Peer-reviewed article
Food insecurity and low access to high-quality food for preconception women in Nepal: the importance of household relationships.
Nadia Diamond-Smith, Jacqueline Shieh, Mahesh Puri, Sheri Weiser ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examines food insecurity and diet quality among newly married women in rural Nepal during the preconception period. Researchers found that women eat fewer high-quality foods after moving to their husband's home compared to their natal home. The quality of a woman's relationship with her mother-in-law was found to be an important factor in whether she could access nutritious food, while her relationship with her husband was not associated with food consumption changes.
Key points
- Newly married preconception women in rural Nepal consumed poor quality diets with fewer high-quality foods important for pregnancy after entering their marital homes compared to their natal homes
- Higher quality relationships with mothers-in-law mediated the association between household food insecurity and a woman eating fewer high-quality foods
- Relationship quality with husbands was not associated with changes in food consumption patterns
- The study involved 200 newly married, preconception women in rural Nepal surveyed in 2018
- Interventions to improve maternal and child nutrition should target all household members, particularly mothers-in-law
Limitations
The cross-sectional design cannot establish causation or follow changes over time within individual women's experiences. The study does not capture the full range of factors influencing food access, such as economic constraints, agricultural production, or cultural food practices beyond household relationships.
Abstract
OBJECTIVE: Women in South Asia, including Nepal, have some of the poorest nutritional indicators globally, leading to poor maternal and child health outcomes. Nepal also suffers from high levels of household food insecurity, and newly married women are at high risk. Intra-household relationships may mediate the relationship between food insecurity and women's nutrition in Nepal for newly married women. Our aim is to understand how newly married, preconception, women's food consumption changes when she enters her husband's home, compared with her natal home. We also explore whether relationship quality with husbands and mothers-in-law mediates the association between food insecurity and eating less high-quality food, using structural equation modelling. DESIGN: Cross-sectional survey data. SETTING: Rural Nepal in 2018. PARTICIPANTS: Data were collected from 200 newly married, preconception women. RESULTS: Women had poor diet quality, and most ate fewer high-quality foods important for pregnancy in their marital, compared with natal, home. Higher quality relationships with mothers-in-laws mediated the association between food insecurity and a woman eating fewer high-quality foods in her marital, compared with natal, home. Relationship quality with husbands was not associated with changes in food consumption. CONCLUSIONS: Preconception, newly married women in Nepal are eating less high-quality foods important for women's health during the preconception period - a key period for avoiding adverse maternal and infant health outcomes. Relationships with mothers-in-law are key to women's access to high-quality food, suggesting that interventions aiming to improve maternal and child nutrition should target all household members.