULTS: Stunting was present in 32% of children (7.5% were severely stunted) and wasting was present in 23% (6.5% were severely wasted). Logistic regression models were used to test association between maternal factors and risk of having stunted or wasted children. Number of people in the household and mother's education were significantly associated with stunting. This breakdown shows that both maternal education and more members in the household were independently protective against stunting. The only maternal autonomy factor significantly associated with stunting and wasting was her ability to decide on major household purchases. The correlation, however, is inverse between stunting and wasting. Mothers who were more autonomous in this scenario were more likely to have children who were wasted, but less likely to have children who were stunted. CONCLUSION: In the psychosocial context of an urban slum in Karnataka, India, maternal autonomy poses an interesting inverse relationship between stunting and wasting suggesting the need for more research on this topic.