Maternal Occupation and Child Stunting in Urban Karachi: A Cross-Sectional Study
Maternal occupation and child stunting in Karachi
DOI:
https://doi.org/10.62807/jowach.v2i3.2025.19-25Keywords:
maternal occupation, stunting, child nutrition, women’s empowerment, Pakistan, Public HealthAbstract
Background
Child stunting remains a major public health issue in Pakistan, with structural and socioeconomic determinants driving outcomes. While maternal education and empowerment have been widely studied, the role of maternal occupation type (professional vs. non-professional) in shaping child nutritional status remains unclear.
Methods
This cross-sectional study analyzed data from 420 mother–child pairs (<5 years) attending two hospitals in Karachi. Maternal occupation was categorized as professional/technical/managerial vs. non-professional/unemployed. Child nutritional status was assessed using WHO criteria. Chi-square, t-tests, and logistic regression were employed to examine associations, adjusting for confounders (education, income, family structure, empowerment).
Results
Overall, 44.2% of children were stunted. Children of professionally employed mothers had significantly lower stunting prevalence (29.4%) compared to non-professional/unemployed mothers (47.1%; χ²=8.12, p=0.004). Adjusted logistic regression confirmed the protective effect of professional maternal occupation against stunting (aOR = 0.52; 95% CI: 0.31–0.87, p=0.012). Subgroup analyses revealed the protective effect was stronger in boys (aOR=0.44, CI: 0.23–0.83) than girls (aOR=0.61, CI: 0.33–1.15). Interaction models suggested maternal education amplified the occupation effect.
Conclusions
Professional maternal occupation independently reduces child stunting risk, even after adjusting for socioeconomic factors. Policies promoting women’s entry into professional sectors may provide downstream benefits for child nutrition.
References
Mahmood T. , Abbas F. , Kumar R. , & Somrongthong R.. Why under five children are stunted in pakistan? a multilevel analysis of punjab multiple indicator cluster survey (mics-2014). BMC Public Health 2020;20(1). https://doi.org/10.1186/s12889-020-09110-9
Haq W. and Abbas F.. A multilevel analysis of factors associated with stunting in children less than 2 years using multiple indicator cluster survey (mics) 2017–18 of punjab, pakistan. Sage Open 2022;12(2). https://doi.org/10.1177/21582440221096127
Vistro JM, Mughal HS, Siddiqui MB. Dietary Patterns, Food Intake Frequency, and Micronutrient Deficiencies in Malnourished Children. J Wom Child Health. 2024;1(4):32-8. DOI: https://doi.org/10.62807/jowach.v1i4.2024.32-38.
Vaivada T. , Akseer N. , Akseer S. , Somaskandan A. , Stefopulos M. , & Bhutta Z.. Stunting in childhood: an overview of global burden, trends, determinants, and drivers of decline. The American Journal of Clinical Nutrition 2020;112:777S-791S. https://doi.org/10.1093/ajcn/nqaa159
Koshy B. , Srinivasan M. , Gopalakrishnan S. , Mohan V. , Scharf R. , Murray‐Kolb L. et al.. Are early childhood stunting and catch-up growth associated with school age cognition?—evidence from an indian birth cohort. Plos One 2022;17(3):e0264010. https://doi.org/10.1371/journal.pone.0264010
Beal T. , Tumilowicz A. , Sutrisna A. , Izwardy D. , & Neufeld L.. A review of child stunting determinants in indonesia. Maternal & Child Nutrition 2018;14(4). https://doi.org/10.1111/mcn.12617
Echouffo‐Tcheugui J. , Guan J. , Fu L. , Retnakaran R. , & Shah B.. Association of concomitant gestational hypertensive disorders and gestational diabetes with cardiovascular disease. JAMA Network Open 2022;5(11):e2243618. https://doi.org/10.1001/jamanetworkopen.2022.43618
Mzumara B. , Bwembya P. , Halwiindi H. , Mugode R. , & Banda J.. Factors associated with stunting among children below five years of age in zambia: evidence from the 2014 zambia demographic and health survey. BMC Nutrition 2018;4(1). https://doi.org/10.1186/s40795-018-0260-9
Genoro B. , Legesse A. , Haile A. , & Tesfaye A.. A cross-sectional study design to assess the determinants of the nutritional status of children aged 6 to 59 months who returned to gedeo after being internally displaced in the guji-gedeo conflict, in gedeb district, snnpr, ethiopia: bayesian binary logistic regression approach. 2022. https://doi.org/10.21203/rs.3.rs-1528953/v1
Alristina A. , Mahrouseh N. , Irawan A. , Laili R. , Zimonyi-Bakó A. , & Feith H.. Prematurity and low birth weight among food-secure and food-insecure households: a comparative study in surabaya, indonesia. Nutrients 2025;17(15):2479. https://doi.org/10.3390/nu17152479
