A Structural Equation Modeling Analysis of Women’s Empowerment Influence on Birth Weight of Infants in West Shewa Zone, Ethiopia

Abstract

AbstractBackground: Infant birth weight is one of the major determinants of morbidity and mortality in children and adults. The proportion of low birth weight is 13% in Ethiopia, while macrosomia is rising over time. The importance of empowering women to achieve maternal and child health outcomes is highly acknowledged. Nevertheless, this aspect has not been sufficiently documented in Ethiopia. Objective: Th is study aimed to assess the effect of women’s empowerment on the birth weight of infants in West Shewa Zone, Ethiopia.Methods: A health facility-based prospective follow-up study was conducted from January to December 2021. Multistage sampling was applied to enroll pregnant women in the study who were followed up until delivery. Women’s empowerment data were collected using an interviewer-administered questionnaire. Analysis was performed among 1,165 mother-newborn pairs, where birth weight was abstracted from the mother’s medical chart. A confirmatory factor analysis was conducted to validate the women’s empowerment measuring tool. Structural equation modeling was employed to investigate the direct effect of women’s empowerment dimensions on birth weight.Results: From the four latent dimensions of women’s empowerment, a positive association was found between pregnant women’s household decision-making power and the birth weight of the infants they delivered (?= 0.091, p=0.040), whereas higher economic empowerment of the women was related to delivering lower birth weight infants (?= -0.444, p < 0.001). Pregnant women’s psychological and time empowerment were not significantly associated with newborn birth weight.Conclusions: The findings of this study illustrated the substantial correlation between women's agency in decision-making realms and their economic independence with the birth weight of their offspring. Augmenting the influence wielded by women in decision-making processes may prove instrumental in augmenting infant birth weights. Nevertheless, the variegated results of this research underscore the imperative for a more comprehensive exploration of the mechanisms underlying the impact of diverse dimensions of women's empowerment on birth weight to optimize the efficacy of empowerment initiatives in safeguarding optimal infant birth weight outcomes. [Ethiop. J. Health Dev. 2023; 37(4): 00-00]Keywords: birth weight, women’s empowerment, structural equation modeling, Ethiopia