Examining the role of women's engagement in khat production on child nutritional outcomes using longitudinal data in East Oromia, Ethiopia

Abstract In eastern Ethiopia, production of khat has increased in recent years, with significant implications for women in khat production and sale. Women have long been engaged in agricultural production in the region, yet the implications of the shift from food crop production to khat/cash crop production on degree and manner of women’s engagement in agriculture and any related changes in nutrition are largely unstudied. Using longitudinal data collected from December 2020 to June 2022 in Haramaya woreda, East Hararghe Zone, Ethiopia, this study aimed to explore the relationship between women’s engagement in khat production and child nutritional outcomes, and to test whether an increase/decrease in women’s engagement in khat production over time was associated with a change in child nutritional outcomes. Primary outcome variables were child length-for-age z-score (LAZ), child weight-for-age z-score (WAZ), child weight-for-length z-score (WLZ), and child minimum dietary diversity (MDD). Mixed effect models using backward stepwise regression were conducted to assess the relationship between women’s engagement in khat production, child nutrition outcomes, and a set of covariates, including women’s empowerment. No relationship was found between women’s engagement in khat production at baseline and child LAZ, WAZ, or WLZ; however, women’s empowerment was positively associated with child LAZ (β = 0.513, p = 0.004) and child WAZ (β = 0.456, p = 0.010) in this model. Women’s high engagement in khat production over time (first year of child’s life) was negatively associated with child LAZ (β = −0.731, p = 0.033) when compared to those who had low engagement over the same time period; women’s empowerment was positively associated with child LAZ (β = 0.693, p < 0.001) in this model. The findings from this study point to a potentially important dynamic between sustained high levels of women’s engagement in khat production and poor child growth outcomes; and contribute to a growing literature linking women’s empowerment in agriculture to improved child growth outcomes. Further research is needed to better understand the relationship between women’s engagement in khat production and women’s empowerment in agriculture.