The Association between Intrahousehold Food Allocation Social Norms and Thinness among Young Adolescent Girls: A Community-Based Study

BACKGROUND: Inequalities in food allocation related to social norms among household members significantly affect the nutritional status and well-being of the vulnerable members of the household, such as adolescent girls. This study assesses the association between social norms related to intrahousehold food allocation and young adolescent girls' thinness. MATERIALS AND METHODS: The study involved 1,083 pairs of mothers/caregivers and young adolescent girls. Data were collected using a structured and pretested questionnaire. Multilevel mixed-effect logistic regression analysis was employed to examine associations using STATA/SE V.14 statistical software. In addition, a stratified analysis was done to investigate the effect of social norms on thinness in food-secure and food-insecure households. RESULT: The overall prevalence of young adolescent girls' thinness was 15.70% (95% CI 13.52–17.86%). Young adolescent girls' thinness was associated with mothers’/caregivers' conformity to inequitable intrahousehold food allocation social norms in food-secure households [Adjusted odds ratio (AOR): 1.43, 95% CI: 1.14–1.80] but not in food-insecure households.        CONCLUSION: Nearly 16% of adolescent girls were thin. Mothers/female caregivers conforming to inequitable intrahousehold food allocation social norms compromise the nutritional status of adolescent girls, particularly in food-secure households. The lack of statistically significant association in food-insecure households hints at the need to address inequality in food-secure households while addressing food shortage to improve the nutritional status of adolescents in low-income countries.  We also recommend more studies in different sociocultural contexts to fully gather the evidence for adopting appropriate policies and practices.