Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 135 Dynamic Role of Mother Empowerment in reducing malnutrition among children: Evidence from Sub-Saharan Africa a Mariam Abbas Soharwardi, a Tusawar Iftikhar Ahmad a Department of Economics, The Islamia University of Bahawalpur, Pakistan. ARTICLE DETAILS ABSTRACT History: Accepted 25 March 2020 Available Online 31 March 2020 In Sub-Saharan Africa, two out of five children are malnourished and malnutrition causes almost half of the child deaths (45%). Mothers are the primary caretaker of children's health, but unfortunately, most of the mothers, are not empowered in Sub-Saharan Africa. This study examined the role of mother’s empowerment in the reduction of malnutrition (stunting, wasting, and underweight) among children under five years of age in twenty-two Sub-Saharan African countries. Cross-sectional data from the most recent Demographic Health Survey (2011-2016) of twenty-two countries are used to analyze the relationship between mother's empowerment and child malnutrition through the binary logistic regression analysis. Results show that the countries with low empowerment, the prevalence of malnutrition is high. Mother empowerment is found to be a statistically significant predictor in reducing malnutrition. Mother’s education, body mass index, and age at first birth proved to be a strong predictor for reducing malnutrition. Household wealth index and household locality also have a statistically significant impact on the reduction of malnutrition. At the household level, malnutrition of children can be minimized by empowering boosting their self-esteem, self-confidence, economic resources, social resources, awareness and decision making. © 2020 The authors. Published by SPCRD Global Publishing. This is an open access article under the Creative Commons Attribution- NonCommercial 4.0 Keywords: Malnutrition, Demographic Health Survey, Binary Logistic Regression JEL Classification: J10, J11 DOI: 10.47067/reads.v6i1.191 Corresponding author’s email address: mariam.abbas@iub.edu.pk 1. Introduction The malnutrition and child survival is influenced by the interaction of parents behaviour at the household level; this interaction affects children under five years more because they do not go to school and stays at home (Badake et al., 2014). Women (mothers) as the primary caregiver to family and children are maybe responsible for the illness of their children. Globally the burden of malnutrition has declined from 32.5 percent to 21.9 percent, and the number of children affected has fallen from 198.2 million to 149.0 million(WHO, 2018). This decline did not meet the SDG-21 . Malnutrition among 1 Sustainable Development Goals 2nd “End hunger, achieve food security and improved nutrition and promote sustainable agriculture.” Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 136 children under five years of age is the result of insufficient food intake, repeated attacks of infectious disease, low education of parents, unhygienic environment, and inadequate childcare(Suara & Aryee, 2018; Yalew, 2014). Given this background, women empowerment plays a very crucial role in determining the nutrition status of children under-five years (Bose, 2011). Mother’s reproductive health and child health outcomes are significant correlates of women's disempowerment (Dimbuene et al., 2018; Hotchkiss, Godha, Gage, & Cappa, 2016). The utilization of child health services depends on women's empowerment. Children of empowered mothers have full access to health services and have an awareness of how to save their children from unhealthy food and environment (Amare, Ahmed, & Meharie, 2019). 1.2 The rationale of the Study An improvement has been seen in reducing malnutrition in the understudy countries, but still, these countries are far from the global target of reducing malnutrition at the end of 2025. In literature, several studies were conducted, for (Nigeria, Burkin Faso, Zimbabwe, Ethiopia, Tanzania, and Ghana) in the context of mother empowerment and child health. The present study explores the role of mother empowerment, at the household level, in reducing malnutrition in twenty-two countries. The role of mother’s empowerment in reducing malnutrition was not previously studied in these twenty-two countries. Therefore, this study is an attempt to fill this gap. Another contribution of this study is to utilize the quantitative measurement of women’s empowerment while following the Kabeer (1999) conceptual framework of resource-agency-outcome. Following are the objectives of the study  To highlight the status of women empowerment across the countries in Sub-Sahara Africa.  To find out the role of mother empowerment in reducing malnutrition in Sub-Sahara African countries. 1.3 Limitation of the Study The current study faces some limitations in the following areas;  Only the ever-married women of 15-49 years having children under five years of age at the time of the survey are selected for this study.  