Paving the way to understanding female-headed households: Variation in household composition across 103 low- and middle-income countries.

Background: Female-headed households (FHHs) are regarded as disadvantaged. There are multiple social trajectories that can lead to women heading households. It is important to distinguish between these trajectories, as well as societal norms and contextual factors, to understand how and when are FHHs represented as a dimension of gender inequity. Our analysis defines and describes a typology of 16 FHH types (FHH16) based on demographic characteristics. Methods: This cross-sectional study used national Demographic Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) in 103 low- and middle-income countries (LMICs) to identify a typology of FHHs based on the family composition and additional household members. We performed descriptive analyses at the household level to generate median proportions of the FHH16 types and selected household characteristics. We conducted cluster analyses to explore FHH16 patterns across naturally grouped clusters of countries and described selected social and economic indicators at the ecological level. Results: The most common FHH16 types were those where the women household heads lived with children only, were alone, or lived with men, women, and children, but without a husband. In Africa and South Asia, the most common FHH was one where women heads resided with children only. In East Asia and the Pacific, the highest proportion of FHHs were those with men, women, and children. In MENA and Eastern Europe & Central Asia, households with women heads living alone were the most prevalent. Latin America had more FHHs with husbands, comparatively, and the most common FHHs were those with heads living alone or with children. Our exploratory cluster analysis generated five clusters with unique FHH16 patterns. The clusters had distinct geographic, contextual and economic characteristics. Conclusions: Our typology showed that FHHs are heterogeneous within and between countries. The ecological analysis emphasized further variation created by different societal and cultural factors. Research around their vulnerabilities and strengths needs to consider these factors and their influence on socioeconomic status and health-related outcomes within households headed by women.