Women's empowerment relates to women's ability to make life choices (158). Higher levels of empowerment were associated with increased income, household decision-making, control over resources, and utilization of health resources (5, 158–160). For nutrition outcomes, empowerment was associated with increased income allocated to food expenditures and improved household food security (160, 161). It was also associated with increased dietary diversity, but had no impact on women's BMI (5, 161, 162). For example, mothers’ participation in empowerment activities through Helen Keller International's Enhanced Homestead Food Production (EHFP) program in Burkina Faso was associated with increased fruit intake (difference-in-differences = 15.8 percentage points, P = 0.02) and nearly statistically significant increases in meat intake and dietary diversity (163). Participation was also associated with decreased prevalence of underweight (difference-in-differences = −8.7 percentage points, P < 0.01) but not overall mean BMI (163). In addition, the EHFP program in Bangladesh and Nepal was associated with decreasing trends in maternal anemia (anemia prevalence decreased by a magnitude of 12%, P = 0.075 in Bangladesh, and 26%, P = 0.009 in Nepal) (160). However, this was not consistent with findings from Cambodia (160).
Fourth and finally, there was a general lack of focus on the relevant delivery platforms for nutrition interventions. Many studies were not explicit about how and where interventions were delivered, and we had to cross-reference multiple sources to identify the delivery platform for many interventions. Delivery platforms are important and relevant information in terms of replicability, but also for identifying who is effectively reached and missed. Information about delivery platforms is also instrumental in understanding gaps in implementation. A greater emphasis on delivery platforms could enhance the reach of nutrition interventions and could also strengthen the capacity to mobilize resources more effectively. For instance, organizing and grouping interventions by delivery platform (e.g., antenatal care, community centers, schools, clinics) or by the relevant stakeholders required for delivery (e.g., ministries, health care providers, teachers, administrators, transporters, etc.) could have the potential to more efficiently deliver nutrition interventions.
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In 2013 about 289,000 women (800 per day) in the world died due to pregnancy-related causes, with large differences between developed and developing countries. Maternal mortality in western nations had been steadily falling, and forms the subject of annual reports and reviews. Yet, between 1987 and 2011, maternal mortality in the United States rose from 7.2 to 17.8 deaths per 100,000 live births, this is reflected in the Maternal Mortality Ratio (MMR). By contrast rates as high as 1,000 per birth are reported in the rest of the world, with the highest rates in Sub-Saharan Africa and South Asia, which account for 86% of such deaths. These deaths are rarely investigated, yet the World Health Organization considers that 99% of these deaths, the majority of which occur within 24 hours of childbirth, are preventable if the appropriate infrastructure, training, and facilities were in place. In these resource-poor countries, maternal health is further eroded by poverty and adverse economic factors which impact the roads, health care facilities, equipment and supplies in addition to limited skilled personnel. Other problems include cultural attitudes towards sexuality, contraception, child marriage, home birth and the ability to recognise medical emergencies. The direct causes of these maternal deaths are hemorrhage, eclampsia, obstructed labor, sepsis and unskilled abortion. In addition malaria and AIDS complicate pregnancy. In the period 2003–2009 hemorrhage was the leading cause of death, accounting for 27% of deaths in developing countries and 16% in developed countries.
For a strong backside that will turn heads wherever you go, Marta Montenegro, a Miami-based exercise physiologist and strength and conditioning coach, recommends completing 100 kettlebell swings nonstop with a moderate weight at the end of a legs workout. [Tweet this tip!] If you can’t access a kettlebell, do deadlifts and hip-thrusters instead. “Women tend to overemphasize the quadriceps even when they think they are working the butt. With these two exercises, you'll have no problem engaging the glutes and posterior muscles of the legs,” Montenegro says.
There were also supplementation programs that targeted nonpregnant women. National supplementation programs that provided food baskets to low-income families increased maternal BMI and improved household food insecurity (92, 93). However, there were some unintended consequences. In Mexico, food transfer programs disproportionately increased weight gain in overweight women compared with underweight women (93), and 1 study in Bangladesh found that food transfers had larger impacts on men's intake than women's intake, except with less preferred foods (94). Adolescents who received protein-energy supplementation at school showed an increase in weight gain during supplementation, as well as improvements in school attendance and mathematics scores (46, 95). However, the impact of supplementation on micronutrient deficiencies and, specifically, hemoglobin concentration, was limited (46).