Only those countries are selected for whom complete information about the indicators of women empowerment (work status, awareness, decision making, self-esteem, and self-confidence) and the indicators of malnutrition (stunting, wasting and underweight) are available. 2. Literature Review 2.1 Women Empowerment ( Measurement) There are different measures and frameworks to define women empowerment in previous literature. Kabeer (1999) defined women empowerment as a process and conceptualize empowerment in terms of resource, agency, and achievement. Beteta (2006) flourish the concept of women empowerment through the Gender Empowerment Enabling Environment (GEEE). The GEEE included questions covers the gender aspects from the World Value Survey and collect data from the women’s organizations in a country and raise the voice for women right and no tolerance of government against gender discrimination. Charmes and Wieringa (2003) hypothesize the women’s empowerment matrix in six dimensions and included the physical, socio-cultural, religious, economic, political, and legal aspects. Moreover, measure this matrix at individual, community, household, state, region and globally. Desai Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 137 (2010) has highlighted that the challenge to measure women empowerment is the lack of gender base data for most of the dimensions and levels. Beteta (2006), also agrees with this lack of data measurement at the household level, Desai (2010) believes that most of the data was available for the aggregate or household level. Data at the community, state, and region levels was available only for very few countries. At the same time, Desai (2010) pointed out that women empowerment was measured with the use of universal indicators. Wherase the dimensions of women empowerment had different values in different regions and countries. (Mosedale, 2005; Odutolu, Adedimeji, Odutolu, Baruwa, & Olatidoye, 2003). In India, women are educated but lacks the decision power, (Jejeebhoy, 2000), in Bangladesh women have better decision power as compared to India but with low education levels (Jejeebhoy & Sathar, 2001) in Nepal women are deprived of the right of the land ownership (Allendorf, 2007). In Pakistan's women have lack of freedom of mobility (Ahmad & Sultan, 2004), in Sub-Saharan Africa they suffering from health issues (Heggdal, 2016) and affecting gender-based violence in Zambia (Hof & Ritchers, 1995). Given the context and background of the countries, a comprehensive index of women empowerment has been constructed through five dimensions and with the help of nineteen indicators. 2.1 Women Empowerment and Malnutrition in Child in under Five years of age Ndaimani, Mhlanga, and Dube-Mawerewere (2018) measured women empowerment by the decision making and access to assets, in Zimbabwe by using the Demographic Health Survey and found a decisive role of mother empowerment in the treatment of diarrhea and uptake of child vaccination in children under five years of age. Amare et al. (2019) studied the nutritional status of children under five years of age and the determinants of child nutritional status and found that the mother’s role had primary importance in the improvement of child nutritional status. For child well-being, women’s decision making autonomy appeared to be the most significant determinant. In India and Nepal, older women with less than two children have more independence in decision making as compared to young mothers. Mother’s with more autonomy in decision making seems to be a good for their children(Ibrahim, Tripathi, & Kumar, 2015). Cunningham, Ruel, Ferguson, and Uauy (2015) explained the link between mother empowerment, childcare, and child nutrition in the rural Nepal. For this study, Women Empowerment in Agriculture Index (WEAI) and five sub-domains of empowerment has been constructed to investigate the relationship between mother empowerment and child’s nutritional status. Findings proved that mother’s empowerment has a strong influence on child care and his/her nutritional status. Mother’s empowerment at home correlates with child health and wellbeing. Empowerment of women and mothers are the prime factors for achieving the targets of social actions and health promotion movements. Mothers in all cultures and regions are the first ones who provide care to their children more than anyone else. The involvement of women in social actions and health promotion programs ensures the success of these efforts. For the social and economic development, the participation of women stands necessary along with giving them empowerment and an unbiased gender environment (Bennett, 2002; Cherayi & Jose, 2016; Kar, Pascual, & Chickering, 1999). Parasar (2004) examined the link between mother empowerment and child nutrition and immunizations in India. Different dimensions of women empowerment