Exposure to nutrition information as a linking mechanism between women's intra-household bargaining power and infant and young child feeding practices in Nepal.

Women's intra-household bargaining power is an important determinant of child nutritional status, but there is limited evidence on how it relates to infant and young child feeding (IYCF) practices. We conducted a cross-sectional analysis using 2012 baseline data from the impact evaluation of Suaahara, a multi-sectoral program in Nepal, focusing on households with children 0-23 months (n=1787). We examined if women's bargaining power was related to exposure to IYCF information, and if exposure to IYCF information was in turn associated with improved IYCF practices: early initiation of breastfeeding, exclusive breastfeeding, minimum meal frequency, and dietary diversity. Bargaining power consisted of four domains: 1) ownership and control of assets, 2) social participation, 3) workload, and 4) household decision-making control and were primarily measured using additive scales. We used generalized structural equation modeling to examine if exposure to IYCF information mediated the relationship between the bargaining domains and the four IYCF practices, separately. Social participation was positively associated with exposure to IYCF information (β=0.266, p<0.001), which in turn was related to early initiation (β= 0.241, p=0.001). We obtained similar results for the relationship between social participation and dietary diversity. Decision-making control was directly associated with exclusive breastfeeding (β=0.350, p=0.036). No domains were associated with minimum meal frequency. Different domains of women's bargaining power may relate to exposure to nutrition information and IYCF behaviors. Understanding specific domains of bargaining power is critical to developing interventions that can effectively address gender-related issues that underlie child nutrition outcomes.