Women, income use and nutrition quality: effects of women’s decision-making in rural households in Cameroon

Abstract Background Women remain central to household food and nutrition security. However, they continue to face several constraints with respect to access, control and use of credit and income. There is theoretical assertion that increasing women's decision-making authority over family income increases spending and leads to gains in nutrition. However, empirical evidence on the links between rural women's income control and household food and nutrition security is inadequate, especially for a developing country, such as Cameroon. Methodology We employ the food consumption score nutrition quality analysis, the income domain of the Abbreviated Women’s Empowerment in Agriculture Index and the Partial Least Square Structural Equations Modelling to examine data collected from 600 rural households in the West region of Cameroon to establish the effects of women’s control over income use on household nutrition quality. To ensure the reliability of our findings, additional tests such as the Confirmatory Tetrad Analysis, the Kolmogorov–Smirnov test with Lilliefors correction, and the Finite Mixture PLS approach are employed. Results From the analyses, we observed that a significant percentage of households have poor nutritional quality, particularly in terms of iron-rich food consumption. Women's control over income use remains low and varies based on the source of income. The analyses show that women's decision-making concerning income use and women's perception of their decision-making ability regarding income use and expenditure are positively associated with higher nutritional quality for the household. In addition, we establish that women's perceptions of their ability to make decisions about income use have a positive direct and total effect on nutrition quality, but a negative indirect effect on the latter, with the direct positive effect outweighing the indirect effect. Conclusions Inadequate consumption of iron-rich foods is pervasive for most households and there is limited control over income used for the majority of women in the study area. Enhancing women’s control over income use has significant implications for household nutrition quality. Hence, women should be empowered to fully exploit their potential at the household level to enhance food security at the community, regional and national levels.