Womens Seclusion during Menstruation and Childrens Health in Nepal

ObjectivesThere is limited empirical evidence from low-income countries on the effects of womens seclusion during menstruation on childrens health. We documented the association between mothers extreme seclusion during menstruation and childrens health in Nepal. MethodsUsing nationally representative data from the 2019 Multiple Indicator Cluster Survey, we examined the relationship between mothers exposure to extreme forms of seclusion during menstruation and anthropometric measures of nutritional status and health outcomes among children ages 5-59 months (n=6,301). We analyzed the data in a regression framework, controlling for potential confounders, including province fixed effects. We assessed extreme seclusion during menstruation based on womens exposure to chhaupadi, a practice in which women are forced to stay away from home--in separate huts or animal sheds--during menstruation and childbirth. ResultsMothers exposure to extreme seclusion during menstruation was associated with 0.18 standard deviation lower height-for-age z-scores (HAZ) (p=0.046) and 0.20 standard deviation lower weight-for-age z-scores (WAZ) (p=0.007) among children. Analysis by the place of seclusion showed that the negative association was stronger when women stayed in animal sheds--0.28 SD for HAZ (p=0.007) and 0.32 SD for WAZ (p<0.001)--than when they stayed in separate huts. Extreme seclusion was associated with higher incidence of acute respiratory symptoms but not with incidence of diarrhea, irrespective of the place of seclusion. ConclusionsWomens extreme seclusion during menstruation in Nepal has profound implications on the physical health of their children. Additional research is needed to ascertain potential mechanisms.