The Influence of Women's Empowerment on Poverty Reduction in the Rural Areas of Bangladesh: Focus on Health, Education and Living Standard.
ABSTRACT: Women's empowerment has a great influence on health, nutrition, education, and the overall well-being of societies as well as of the children and households. This study investigates the effect of women's empowerment on poverty reduction and focuses on household deprivation, in terms of education, health, and standard of living. Primary data was collected from 914 married women from rural areas of Bangladesh using a well-structured questionnaire and a random sampling technique. Descriptive statistics, logistic regression, and ordinary least squares models were used in this study. The results indicate that increased women's access to education, asset ownership, decision-making power on children's health and education, and access to medical facilities, have caused a significant decline in income poverty and multidimensional poverty. However, gender violence, taking resources against women's will, and preventing women from working outside, have caused a considerable decline in per capita income and an increase in income poverty and multidimensional poverty. Overall, it is found that women's empowerment has a great impact on the reduction of income poverty and multidimensional poverty in society. The findings of the study can assist and guide policymakers to initiate appropriate strategies for women's empowerment to reducing poverty in Bangladesh while making progress towards other social and developmental goals.
Project description:One of the most important approaches to improving the health of mothers and newborns has been the continuum of care (CoC) for maternal health. Women's lack of empowerment may be an obstacle to accessing CoC in male-dominated societies. However, research often defines empowerment narrowly, despite the fact that multiple components of empowerment can play a role. The aim of this study was to look at the relationship between CoC for maternal health and measures of empowerment among Bangladeshi women. The data for this analysis came from the Bangladesh Demographic and Health Survey 2017-2018. The research centered on a subset of 4942 married women of reproductive age who had at least one live birth in the 3 years preceding the survey. Women's empowerment was measured using SWPER Global, a validated measure of women's empowerment for low- and middle-income countries. CoC for maternal health was measured at three stages of pregnancy, pregnancy, delivery, and the postpartum period. To estimate adjusted odds ratios, we specified three-level logistic regression models for our three binary response variables after descriptive analysis. Just 30.5% of mothers completed all phases of the CoC (ANC 4+, SBA, and PNC). After adjusting for individual, household, and community level variables, women with high social independence (adjusted odds ratio [AOR] 1.97; 95% confidence interval [CI] 1.58-2.47) had 97% more ANC 4+ visits, 176% higher retention in SBA (AOR 2.76; 95% CI 1.94-3.94), and 137% higher completion of full CoC (AOR 2.37; 95% CI 1.16-4.88) than women with low social independence. Frequency of reading newspapers or magazines, woman's education, age at first cohabitation, and age of the woman at first birth were significant predictors of CoC at all three stages, namely pregnancy, delivery, and postpartum, among the various indicators of social independence domain. Moreover, the intraclass correlation showed that about 16.20%, 8.49%, and 25.04%, of the total variation remained unexplained even after adjustments of individual, household and community level variables for models that predicted ANC 4+ visits, CoC from pregnancy to SBA, and CoC from delivery to the early postnatal period. The low completion rate of complete CoC for maternal health imply that women in Bangladesh are not getting the full health benefit from existing health services. Health promotion programs should target mothers with low levels of education, mothers who are not exposed to print media, and mothers who are younger at the time of birth and their first cohabitation to raise the rate of completing all levels of CoC for maternal health.
Project description:<h4>Introduction</h4>There is growing interest in assessing the impact of health interventions, particularly when women are the focus of the intervention, on women's empowerment. Globally, research has shown that interventions targeting nutrition, health and economic development can affect women's empowerment. Evidence suggests that women's empowerment is also an underlying determinant of nutrition outcomes. Depending on the focus of the intervention, different domains of women's empowerment will be influenced, for example, an increase in nutritional knowledge, or greater control over income and access to resources.<h4>Objective</h4>This study evaluates the impact of the Shonjibon Cash and Counselling (SCC) Trial that combines nutrition counselling and an unconditional cash transfer, delivered on a mobile platform, on women's empowerment in rural Bangladesh.<h4>Methods and analysis</h4>We will use a mixed-methods approach, combining statistical analysis of quantitative data from 2840 women in a cluster randomised controlled trial examining the impact of nutrition behaviour change communications (BCCs) and cash transfers on child undernutrition. Pregnant participants will be given a smartphone with a customised app, delivering nutrition BCC messages, and will receive nutrition counselling via a call centre and an unconditional cash transfer. This study is a component of the SCC Trial and will measure women's empowerment using a composite indicator based on the Project-Level Women's Empowerment in Agriculture Index, with quantitative data collection at baseline and endline. Thematic analysis of qualitative data, collected through longitudinal interviews with women, husbands and mothers-in-law, will elicit a local understanding of women's empowerment and the linkages between the intervention and women's empowerment outcomes. This paper describes the study protocol to evaluate women's empowerment in a nutrition-specific and sensitive intervention using internationally validated, innovative tools and will help fill the evidence gap on pathways of impact, highlighting areas to target for future programming.<h4>Ethics and dissemination</h4>Ethical approval has been obtained from the International Centre for Diarrhoeal Disease Research (Ref. PR 17106) and The University of Sydney (Ref: 2019/840). Findings from this study will be shared in Bangladesh with dissemination sessions in-country and internationally at conferences, and will be published in peer-reviewed journals.