have been evaluated for capturing their effects on children's health and survival. Decision making and education have a more significant impact on child immunizations and nutrition. Children of more empowered mothers have proper vaccinations and nutrition on time as compared to less empowered mothers(Bhandari & Chhetri, 2013; Chipili, Msuya, Pacific, & Majili, 2018; Lamontagne, Engle, & Zeitlin, 1998). In Pakistan Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 138 decision making in the purchase of food, purchase of clothing, in medical treatment and travel have more influence on child health care practices along with the wealth of households. Empowerment is revealed as the prime factor in the promotion of health care practices in children, even women of wealthy families with no empowerment seems to fail to provide child care in an appropriate way (Khan, 2018). 3. Methodology For analysis, data has been extracted from the most recent Demographic Health surveys (2011- 2016) for analyses. DHS surveys present a wide range of evidence on the target sample of the population comparable across the countries. DHS data is national-level data and collected by cluster sampling method by multi-stages. Women between 15 to 49 years of age are appropriate to participate and men from 15 to 65 years are also applicable to participate2. 3.1 Countries selection criteria for Analysis Only countries with the DHS datasets (2011-2016) and with comprehensive indicators of anthropometric measures of children under five-year of age and indicators selected for women empowerment were included in the study. Following the criteria, only 22 Sub-Sharan African countries out of 49 were included. Missing values are not included in the analysis. 3.2 Conceptual Framework for model Malnutrition is a globally addressed issue. The most common forms of malnutrition are stunting, wasting, and underweight. It is the outcome of insufficient food intakes, irregular eating habits dietary and repeated infectious diseases(WHO, 2018). Inadequate food intake and improper eating habits linked with psychological and family factors. Moreover, inadequate sanitation-related with the environmental condition of households. A household is a multi-person unit where a family or group of persons lives together. In homes, mothers are the primary caregiver of children. Children's health and nutritional status grew up under the observation of mothers. For this study, we start from the household which maximizes a preference function U=U(Yi….Yn) …………………………Equation (1) Subject to the resource allocation ∑PiYi=I=W+V ………………………Equation (2) Household is unit assumed to produce and consume vector of commodities (Yi), constituted by Becker (1965) and Strauss and Thomas (1995) in their theories of time allocation and revised theories of choice forming the household’s utility function. Yi are the market commodities purchased, and pi is the market price, I is money income, W is wage and V is income from other sources (Aguiar, Botelho, Lago, Maças, & Sampaio, 2012; Aguiar & Hurst, 2007; Juster & Stafford, 1985). Households usually will be maximizing their utility by combining the time and market good to produce more necessary public goods (healthy children) which have a direct effect on the human capital accumulations for the household as well as for nations. The new utility function of household’s is now represented as; U=f(Yi,Ni,Li)……………….Equation (3) 2 Details related to data collection and sampling methodology used for DHS surveys are present on the website (Measure DHS, 2019). Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 139 The household is then assumed to produce a vector of commodities Ni. These commodities are associated with different types of activities related to nurturing and rearing children to enhance their nutritional status (Becker, 1965; Becker, Fonseca-Becker, & Schenck-Yglesias, 2006; Grossman, 1972; Willis, 1973). The good nutritional status is estimated by standardizing anthropometric measures (Stunting, Wasting, and underweight). The household utility function is therefore maximized subject to different constraints including the time-specific nutrition and income. Following the work of Grossman (1972) general health production function, the reduced form of production function of health (nutritional status) of a child in a household can be derived as (Garcia, Alderman, & Sathar, 1989; Jamal, 2018; Khan & Raza, 2014, 2016) Hi=f(WEmp, Mi, Ci, Fi, Hi, Ci) i=1,2,3 … ….Equation (5) Hi is health (malnutrition ) which depended on the vector of health inputs; women/mother’s empowerment (WEmp), mother’s characteristics (Mi), Child (Ci), father characteristics (Fi), household’s characteristic (Hi)and country characteristics. In this study, the focus is on the development of the relationship between health (malnutrition) and empowerment, along with parent's and households’ characteristics. The production function of health Eq(5) presents the economics of non- market activities which plays the more important role of the vector of inputs for the production of market goods (Becker, 1974, 1981; Becker & Lewis, 1973; Cummins et al., 1991). Investing time in the health of a child results in human capital formation which in turn becomes the life cycle earnings and productivity (Browning et al., 2014). 