Lukwa A. , Siya A. , Zablon K. , Azam J. , & Alaba O.. Socioeconomic inequalities in food insecurity and malnutrition among under-five children: within and between-group inequalities in zimbabwe. BMC Public Health 2020;20(1). https://doi.org/10.1186/s12889-020-09295-z
Soharwardi M. , Malik N. , Anjum R. , Haleem M. , Leghari I. , Ahmad J. et al.. Role of maternal empowerment in addressing child malnutrition: evidence from asian developing countries. Children 2025;12(5):597. https://doi.org/10.3390/children12050597
Akbar M. , Asif A. , & Hussain F.. Does maternal empowerment improve dietary diversity of children? evidence from pakistan demographic and health survey 2017–18. The International Journal of Health Planning and Management 2022;37(6):3297-3311. https://doi.org/10.1002/hpm.3558
Wong R. and Whitehead C.. Exploring how structural forms of power shape the training of intraprofessional collaboration between family physicians and specialty physicians in outpatient workplace settings. Medical Education 2025;59(8):842-852. https://doi.org/10.1111/medu.15607
Shankar S. , Phinney R. , Krapek A. , & Surapaneni V.. Building a community-centered public health advocacy training program for medical students. Journal of Public Health Management & Practice 2022;28(4):E692-E701. https://doi.org/10.1097/phh.0000000000001486
Nabimanya B. , Mayanja E. , Kyarikunda M. , Nkamusiima D. , Kagarura W. , Kiwuwa-Muyingo S. et al.. Empowering women economically is more important than personal and socio-cultural empowerment. analysis of 2022 kenya demographic and health survey. 2024. https://doi.org/10.21203/rs.3.rs-4138861/v1
Tiwari P. and Malati N.. Role of training in women empowerment: an empirical analysis. Journal of Technical Education and Training 2023;15(1). https://doi.org/10.30880/jtet.2023.15.01.020
Saaka M.. Women's decision-making autonomy and its relationship with child feeding practices and postnatal growth. Journal of Nutritional Science 2020;9. https://doi.org/10.1017/jns.2020.30
Win H. , Shafique S. , Mizan S. , Wallenborn J. , Probst‐Hensch N. , & Fink G.. Association between mother’s work status and child stunting in urban slums: a cross-sectional assessment of 346 child-mother dyads in dhaka, bangladesh (2020). Archives of Public Health 2022;80(1). https://doi.org/10.1186/s13690-022-00948-6
Win H. , Wallenborn J. , Probst‐Hensch N. , & Fink G.. Understanding urban inequalities in children’s linear growth outcomes: a trend and decomposition analysis of 39,049 children in bangladesh (2000-2018). BMC Public Health 2021;21(1). https://doi.org/10.1186/s12889-021-12181-x
Saaka M.. Women's decision-making autonomy and its relationship with child feeding practices and postnatal growth. Journal of Nutritional Science 2020;9. https://doi.org/10.1017/jns.2020.30
Nguyen P. , Tran L. , Kachwaha S. , Sanghvi T. , Mahmud Z. , Zafimanjaka M. et al.. Enhanced quality of nutrition services during antenatal care through interventions to improve maternal nutrition in bangladesh, burkina faso, ethiopia, and india. Journal of Global Health 2025;15. https://doi.org/10.7189/jogh.15.04054
Bezie M. , Asebe H. , Asnake A. , Fente B. , Asmare Z. , Gebrehana A. et al.. Factors associated with concordance of mother-child (6–23 months) dietary diversity in sub-saharan africa. Plos One 2025;20(2):e0318493. https://doi.org/10.1371/journal.pone.0318493
Guja T. , Melaku Y. , & Andarge E.. Concordance of mother-child (6–23 months) dietary diversity and its associated factors in kucha district, gamo zone, southern ethiopia: a community-based cross-sectional study. Journal of Nutrition and Metabolism 2021;2021:1-11. https://doi.org/10.1155/2021/8819846
Bucher‐Koenen T. , Farbmacher H. , Guber R. , & Vikström J.. Double trouble: the burden of child-rearing and working on maternal mortality. Demography 2020;57(2):559-576. https://doi.org/10.1007/s13524-020-00868-6
McKinn S. , Duong T. , Foster K. , & McCaffery K.. A qualitative analysis of factors that influence vietnamese ethnic minority women to seek maternal health care. BMC Pregnancy and Childbirth 2019;19(1). https://doi.org/10.1186/s12884-019-2375-7
Shiri-Mohammadabad H. and Afshani S.. Women’s self-care behavior and its relationship with social capital in yazd, iran. BMC Women's Health 2021;21(1). https://doi.org/10.1186/s12905-021-01469-0
Collins C. , Landivar L. , Ruppanner L. , & Scarborough W.. Covid‐19 and the gender gap in work hours. Gender, Work & Organization 2020;28(S1):101-112. https://doi.org/10.1111/gwao.12506
Quisumbing A. , Sproule K. , Martínez E. , & Malapit H.. Do tradeoffs among dimensions of women’s empowerment and nutrition outcomes exist? evidence from six countries in africa and asia. Food Policy 2021;100:102001. https://doi.org/10.1016/j.foodpol.2020.102001
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