TY - JOUR
T1 - Maternal Agency Influences the Prevalence of Diarrhea and Acute Respiratory Tract Infections Among Young Indonesian children
AU - Agustina, Rina
AU - Shankar, Anita V.
AU - Ayuningtyas, Azalea
AU - Achadi, Endang L.
AU - Shankar, Anuraj H.
N1 - Funding Information:
RA received a scholarship to attend the course and workshop at the Harvard School of Public Health entitled ‘Analysis of Health and Nutrition Data from Low-Income Countries’, and support for manuscript preparation and analysis, from the Higher Education Network Ring Initiative (HENRI) Program, a partnership supported by a grant from the United States Agency for International Development-Indonesia (Cooperative Agreement AID-497-A-11-00002) to the Harvard School of Public Health in partnership with, and with in-kind contributions from, the SEAMEO Regional Centre for Food and Nutrition, University of Mataram, Andalas University, the Summit Institute of Development, and Helen Keller International, with additional contributions from the Rajawali Foundation and Harvard Kennedy School Indonesia Program.
Publisher Copyright:
© 2014, Springer Science+Business Media New York.
PY - 2015/5/1
Y1 - 2015/5/1
N2 - To examine the relationship between measures of mother’s caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002–2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother’ caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1–4) and the prevalence of diarrhea and ARTIs in the youngest child <5 years of age was assessed with multivariate logistic regression adjusting for socioeconomic status, residence type, mother’s age and education, family size, child’s age and sex, immunization status and received vitamin A supplementation. Moderate levels (level 3) of practice and experience were associated with decreased diarrheal risk (adjusted OR 0.86, 95 % CI 0.75–0.98), but not for ARTIs. Children of mothers with higher levels (level 4) of agency were protected against both diarrhea (adjusted OR 0.68, 95 % CI 0.60–0.77) and ARTIs (adjusted OR 0.77, 95 % CI 0.66–0.91). Stratified analyses with child’s age and mother’s education, and tests of interaction, showed that agency had a stronger effect on diarrhea and ARTIs prevalence in children <2 years of age. Maternal caretaking, especially agency, is strongly associated with lower prevalence of diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.
AB - To examine the relationship between measures of mother’s caretaking, practice and individual agency on acute diarrhea and respiratory tract infections (ARTIs) of Indonesian children. Using population-based household data from the Indonesian Demographic Health Surveys for 2002–2003 (n = 9,151 children) and 2007 (n = 9,714 children), we selected 28 indicators related to mother’ caretaking, and applied principal component analysis to derive indices for access to care, practice and experience, and agency. The association between index quartiles (level 1–4) and the prevalence of diarrhea and ARTIs in the youngest child <5 years of age was assessed with multivariate logistic regression adjusting for socioeconomic status, residence type, mother’s age and education, family size, child’s age and sex, immunization status and received vitamin A supplementation. Moderate levels (level 3) of practice and experience were associated with decreased diarrheal risk (adjusted OR 0.86, 95 % CI 0.75–0.98), but not for ARTIs. Children of mothers with higher levels (level 4) of agency were protected against both diarrhea (adjusted OR 0.68, 95 % CI 0.60–0.77) and ARTIs (adjusted OR 0.77, 95 % CI 0.66–0.91). Stratified analyses with child’s age and mother’s education, and tests of interaction, showed that agency had a stronger effect on diarrhea and ARTIs prevalence in children <2 years of age. Maternal caretaking, especially agency, is strongly associated with lower prevalence of diarrhea and ARTIs in younger children. Interventions specifically designed to promote maternal autonomy and decision-making may lead to improved child health.
KW - Children
KW - Diarrhea
KW - Indonesia
KW - Maternal agency
KW - Respiratory tract infections
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U2 - 10.1007/s10995-014-1603-z
DO - 10.1007/s10995-014-1603-z
M3 - Article
C2 - 25108503
AN - SCOPUS:84939894525
SN - 1092-7875
VL - 19
SP - 1033
EP - 1046
JO - Maternal and child health journal
JF - Maternal and child health journal
IS - 5
ER -