3.3 Indicators of Malnutrition The three most common anthropometric indicators used to measure malnutrition in children of under five years age are stunting (low height-for-age), wasting (low weight-for-height), and underweight (low weight-for-age) calculating Z score below than −2 standard deviations (SD) (Jamal, 2017; Khan & Raza, 2014). Table 1 Measurement Scale for Malnutrition (Dependent Variable) Measure Description Measurement Scale in DHS Data Stunting Height-for-Age If a child is stunting 1, otherwise 0 Wasting Weight-for Height If a child is wasting 1, otherwise 0 Underweight Weight-for Age If a child is underweight 1, otherwise 0 CIAF Composite Index of Anthropometric Failure If a Child is undernourished 1, otherwise 0 (Khan & Raza, 2014, 2016) 3.4 Conceptual Framework for Women Empowerment The concept of empowerment previously defined in the term of power, autonomy, control, self- efficacy, and as a goal. The power is someone’s ability to make choices and express the concept of empowerment as a process by which people who have been denied to get the ability to make choices, become able to make choices (Kabeer, 1999, 2001). It is challenging to define empowerment in a single dimension because it is a multidimensional process. Change does not occur in one step or sudden; it takes time, strategies and planning. If a person who denied to make choices suddenly asked her/him to make choices, they cannot make the right choices. Kabeer (1999) explained the ability to exercise choices in terms of three interrelated dimensions resource, agency, and achievement. Resources are not only economic but also included human and social, serves to enhance the ability to make choices. Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 140 Change in resources, change the ability to make choices because resources are measured as potential rather than actualized choices. Agency is the ability to recognize one’s goal and acts upon it. In the scenario of Kabeer (1999), resource-agency-achievement framework, the present study explained empowerment as a process that can be attained in terms of five interrelated dimensions- work status, awareness, decision making, self-esteem, and self-confidence. Table 2 Women Empowerment Index: A Representation of Kabeer’s Framework (1999) Main Concept Kabeer’s Dimensions Sub- Dimensions Indicators Women Empowerment Index Resource Work status  Respondent is currently Working  Respondent 's Employment Status Awareness  Respondent Watching TV  Respondent reading Newspaper or Magazines  Respondent listening to the radio  Heard about family planning on the radio  Heard about family planning on TV  Heard about family planning from newspapers Agency Decision- Making  The decision to spends about women's Husband earnings  The decision to women’s Health  The decision about large household purchases  The decision about visits to family or relatives Achievement Self-Esteem  Beating justified if wife argues with husband  Beating justified if the wife neglects children  Beating justified if Without telling husband  Beating justified if the wife refuses to  For sex  for have sex with the husband  Beating justified if wife burns food Self- Confidence  Getting medical help for self: not want to go alone  Getting medical help for self: Getting  Money for treatment Source: DHS Data 3.5 Statistical Analysis Descriptive statistics and cross-tabulation have used to describe the current situation of women's empowerment and malnutrition within the countries of Sub-Saharan. SPSS 22.0 version has used to analyze the data. The Mother Empowerment Index is calculated through the Factor Analysis. These underlying factors are inferred from the correlations among the p variables. Each factor is estimated as a weighted sum of the p variables. The ith factor is thus Fi=Wi1S1+ Wi2S2+ Wi3S3+…+ WipSp Eq1 Wip is the weight for mth principal component and Pth variables. S variables used in factor analysis. (Antony & Rao, 2007; Gupta & Yesudian, 2006; Hightower, 1978). These factor scores have accumulated the mother empowerment index in the range of 01-4.4. This mother empowerment is then further divided into three groups low, medium and high as followed by (Brajesh & Shekhar, 2015; Jeckoniah, Nombo, & Mdoe, 2012). Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 141 4. Results and Discussion According to Table 3 within the Sub-Saharan African countries, it is found that Congo Democratic, Chad, and Sierra Leon are the countries where malnutrition is at extremely alarming followed by stunting (44.1%,42.9%,37.7%), wasting (23.2%,32.5%,16.0%) and underweight (7.9%,14.2%,9.4%). These are the same countries where high mother empowerment is at its lowest (3.4%,1.3%,3.4%). Gabon, Kenya, Nambia, and Uganda are the countries where malnutrition is comparatively low followed by stunting (22.9%,27.1%,23.0%,30.3%), wasting (8.3%,13.2%,13.8%,13.1%) and underweight (4.1%,5.5%,8.0%,5.3%). These are the countries where mother empowerment is comparable to other countries is high (17.6%,36.5%,44.6%,26.6%). The same trend and inverse relationship between mother empowerment and malnutrition have been found in the remaining Sub-Saharan African countries. Table 3 Current Situation of Women Empowerment and Malnutrition Evidence from DHS Sr# Countries Years Mother Empowerment Malnutrition Low Medium High Stunting z score<-2 Wasting z score<-2 Underweight z score<-2 1 Burkina Faso 2014 7.6% 82.0% 10.4% 34.2% 24.9% 15.3% 2 Ethiopia 2016 23.4% 65.1% 11.5% 35.9% 25.2% 11.9% 3 Gabon 2012 8.0% 74.4% 17.6% 22.9% 8.3% 4.1% 4 Gambia 2013 7.6% 82.5% 10.0% 25.8% 17.9% 11.7% 5 Comoros 2012 7.9% 77.3% 14.8% 27.7% 14.5% 11.6% 6 Congo Democratic 2014 20.9% 75.8% 3.4% 44.1% 23.2% 7.9 7 Cote d'Ivoire 2012 16.0% 76.8% 7.2% 29.8% 14.6% 7.1% 8 Cameroon 2014 10.0% 77.6% 12.4% 31.6% 13.7% 5.7% 9 Chad 2015 38.9% 59.8% 1.3% 42.9% 32.5% 14.2% 10 Kenya 2014 5.2% 58.2% 36.5% 27.1% 13.2% 5.5% 11 Liberia 2013 1.5% 81.0% 17.5 30.9% 15.3% 6.6% 12 Mali 2013 1.9% 79.2% 18.9% 37.7% 25.2% 12.6% 13 Malawi 2016 1.8% 77.0% 21.2% 35.2% 25.2% 12.6% 14 Mozambique 2011 2.5% 75.6% 22.0% 39.3% 11.9% 3.2% 15 Namibia 2013 4.1% 51.3% 44.6% 23.0% 13.8% 8.0% 16 Nigeria 2015 12.9% 68.2% 18.9% 36.1% 26.9% 16.6% 17 Sierra Leon 2013 19.1% 77.5% 3.4% 37.7% 16.0% 9.4% 18 Tanzania 2016 8.5% 72.3% 19.2% 33.4% 13.7% 4.8% 19 Tonga 2014 5.9% 83.4% 10.6% 28.3% 16.8% 7.3% 20 Uganda 2011 4.1% 69.3% 26.6% 30.3% 13.1% 5.3% 21 Zimbabwe 2011 1.9% 83.0% 15.1% 30.7% 9.7% 5.3% 22 Zambia 2013 2.1% 82.0% 15.9% 38.2% 14.4% 6.1% Source DHS Table 4 depicts the results of binary logistic regression and explains the relationship between mother empowerment and malnutrition among children under five years. Composite women empowerment has a significant impact on all the indicators of malnutrition. Women with high and medium composite empowerment index negatively affect the stunting, wasting, underweight with odds ratios less than one. Mother empowerment is assessed through working status, awareness, decision making, self-esteem, and self-confidence. All these dimensions of empowerment make a mother secure Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 142 and take better care of her child rather than disempowered women (Haroon, 2018; Ndaimani et al., 2018; Siddhanta & Chattopadhyay, 2017) Table 4 Results of Binary Logistic Regression Stunting (Height for age) <-2SD Wasting (Weight for height) <-2SD Underweight (Weight for age) <-2SD Independent Variables Std. Err. Logistic Ratio Std. Err. Odd Ratio Std. Err. Composite Women Empowerment Index(Low as reference category) Medium 0.817*** 0.055 0.875** 0.066 0.769** 0.088 High 0.909*** 0.031 0.923** 0.039 0.806*** 0.053 Mother Body Mass Index (less than 18.5 kg/m2 is reference category) More than 18.5 kg/m2 0 .974** 0.012 0 .979 0.014 0.910*** 0.020 Mother's Education ( No Education is reference category) Primary 0.911*** 0.016 0.734*** 0.019 0.689*** 0.026 Secondary 0.861*** 0.018 0.731*** 0.022 0.766*** 0.030 Higher 0.798*** 0.033 0.732*** 0.040 0.829*** 0.053 Mother’s age on her first birth ( Age below 19 years old is reference category) 20-25 0.891*** 0.015 0.958** 0.018 0.954* 0.025 Above than 25 0.851*** 0.034 0.890*** 0.043 0.941 0.056 Child Age in months 1.001** .001 1.001 .001 0.998 .001 Child Gender ( Male child as reference category) Female Child 0.980* .037 1.041** .024 1.043* 0.038 Father’s Education ( No Education is reference category) Primary 0.900*** 0.017 0.757*** 0.020 0.740*** 0.027 Secondary 0.946*** 0.020 0.821*** 0.024 0.781*** 0.032 Higher 0.975 0.031 0.962* 0.037 0.939 0.049 Father's employment status ( Father did not work is reference category) Father did work 0 .898*** 0.016 0 .949*** 0.019 0 .956* 0.0 27 Household's Wealth status (Poorest is reference category) Poorer 0.942*** 0.022 0.883*** 0.027 0.882*** 0.041 Middle 0.999 0.021 0.959 0.026 0.980 0.042 Richer 0.959** 0.020 0.914*** 0.025 0.932** 0.046 Richest 0.951*** 0.018 0.899*** 0.023 0.933** 0.056 Type of Residence ( Rural areas are reference category) Urban Areas 0.974*** 0.026 0.962*** 0.027 0.923*** 0.026 <=5 0 .992 0.018 0.944*** 0.022 0 .873*** 0.028 <=4 0 .963** 0.018 1.042* 0.022 1.078** 0.029 Constant 1.519** 0.154 1.276 0.184 0.533** 0.273 Cox & Snell R Square .005 .013 .008 Nagelkerke R Square .007 .020 .018 Mother's body mass index, mother education, and maternal age on her first birth, and each have its different effect on malnutrition. Regression results proved that body mass index 