Women's empowerment relates to women's ability to make life choices (158). Higher levels of empowerment were associated with increased income, household decision-making, control over resources, and utilization of health resources (5, 158–160). For nutrition outcomes, empowerment was associated with increased income allocated to food expenditures and improved household food security (160, 161). It was also associated with increased dietary diversity, but had no impact on women's BMI (5, 161, 162). For example, mothers’ participation in empowerment activities through Helen Keller International's Enhanced Homestead Food Production (EHFP) program in Burkina Faso was associated with increased fruit intake (difference-in-differences = 15.8 percentage points, P = 0.02) and nearly statistically significant increases in meat intake and dietary diversity (163). Participation was also associated with decreased prevalence of underweight (difference-in-differences = −8.7 percentage points, P < 0.01) but not overall mean BMI (163). In addition, the EHFP program in Bangladesh and Nepal was associated with decreasing trends in maternal anemia (anemia prevalence decreased by a magnitude of 12%, P = 0.075 in Bangladesh, and 26%, P = 0.009 in Nepal) (160). However, this was not consistent with findings from Cambodia (160).
Home visits ↓ anemia, ↑ Hgb, ↑ food consumption, ↑ weight gain (underweight adolescents), NC mortality, ↓ fatigue ↓ anemia, ↑ serum folate, ↑ serum B-12, NC mortality, NC depression ↓ anemia, ↑ MN status (Hgb, ferritin, folate, B-12, zinc, riboflavin), ↑/NC serum retinol, ↓/NC night blindness, ↑ weight gain, NC maternal mortality, NC depression
Adult women, and particularly women with children, were the primary targets for empowerment interventions. Empowerment interventions were predominantly delivered through community-based programs, including home visits, community groups, and community centers (5, 161, 163). There was some evidence that empowerment interventions that included delivery platforms such as radio and television, as a complement to the community- and home-based delivery platforms (5), could have some impact on reaching a wider audience. Adolescent girls were largely not the target of empowerment interventions, except for those relating to reproductive health (158), and could potentially benefit from them.
Oaks BM, Young RR, Adu-Afarwuah S, Ashorn U, Jackson KH, Lartey A, Maleta K, Okronipa H, Sadalaki J, Baldiviez LM et al. Effects of a lipid-based nutrient supplement during pregnancy and lactation on maternal plasma fatty acid status and lipid profile: results of two randomized controlled trials. Prostaglandins Leukot Essent Fatty Acids 2017;117:28–35.
What you eat and drink is influenced by where you live, the types of foods available in your community and in your budget, your culture and background, and your personal preferences. Often, healthy eating is affected by things that are not directly under your control, like how close the grocery store is to your house or job. Focusing on the choices you can control will help you make small changes in your daily life to eat healthier.
Globally, women's access to health care remains a challenge, both in developing and developed countries. In the United States, before the Affordable Health Care Act came into effect, 25% of women of child-bearing age lacked health insurance. In the absence of adequate insurance, women are likely to avoid important steps to self care such as routine physical examination, screening and prevention testing, and prenatal care. The situation is aggravated by the fact that women living below the poverty line are at greater risk of unplanned pregnancy, unplanned delivery and elective abortion. Added to the financial burden in this group are poor educational achievement, lack of transportation, inflexible work schedules and difficulty obtaining child care, all of which function to create barriers to accessing health care. These problems are much worse in developing countries. Under 50% of childbirths in these countries are assisted by healthcare providers (e.g. midwives, nurses, doctors) which accounts for higher rates of maternal death, up to 1:1,000 live births. This is despite the WHO setting standards, such as a minimum of four antenatal visits. A lack of healthcare providers, facilities, and resources such as formularies all contribute to high levels of morbidity amongst women from avoidable conditions such as obstetrical fistulae, sexually transmitted diseases and cervical cancer.