Domestic Violence and Maternal Nutritional Status in Nepal: Findings from NDHS, 2016
Background: Global literature suggests that domestic violence has a significant impact on the nutritional status of mothers. Domestic violence increases stress levels, which result in poor self-care including the consumption of less food and in turn, low body mass index (BMI). There is little empirical evidence on the relationship between domestic violence and maternal nutritional status in Nepal.
Objective: This paper assesses the associations between domestic violence and maternal nutritional status in Nepal.
Method: A nationally representative cross-sectional household survey, known as the Nepal Demographic and Health Survey (NDHS) 2016, includes information on a wide variety of health topics, as well as socio-economic and demographic and other information for sub-populations, such as women’s experiences with domestic violence. For this analysis, maternal nutrition measures will include as BMI and anemia (<11.0 g/dl). For this analysis, only women who responded to the domestic violence survey questions (n=3562) and have BMI (n=3288) and anemia (n=3542) data were included. Potentially confounding factors at the individual, household and community level were included in the adjusted models such as age, family size, no of living children, education status, employment, caste/ethnicity, headship of the households, assets ownership, wealth status, husband alcohol consumption habit etc. To explore the associations between domestic violence and BMI and anemia separate logistic regression models were used.
Result: Findings reveals that approximately 26% of women had experienced domestic violence. Among them, 18.0% were found to have BMI (<18.5) compared to 12.8% for those never experienced domestic violence. Likewise, 45.5% women who had ever experienced any form of domestic violence were found to be anemic compared to 37.6% for those who never experienced domestic violence. The odds ratio (OR) shows a positive significant association between domestic violence with BMI (<18.5) (unadjusted OR=1.5, P=0.000, CI=1.2-1.9; Adjusted OR =1.4, P=0.01, CI=1.1-1.8) and domestic violence and anemia (unadjusted OR=1.4, P=0.000, CI =1.1-1.7; Adjusted OR =1.3, P=0.03, CI=1.0-1.6).
Conclusion: Domestic violence and maternal nutritional status are associated in Nepal. Thus, national and sub-national health and nutrition policies and programs, including Nepal’s Multi-sectoral Nutrition Plan, should focus on this issue. Addressing violence may be a mechanism for improving maternal nutritional status in Nepal. Further research, including experimental studies, are needed to confirm the directionality and pathway for how domestic violence and maternal nutrition are related.
Key words: domestic violence, BMI, anemia, Nepal