18.5Kg/m2, Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 143 education, and age at first birth above 20 years have a significant role in reducing malnutrition. Mother’s health, education, and age at first birth interlinked with the health and care of her child (Amare et al., 2019; Scantlan & Previdelli, 2013). Malnutrition increased with the increase in child age because chances to increase in malnutrition among children under five years have more probability if they do not take the proper and sufficient food intake (Khan, Mann, Zafar, Hashmi, & Akhtar, 2010; Khan & Raza, 2014) In the female child there are fewer chances to be stunting and wasting but have more chances to be underweight as compared to male children. The total number of children ever born has its significant effect in reducing the stunning, wasting and underweight (Amare et al., 2019; Nosheen & Chaudhry, 2018) Father education and father employment status and have a different impact on stunting, wasting and underweight. According to the results of table 7, binary logistic regression results proved that father education and employment status have a negative and significant effect on stunting, wasting and underweight. Household characteristics were measured by three different characteristics of household wealth status, total household members, type of residence, and each component have a significant effect on stunting, wasting and underweight. The binary logistic regression results proved that household richest wealth status, total household member equal to or less than four and locality in urban have a negative and significant effect on stunting, wasting, underweight. Household wealth and locality (urban) provide support to provide sufficient, proper and healthy food to children in urban areas provision of hospital, vaccination and awareness more significant than the rural areas (Kumar, Mittal, & Sharma, 2010; Kyu et al., 2016; Njau et al., 2006). 5. Conclusion In this study, an association of mother’s empowerment index with the indicators of malnutrition was found to be statistically significant. However, all three indicators of malnutrition were significantly associated with the sociodemographic characteristics of mother, father, children and household. There is a need for policymakers to strengthen the change in the social behavior of family strategies, as this will be likely to increase uptake of child health services. Policymakers in low-income countries can consider promoting gender equality in health, education and in decision making to improve children’s health care. References Aguiar, M., Botelho, G., Lago, C., Maças, V., & Sampaio, J. (2012). A review on the effects of soccer small-sided games. Journal of human kinetics 33, 103-13. Aguiar, M., & Hurst, E. (2007). Measuring trends in leisure: the allocation of time over five decades. The Quarterly Journal of Economics 122(3), 969-1006. Ahmad, F., & Sultan, M. (2004). Women's empowerment and mobility in Pakistan: Result from a National Survey. Paper presented at the Fifth Annual Research conference. Allendorf, T. D. (2007). Residents’ attitudes toward three protected areas in southwestern Nepal. Biodiversity Conservation 16(7), 2087. Amare, Z. Y., Ahmed, M. E., & Meharie, A. B. (2019). DHS WORKING PAPERS. 1-24. Antony, G., & Rao, K. V. (2007). A composite index to explain variations in poverty, health, nutritional status and standard of living: Use of multivariate statistical methods. Public Health, 121(8), 578- 87. Badake, Q., Maina, I., Mboganie, M., Muchemi, G., Kihoro, E., Chelimo, E., & Mutea, K. (2014). Nutritional status of children under five years and associated factors in Mbeere South District, Kenya. African Crop Science Journal 22, 799-806. Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 144 Becker, G. S. (1965). A Theory of the Allocation of Time. The Economic Journal 493-517. Becker, G. S. (1974). A theory of social interactions. Journal of Political Economy 82(6), 1063-93. Becker, G. S. (1981). Altruism in the Family and Selfishness in the Market Place. Economica 48(189), 1- 15. Becker, G. S., & Lewis, H. G. (1973). On the Interaction between the Quantity and Quality of Children. Journal of Political Economy 81(2, Part 2), S279-S88. Becker, S., Fonseca-Becker, F., & Schenck-Yglesias, C. (2006). Husbands' and wives' reports of women's decision-making power in Western Guatemala and their effects on preventive health behaviours. Social Science and Medicine, 62. doi:10.1016/j.socscimed.2005.10.006 Bennett, L. (2002). Using empowerment and social inclusion for pro-poor growth: a theory of social change. Working Draft of Background Paper for the Social Development Strategy Paper. Washington, DC: World Bank. Beteta, H. C. (2006). What is missing in measures of women's empowerment? Journal of Human Development Capabilities 7(2), 221-41. Bhandari, T. R., & Chhetri, M. (2013). Nutritional status of under five year children and factors associated in