Project description:<h4>Objective</h4>To examine the relationship between women's empowerment and maternal healthcare utilisation in Bangladesh.<h4>Design</h4>This cross-sectional study uses data from the most recent nationally representative Bangladesh Demographic and Health Survey, 2017-2018.<h4>Setting</h4>Bangladesh.<h4>Participants</h4>Married women aged 15-49 years who had a live birth within the 3 years preceding the survey (n=4767).<h4>Primary and secondary outcome measures</h4>Women's empowerment was measured using the recently developed and validated survey-based Women's emPowERment (SWPER) index. The index includes three domains: social independence, decision-making and attitude to violence. Outcomes included utilisation of at least one antenatal care from skilled providers (ANC1), at least four antenatal care visits (≥4 ANC), delivery assisted by a skilled birth attendant (SBA) and a postnatal visit within 2 days of delivery (PNC). Logistic regression analyses were used to assess the identified relationships.<h4>Results</h4>Among participants, 83% received ANC1, 46.3% received ≥4 ANC, 51.9% reported SBA and 50.9% sought PNC. Women with high levels of social empowerment relative to those with low levels were more likely to use ANC1 (adjusted OR (AOR) 1.85; 95% CI 1.40 to 2.45), ≥4 ANC (AOR 1.55; 95% CI 1.27 to 1.90), SBA (AOR 2.12; 95% CI 1.71 to 2.62) and PNC (AOR 1.95; 95% CI 1.56 to 2.44). Compared with women with low levels of decision-making empowerment, women with high levels were more likely to use SBA (AOR 1.49; 95% CI 1.21 to 1.83) and PNC (AOR 1.47; 95% CI 1.19 to 1.81). Additionally, significant inequality was observed among women moving from low to high empowerment in all domains of the empowerment index.<h4>Conclusions</h4>Higher empowerment levels were positively associated with maternal healthcare utilisation in Bangladesh. Our findings suggest the need to address women's empowerment in policies aiming to expand health service utilisation.
Project description:Although women's empowerment has gained attention over the last two decades, our understanding of the associations between different dimensions of women's empowerment and different children's health outcomes is limited. This study aims to measure the extent of women's empowerment and to examine its associations with the children's health status in Ethiopia. Data were obtained from the 2016 Ethiopian Demographic and Health Survey (EDHS). The sample is restricted to a sub-sample of 10,641 women from 15 to 49 years old and their children under the age of five years. We used children's height-for-age and weight-for-height Z-scores and pneumonia and anemia experience as indicators of children's health outcome. Women's empowerment is measured by five indices reflecting their participation in decision-making, attitudes towards wife-beating by husband, barriers to health care access, asset ownership, and socio-economic variables. These indicators of empowerment were constructed using exploratory and confirmatory factor analysis. A Multiple Indicators Multiple Causes (MIMIC) model was employed to examine the relationship between women's empowerment and latent child health outcomes, after controlling for relevant covariates. Results suggests that enhancing women's empowerment in the household in terms of their socio-economic status (i.e., increasing women's access to education, information, media, and promoting saving) was associated with less likelihood of the children's being stunted or wasted (p<0.05). Higher women's empowerment in terms of household decision-making power were also associated with better children's health status measured by the children's experience of pneumonia and anemia (p<0.05). All aspects of women's empowerment are not related with children's health indicators. Women's empowerment dimensions related with child health have a varying degree of association with the different children's health indicators. Gender-specific policies focusing on increasing women's access to education, media, information, and promoting saving and their participation in the household decision making are some of the strategies for improving their children's health and wellbeing.
