Women's Empowerment and Infant and Young Child Feeding Practice in Low- and Middle-Income Countries: A Systematic Review

Adherence to the WHO guidelines for infant and young child feeding (IYCF) practice in low- and middle-income countries (LMIC) is unsatisfactory. Women's empowerment has been noticed as the key factor which mediating intra-household resources to achieve optimal IYCF practice. Thus, we undertook a systematic review of studies exploring the indicator of women's empowerment, which influenced IYCF practice. Keyword searches were conducted in Scopus, CINAHL, Science Direct, PubMed, and Google Scholar using combinations of the following terms: empowerment, women, feeding behaviour, and infant. The bibliography was also searched for potential publications. Studies were included if involved children <2 years old and their mother/carer as participants, conducted in LMIC, published from 2011 or later, and English. Researchers performed study selection, data extraction, quality appraisal, and thematic analysis. From 17 861 results, twenty-four studies were included. Mostly, socioeconomic status and education used as the indicator of women's empowerment in IYCF practice. We found women's empowerment indicators that facilitate IYCF practices, namely a sense of leadership, high education, land ownership, involvement in household decision- making processes, against domestic violence, high socioeconomic status, and employment. Meanwhile, the indicators that inhibit uneducated or low education, forced to be head of the family, not involved in the decisionmaking process in family, low socioeconomic status, and high workload. Women's autonomy over resources is debatable as a facilitator or barrier, as we found inconsistent results. This review highlighted the indicator of women empowerment, which is important for proper IYCF practice. Future research and empowerment intervention to improve IYCF should address these findings.