Adequate nutrient intake is vital for the maintenance of good health, which is the foundation of stable and prosperous livelihoods and the economic development of any nation. Malnutrition is a major global issue that is prevalent in developing countries, notably in Africa and Asia . Food insecurity and malnutrition are strongly associated with gender in Bangladesh. About 54% of Bangladeshi women of reproductive age (10–49 years) consume an insufficient variety of diets . Chronic child malnutrition and food insecurity are prevalent in South Asia , especially in Bangladesh, due to women’s low status and gender disparities in health and education. Micronutrient deficiency has adverse health outcomes such as congenital disabilities, growth suppression, diminished memory, as well as increased morbidity and mortality for themselves and their offspring [4, 5].
Anemia is a common disorder in Bangladesh, affecting approximately 42.4% of women (Hb < 12 g/dL). The incidence of this disease is significantly higher among pregnant women (49.6%) . Non-pregnant non-lactating (NPNL) women aged 15–49 years are critically deficient in the micronutrient zinc (S. zinc level < 10.1 mmol/l) . Deficiency of iodine, vitamin A, folate, and vitamin B12 was noticed among 42.1%, 5.4%, 9.1%, and 22% Bangladeshi women, respectively [6, 7]. Different socioeconomic statuses such as the maternal education level, place of residence, and wealth index influenced the micronutrient status of the women in Bangladesh [6, 8]. Generally, the monotonous consumption of starchy staple foods and other foods with lower nutritional quality is one of the main reasons for the micronutrient deficiency in individuals, especially in pregnant women and lactating mothers [5, 9]. Acute scarcity of micronutrients increases the death rate of the childbearing mother as well as the child . Nutrient-dense foods and a diverse diet are vital components of effective complementary eating habits to satisfy the nutrient requirements and promote sufficient development. According to international standards, supplementary items, including a range of foods from various categories such as nutrient-rich flesh foods or fortified foods, should be consumed in limited doses several times a day.
Dietary diversity (DD), an essential component of dietary quality, is one of the benchmarks of the World Health Organization (WHO, 2009) for assessing an individual’s feeding habits . DD is characterized as the simple count of foods and food groups eaten during the previous 24 h, which is a good indicator of the improved nutritional adequacy of the diet [4, 11, 12]. In broad surveys and other data collection activities, DD is primarily used as a surrogate measure of micronutrient density or dietary adequacy . In developed countries, a higher DD score is associated with the enhanced nutritional status of infants . Increasing the intake of diverse diets (more food groups) may fulfill the nutritional requirement, especially among women [12, 13]. Women’s decision-making autonomy is an important aspect of women’s empowerment, increasing the chance of purchasing various foods to meet their nutritional requirements .
Women’s empowerment, a fundamental issue of life, is the foundation of the population and development program of a country. Each year, more than 222 thousand deaths occur among mothers, of which at least 30% suffer from serious diseases and debilitating injuries . Researchers have used various approaches and indicators to assess empowerment. It is usually measured by six different dimensions, economic, socio-cultural, familial, interpersonal, legal, political, and psychological . In 2020, Coates et al. suggested that the access to and control of household resources, household-level decision-making, and freedom of movement were the important factors that determined the empowerment of women . Sharma and Kader reported that decision-making autonomy was an important indicator of women’s empowerment, which significantly influenced the child nutrition status in the rural areas of Bangladesh . Other relevant studies emphasized the relationship between woman empowerment and child nutrition [17–20]. Women’s decision-making autonomy is often an indicator of empowerment in several situations and was shown to affect the use of contraception by women , infant birth weight , negotiation for safer sex , and health care , among others.
To the best of our knowledge, no previous study has examined the relationship of women empowerment and their demographic conditions with the achievement of higher dietary diversity, using data representative of the country. One previous study reported a promising relationship between woman empowerment and household dietary diversity, although it was limited to the participants of the Habiganj district of Bangladesh . This study aimed to examine the relationship between women’s decision-making autonomy and their attainment of higher DD, as well as confirm the sociodemographic variables that can independently predict women’s attainment of higher DD using the country representative data collected by the Bangladesh Demographic and Health Survey.