Project description:<h4>Background</h4>Intimate partner violence (IPV) has been recognized as a defining human rights, development and public health issue of our time. Economic empowerment is one of the most promising interventions to reduce IPV in sub-Saharan Africa, yet the evidence around economic factors that are key to ensure a reduction in IPV are still mixed. Furthermore, there is a lack of clarity on what kinds of economic empowerment works for which population group. This paper seeks a more nuanced understanding, by investigating whether the associations between indicators of economic empowerment and physical and/or sexual IPV are similar between the general population of women and among urban versus rural and young, or middle aged women versus older women.<h4>Methods</h4>Using couples data from 25 DHS surveys across 15 countries (n = 70,993 women and men aged 15 and above at time of survey), we analyse how household wealth, men's and women's education and employment status, decision making on women's income, differences in education and employment of women and their partners and women's cash income are associated with physical and/or sexual IPV. We also provide sub-analyses for both urban and rural areas and for women aged, 15 to 24 25 to 34 and 35 to 49.<h4>Results</h4>Across all surveys, 20% of women reported physical and/or sexual IPV in the last 12 months. On the one hand, our findings reinforced certain well-established patterns between women's economic empowerment and IPV, with women's and men's higher levels of education and increased household wealth associated with a decrease in IPV, and women's employment, especially if only the woman worked, and women earning more than her partner associated with an increase in IPV. Most patterns did not differ across urban and rural settings and age groups, but notable differences emerged regarding household wealth, women's and men's employment in the last 12 months and relative employment and education.<h4>Conclusions</h4>Factors relating to women's economic empowerment are vital in understanding and addressing IPV. Our analysis indicate however that future interventions need to consider the differing needs of urban and rural areas as well as be targeted to different age groups.
Project description:<h4>Background</h4>Nigeria is experiencing a high level of urbanization and urban poverty. Within Nigeria maternal and child health and family planning outcomes may differ by residence (capital city, urban/non-capital city and rural) as well as by measures of women's empowerment and wealth. This paper presents a detailed analysis of maternal and child health and family planning outcomes in Plateau State, Nigeria.<h4>Methods</h4>Data came from the 2017 Nigerian Urban Reproductive Health Initiative Sustainability Study. Multivariable logistic regression was used to study the associations between the key independent variables of residence, women's empowerment and wealth with having a skilled birth attendant at childbirth and childhood preventative visits. The women's empowerment variables included perceptions about household decision-making, financial decision-making, views on wife beating and having a prohibition, defined as a restriction on specific activities imposed by a woman's husband. Multinomial regression was used to study the association of the same factors with the family planning outcome which had three categories - no use, traditional method use and modern method use. Regressions were also run separately for urban and rural populations.<h4>Results</h4>Women in the capital city of Jos were significantly more likely to have a skilled birth attendant at childbirth, take a child to a preventative visit and use family planning than women in rural areas of Plateau State. Three of the four measures of empowerment (household decision-making, financial decision-making and having a prohibition) were significantly associated with the family planning outcome, while having a prohibition was negatively associated with having a skilled birth attendant at childbirth. In rural areas, women involved in financial decisions were significantly less likely to use a modern method compared to a traditional method. Wealth was a significant factor for all outcomes.<h4>Discussion</h4>State-level analyses can provide valuable information to inform programs and policies at a local level. Efforts to improve use of maternal and child health and family planning services in Plateau state, Nigeria, should consider women's empowerment, residence and poverty. Community education on the effectiveness of modern versus traditional methods and potential side effects of specific modern methods, may help women make informed decisions about contraception.
Project description:<b>Background:</b> Women's status and empowerment influence health, nutrition, and socioeconomic status of women and their children. Despite its benefits, however, research on women's empowerment in Sub-Saharan Africa (SSA) is limited in scope and geography. Empowerment is variably defined and data for comparison across regions is often limited. The objective of the current study was to identify domains of empowerment from a widely available data source, Demographic and Health Surveys, across multiple regions in SSA. <b>Methods:</b> Demographic and Health Surveys from nineteen countries representing four African regions were used for the analysis. A total of 26 indicators across different dimensions (economic, socio-cultural, education, and health) were used to characterize women's empowerment. Pooled data from all countries were randomly divided into two datasets-one for exploratory factor analysis (EFA) and the other for Confirmatory Factor Analysis (CFA)-to verify the factor structure hypothesized during EFA. <b>Results:</b> Four factors including attitudes toward violence, labor force participation, education, and access to healthcare were found to define women's empowerment in Central, Southern, and West Africa. However, in East Africa, only three factors were relevant: attitudes toward violence, access to healthcare ranking, and labor force participation. There was limited evidence to support household decision-making, life course, or legal status domains as components of women's empowerment. <b>Conclusion:</b> This foremost study advances scholarship on women's empowerment by providing a validated measure of women's empowerment for researchers and other stakeholders in health and development.