Kapilvastu District, Nepal. Journal of Nutritional Health & Food Science, 1(1), 1-6. Bose, S. (2011). The effect of women's status and community on the gender differential in children's nutrition in India. Journal of biosocial science 43(5), 513-33. Brajesh, & Shekhar, D. C. (2015). Level of Women Empowerment and It’s Determinates in Selected South Asian Countries. Journal Of Humanities And Social Science (IOSR-JHSS), 20(4), 94. Browning, T., Bouman, H., Henderson, G., Mather, T., Pyle, D., Schlosser, C., . . . Moore, C. (2014). Strong responses of Southern Ocean phytoplankton communities to volcanic ash. Geophysical Research Letters, 41(8), 2851-57. Charmes, J., & Wieringa, S. (2003). Measuring women's empowerment: an assessment of the gender- related development index and the gender empowerment measure. Journal of Human Development, 4(3), 419-35. Cherayi, S., & Jose, J. P. (2016). Empowerment and social inclusion of Muslim women: Towards a new conceptual model. Journal of Rural Studies, 45, 243-51. Chipili, G., Msuya, J., Pacific, R., & Majili, S. (2018). Women Empowerment and the Nutrition Status of Children Aged Between 6-59 Months. Journal of Nutrition and Health Sciences, 5(2), 208. Cueva Beteta, H. (2006). What is missing in measures of women's empowerment? Journal of Human Development, 7(2), 221-41. Cummins, R. O., Chamberlain, D. A., Abramson, N., Allen, M., Baskett, P., Becker, L., . . . Eisenberg, M. (1991). Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. A statement for health professionals from a task force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council. Circulation 84(2), 960-75. Cunningham, K., Ruel, M., Ferguson, E., & Uauy, R. (2015). Women's empowerment and child nutritional status in S outh A sia: a synthesis of the literature. Maternal & Child Nutrition, 11(1), 1-19. Desai, M. (2010). Hope in hard times: Women's empowerment and human development. Retrieved from Dimbuene, Z. T., Amo-Adjei, J., Amugsi, D., Mumah, J., Izugbara, C. O., & Beguy, D. (2018). Women’s education and utilization of maternal health services in Africa: A multi-country and socioeconomic status analysis. Journal of biosocial science 50(6), 725-48. Garcia, M., Alderman, H., & Sathar, Z. A. (1989). Patterns and determinants of malnutrition in children in Pakistan: impact of community health [with comments]. The Pakistan Development Review, 28(4), 891-902. Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 145 Grossman, M. (1972). On the concept of health capital and the demand for health. Journal of Political Economy, 80(2), 223-55. Gupta, K., & Yesudian, P. P. (2006). Evidence of women’s empowerment in India: A study of socio- spatial disparities. Geo Journal, 65(4), 365-80. Haroon. (2018). Exploring the relationship between mothers Empowerment and Child Nitritional Status : An Evidence from Pakistan. Pakistan Journal of Applied Economics, 28(2), 189-211. Heggdal, V. K. (2016). Female Empowerment and Fertility in Sub-Saharan Africa: An Instrumental Variables Approach. Hightower, W. L. (1978). Development of an index of health utilizing factor analysis. Medical Care, 245- 55. Hof, C., & Ritchers, A. (1995). Exploring intersections between teenage pregnancy and gender violence: lessons from Zimbabwe. African Journal of Reproductive Health, 3. doi:10.2307/3583229 Hotchkiss, D. R., Godha, D., Gage, A. J., & Cappa, C. (2016). Risk factors associated with the practice of child marriage among Roma girls in Serbia. J BMC international health human rights 16(1), 6. Ibrahim, A., Tripathi, S., & Kumar, A. (2015). The effect of women’s empowerment on child health status: study on two developing nations. International Journal of Scientific Research Publications, 5(4), 1-8. Jamal, H. (2017). Explaining Spousal Physical Violence through Dimensions of Women Empowerment: Evidence from Pakistan. Jamal, H. (2018). EXPLORING THE RELATIONSHIP BETWEEN MOTHER’S EMPOWERMENT AND CHILD NUTRITIONAL STATUS: An Evidence from Pakistan. Pakistan Journal of Applied Economics, 28(2), 189-211. Jeckoniah, J., Nombo, C., & Mdoe, N. (2012). Determinants of women empowerment in the onion value chain: a case of Simanjiro district in Tanzania. Journal of Economics and Sustainable Development, 3(10), 88-99. Jejeebhoy, S. (2000). Women's autonomy in rural India: Its dimensions, determinants, and the influence of context. In H. B. Presser & G. Sen (Eds.), Women's Empowerment and Demographic Processes: Moving Beyond Cairo. New York: Oxford University Press. Jejeebhoy, S., & Sathar, Z. A. (2001). Women's autonomy in India and Pakistan: the influence of religion and region. Population and Development Review, 27. doi:10.1111/j.1728-4457.2001.00687.x Juster, F. T., & Stafford, F. P. (1985). Time, goods, and well-being. Kabeer, N. (1999). Resources, agency, achievements: Reflections on the measurement of women's empowerment. Development and Change, 30(3), 435-64. Kabeer, N. (2001). Reflections on the