Are children in female-headed households at a disadvantage? An analysis of immunization coverage and stunting prevalence : in 95 low- and middle-income countries

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dc.contributor.author Wendt, Andrea
dc.contributor.author Hellwig, Franciele
dc.contributor.author Saad, Ghada E.
dc.contributor.author Faye, Cheikh
dc.contributor.author Mokomane, Zitha
dc.contributor.author Boerma, Ties
dc.contributor.author Barros, Aluisio J.D.
dc.contributor.author Victora, Cesar
dc.date.accessioned 2022-04-13T12:45:00Z
dc.date.available 2022-04-13T12:45:00Z
dc.date.issued 2021-09
dc.description.abstract Studies of inequalities in child health have given limited attention to household structure and headship. The few existing reports on child outcomes in male and female-headed households have produced inconsistent results. The aim of our analyses was to provide a global view of the influence of sex of the household head on child health in cross-sectional surveys from up to 95 LMICs. Studied outcomes were full immunization coverage in children aged 12–23 months and stunting prevalence in under-five children. We analyzed the most recent nationally-representative surveys for each country (since 2010) with available data. After initial exploratory analyses, we focused on three types of households: a) male-headed household (MHH) comprised 73.1% of all households in the pooled analyses; b) female Headed Household (FHH) with at least one adult male represented 9.8% of households; and c) FHH without an adult male accounted for 15.0% of households. Our analyses also included the following covariates: wealth index, education of the child’s mother and urban/rural residence. Meta-analytic approaches were used to calculate pooled effects across the countries with MHH as the reference category. Regarding full immunization, the pooled prevalence ratio for FHH (any male) was 0.99 (0.97; 1.01) and that for FHH (no male) was 0.99 (0.97; 1.02). For stunting prevalence, the pooled prevalence ratio for FHH (any male) was 1.00 (0.98; 1.02) and for FHH (no male) was 1.00 (0.98; 1.02). Adjustment for covariates did not lead to any noteworthy change in the results. No particular patterns were found among different world regions. A few countries presented significant inequalities with different directions of association, indicating the diversity of FHH and how complex the meaning and measurement of household headship may be. Further research is warranted to understand context, examine mediating factors, and exploring alternative definitions of household headship in countries with some association. en_US
dc.description.department Sociology en_US
dc.description.librarian hj2021 en_US
dc.description.sponsorship The International Development Research Centre, Bill & Melinda Gates Foundation, Wellcome Trust and ABRASCO (Associacao Brasileira de Saude Coletiva). en_US
dc.description.uri https://www.elsevier.com/locate/ssmph en_US
dc.identifier.citation Wendt, A., Hellwig, F., Saad, G.E. et al. 2021, 'Are children in female-headed households at a disadvantage? An analysis of immunization coverage and stunting prevalence : in 95 low- and middle-income countries', SSM - Population Health, vol. 15, art. 100888, pp. 1-11, doi: 10.1016/j.ssmph.2021.100888. en_US
dc.identifier.issn 2352-8273 (online)
dc.identifier.other 10.1016/j.ssmph.2021.100888
dc.identifier.uri https://repository.up.ac.za/handle/2263/84883
dc.language.iso en en_US
dc.publisher Elsevier en_US
dc.rights © 2021 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY licence. en_US
dc.subject Immunization en_US
dc.subject Stunting en_US
dc.subject Female-headed households en_US
dc.subject Woman-headed households en_US
dc.subject Low- and middle-income countries (LMICs) en_US
dc.title Are children in female-headed households at a disadvantage? An analysis of immunization coverage and stunting prevalence : in 95 low- and middle-income countries en_US
dc.type Article en_US


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