Project description:This study examines the associations between women's empowerment and family planning use in Jimma Zone, Western Ethiopia. A total of 746 randomly selected married women of reproductive age were interviewed. The data were employed by structural equation modelling (SEM) to investigate the complex and multidimensional pathways to show women's empowerment domains in family planning utilisation. Results of the study revealed that 72% of married women had used family planning. Younger women, having access to information, having access to health facilities and being aware about family planning methods, living in a rural area, having an older partner and increased household decision-making power were associated with using family planning methods. Women's empowerment is an important determinant of contraceptive use. Women's empowerment dimensions included increased household decision-making power, socio-demographic variables and having access to information about family planning and accessible health facilities. These were found to be important determinants of contraceptive use. Future interventions should focus on integrating women's empowerment into family planning programming, particularly in enhancing women's autonomy in decision making. Further research is warranted on the socio-cultural context of women that influences women's empowerment and family planning use to establish an in-depth understanding and equity of women in society.
Project description:<h4>Background</h4>Women's empowerment has a strong potential to promote sustainable development. We evaluate the association between women's empowerment and the Composite Coverage Index (CCI), a weighted average of coverage of eight interventions in reproductive, maternal, newborn and child health (RMNCH). We also assess whether these effects are modified by wealth.<h4>Methods</h4>We used Demographic and Health Survey data from 62 low- and middle-income countries. Women's empowerment was measured using the three domains (attitude to violence, social independence and decision making) of the survey-based indicator of women's empowerment (SWPER). Analyses followed an ecological design. Meta-regression models were used to account for within-country uncertainty in the CCI. We also carried out meta-regression with wealth quintiles of households as the units of analyses and tested for interaction between wealth and each empowerment domain.<h4>Results</h4>We found positive associations between the three domains of SWPER and CCI at the country level. One standard deviation change in empowerment increased the CCI by 14.2 percentage points (attitude to violence), 15.3 percentage points (decision-making), and 16.3 percentage points (social independence). The association between social independence and CCI was modified by wealth: each additional standard deviation was associated with 21.8 (95% confidence interval (CI) = 14.0-29.6) and 8.7 (95% CI = 5.4-12.0) percentage points increase in the CCI among the poorest and the richest quintiles, respectively.<h4>Conclusions</h4>Our findings suggest that efforts toward the achievement of SDG5 (Achieve gender equality and empower all women and girls) may support improvements in RMNCH in low- and middle-income countries, especially among the poorest women and children.
Project description:The relationship between women's empowerment and women's nutrition is understudied. We aimed to elucidate this relationship by quantifying possible pathways between empowerment and dietary diversity among women in rural Bangladesh. In 2015, we conducted a cross-sectional survey of 2,599 married women ages 15-40 (median: 25) living in 96 settlements of Habiganj District, Bangladesh, as a baseline for the Food and Agricultural Approaches to Reducing Malnutrition trial. We collected data on women's empowerment (highest completed grade of schooling and agency), dietary diversity, and demographic factors, including household wealth. We used exploratory factor analysis and confirmatory factor analysis on random split-half samples, followed by structural equation modelling, to test pathways from schooling, through domains of women's agency, to dietary diversity. Factor analysis revealed 3 latent domains of women's agency: social solidarity, decision-making, and voice with husband. In the adjusted mediation model, having any postprimary schooling was positively associated with voice with husband (?41 = .051, p = .010), which was positively associated with dietary diversity (?54 = .39, p = .002). Schooling also had a direct positive association with women's dietary diversity (?51 = .22, p < .001). Neither women's social solidarity nor decision-making mediated the relationship between schooling and dietary diversity. The link between schooling and dietary diversity was direct and indirect, through women's voice with husband but not through women's social solidarity or decision-making. In this population, women with postprimary schooling seem to be better able to negotiate improved diets for themselves.