measurement of women’s empowerment’in ‘Discussing women’s empowerment: theory and practice’. Sida Studies, 3. Kabeer, N. (2002). Resources, agency, achievements: reflections on the measurement of women's empowerment. Development and Change, 30. doi:10.1111/1467-7660.00125 Kabeer, N. (2005). Gender equality and women's empowerment: A critical analysis of the third millennium development goal 1. Gender & Development, 13(1), 13-24. Kar, S. B., Pascual, C. A., & Chickering, K. L. (1999). Empowerment of women for health promotion: a meta-analysis. Social Science and Medicine, 49(11), 1431-60. Khan, Mann, Zafar, Hashmi, & Akhtar. (2010). Determinants of women empowerment: a case study from district Rawalpindi, Punjab, Pakistan. Pakistan Journal of Science, 62(1). Khan, R. E. A., & Raza, M. A. (2014). Child malnutrition in developing economies: a case study of Bangladesh. Quality & Quantity, 48(3), 1389-408. Khan, R. E. A., & Raza, M. A. (2016). Determinants of malnutrition in Indian children: new evidence from IDHS through CIAF. Journal of Quality & Quantity, 50(1), 299-316. Khan, R. E. A., Tasnim KHAN, and Shakeela BIBI. (2018). Women Empowerment and Household Review of Economics and Development Studies, Vol. 6 (1) 2020, 135-146 146 Wealth: Implication for Child Health-Care. Pakistan Journal of Applied Economics, Special Issue(Special Issue), 273-89. Kumar, D., Mittal, P. C., & Sharma, M. K. (2010). Socio-demographic risk factors of child undernutrition. Journal of Pediatric Sciences, 2(1). Kyu, H. H., Pinho, C., Wagner, J. A., Brown, J. C., Bertozzi-Villa, A., Charlson, F. J., . . . Ferrari, A. J. (2016). Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013: findings from the global burden of disease 2013 study. JAMA Pediatrics, 170(3), 267-87. Lamontagne, J. F., Engle, P. L., & Zeitlin, M. F. (1998). Maternal employment, child care, and nutritional status of 12–18-month-old children in Managua, Nicaragua. Social Science Medicine 46(3), 403- 14. Malhotra, A., & Schuler, S. R. (2005). Women’s empowerment as a variable in international development. Measuring empowerment: Cross-disciplinary perspectives, 1(1), 71-88. Measure DHS. (2019). DHS Overview. Retrieved from https://dhsprogram.com/What-We-Do/Survey- Types/DHS-Questionnaires.cfm#CP_JUMP_16175 Mosedale, S. (2005). Assessing women's empowerment: towards a conceptual framework. Journal of International Development, 17(2), 243-57. Ndaimani, A., Mhlanga, M., & Dube-Mawerewere, V. (2018). The association between women’s empowerment and uptake of child health services: a demographic and health survey-based synthesis. DHS Working Paper, 1-34. Njau, D., Goodman, C., Kachur, S. P., Palmer, N., Khatib, R. A., Abdulla, S., . . . Bloland, P. (2006). Fever treatment and household wealth: the challenge posed for rolling out combination therapy for malaria. Tropical Medicine and International Health, 11. doi:10.1111/j.1365-3156.2006.01569.x Nosheen, F., & Chaudhry, I. S. (2018). Women Empowerment and Micro Finance Programmes in Southern Punjab: An Empirical Study. Pakistan Journal of History & Culture, 39(1). Odutolu, O., Adedimeji, A., Odutolu, O., Baruwa, O., & Olatidoye, F. (2003). Economic empowerment and reproductive behaviour of young women in Osun state, Nigeria. African Journal of Reproductive Health, 92-100. Parasar, S. (2004). A Multidimensional Approach to Women’s Empowerment and its Links to the Nutritional Status and Immunization of Children in India. In (pp. 1-41): Working Paper. Department of Sociology and Maryland Population Research …. Scantlan, & Previdelli. (2013). Women’s empowerment and childhood malnutrition in Timor-Leste: a mixed-methods study. Oregon: Mercy Corps. Siddhanta, A., & Chattopadhyay, A. (2017). Role of Women’s Empowerment in Determining Child Stunting in Eastern India and Bangladesh. Social Science Spectrum, 3(1), 38-51. Strauss, J., & Thomas, D. (1995). Human resources: Empirical modeling of household and family decisions. Handbook of Development Economics 3, 1883-2023. Suara, S., & Aryee, P. (2018). GROWTH FALTERING AND INADEQUATE DIETARY INTAKE AMONG CHILDREN (6-23 MONTHS OLD) IN SISSALA EAST DISTRICT, GHANA. International Journal of Development 5(1), 75-87. WHO. (2018). Malnutrition. Retrieved from https://www.who.int/news-room/fact- sheets/detail/malnutrition Willis, R. J. (1973). A new approach to the economic theory of fertility behavior. Journal of Political Economy, 81(2, Part 2), S14-S64. Yalew, B. M. T. (2014). Prevalence of malnutrition and associated factors among children age 6-59 months at lalibela town administration, North WolloZone, Anrs, Northern Ethiopia. J Nutr Disorders, 4(132), 2161-0509. https://dhsprogram.com/What-We-Do/Survey-Types/DHS-Questionnaires.cfm#CP_JUMP_16175 https://dhsprogram.com/What-We-Do/Survey-Types/DHS-Questionnaires.cfm#CP_JUMP_16175 https://www.who.int/news-room/fact-sheets/detail/malnutrition https://www.who.int/news-room/fact-sheets/detail/malnutrition