Women’s participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana|
Amugsi, Dickson A.; Lartey, Anna; Kimani-Murage, Elizabeth & Mberu, Blessing U.
Background: Low-quality monotonous diet is a major problem confronting resource-constrained settings across
the world. Starchy staple foods dominate the diets in these settings. This places the population, especially women
of reproductive age, at a risk of micronutrients deficiencies. This study seeks to examine the association between
women’s decision-making autonomy and women’s achievement of higher dietary diversity (DD) and determine the
socio-demographic factors that can independently predict women’s attainment of higher DD.
Methods: The study used data from the 2008 Ghana Demographic and Health Survey. The participants comprised
of 2262 women aged 15–49 years and who have complete dietary data. The DD score was derived from a 24-h
recall of intake of foods from nine groups. The score was dichotomized into lower DD (DD ≤4) and higher (DD ≥5).
Logistic regression was used to assess the association between women decision-making autonomy (final say on
how to spend money, making household purchases, own health care, opinions on wife-beating, and sexual
intercourse with husband) and the achievement of higher DD. The logistic regression models were adjusted for
covariates at the individual and household levels.
Results: The analysis showed that women participation in decision-making regarding household purchases was
significantly associated with higher DD, after adjusting for individual and household level covariates. The odds of
achieving higher DD were higher among women who had a say in deciding household purchases, compared to
women who did not have a say (OR = 1.74, 95 % CI = 1.24, 2.42). Women who had more than primary education
were 1.6 times more likely to achieve higher DD, compared to those with no education (95 % CI = 1.12, 2.20).
Compared to women who lived in polygamous households, those who lived in monogamous households had
higher odds of achieving higher DD (OR = 1.42, 95 % CI = 1.04, 1.93).
Conclusions: Net other covariates, women who have a say in making household purchases are more likely to achieve
higher DD compare to those who do not have a say. This may indicate autonomy to buy nutritious foods, suggesting
that improving women decision-making autonomy could have a positive impact on women dietary intake.
Women; Higher; Dietary diversity; Ghana