scholarly journals Do empowered women receive better quality antenatal care in Pakistan? An analysis of demographic and health survey data

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262323
Author(s):  
Muhammad Asim ◽  
Waqas Hameed ◽  
Sarah Saleem
Keyword(s):  
Decision Making ◽  
Antenatal Care ◽  
Health Survey ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Women Empowerment ◽  
Household Decision ◽  
Household Decision Making ◽  
To Receive

Introduction Quality antenatal care is a window of opportunity for improving maternal and neonatal outcomes. Numerous studies have shown a positive effect of women empowerment on improved coverage of maternal and reproductive health services, including antenatal care (ANC). However, there is scarce evidence on the association between women’s empowerment and improved ANC services both in terms of coverage and quality. Addressing this gap, this paper examines the relationship between multi-dimensional measures of women empowerment on utilization of quality ANC (service coverage and consultation) in Pakistan. Methods We used Pakistan Demographic and Health Survey 2017–18 (PDHS) data which comprises of 6,602 currently married women aged between 15–49 years who had a live birth in the past five years preceding the survey. Our exposure variables were three-dimensional measures of women empowerment (social independence, decision making, and attitude towards domestic violence), and our outcome variables were quality of antenatal coverage [i.e. a composite binary measure based on skilled ANC (trained professional), timeliness (1st ANC visit during first trimester), sufficiency of ANC visits (4 or more)] and quality of ANC consultation (i.e. receiving at least 7 or more essential antenatal components out of 8). Data were analysed in Stata 16.0 software. Descriptive statistics were used to describe sample characteristics and binary logistic regression was employed to assess the association between empowerment and quality of antenatal care. Results We found that 41.4% of the women received quality ANC coverage and 30.6% received quality ANC consultations during pregnancy. After controlling for a number of socio-economic and demographic factors, all three measures of women’s empowerment independently showed a positive relationship with both outcomes. Women with high autonomy (i.e. strongly opposed the notion of violence) in the domain of attitude to violence are 1.66 (95% CI 1.30–2.10) and 1.45 (95% CI 1.19–1.75) and times more likely to receive antenatal coverage and quality ANC consultations respectively, compared with women who ranked low on attitude to violence. Women who enjoy high social independence had 1.87 (95% CI 1.44–2.43) and 2.78 (95% CI 2.04–3.79) higher odds of quality antenatal coverage and consultations respectively, as compared with their counterparts. Similarly, women who had high autonomy in household decision making 1.98 (95% CI 1.60–2.44) and 1.56 (95% CI 2.17–1.91) were more likely to receive quality antenatal coverage and consultation respectively, as compared to women who possess low autonomy in household decision making. Conclusion The quality of ANC coverage and consultation with service provider is considerably low in Pakistan. Women’s empowerment related to social independence, gendered beliefs about violence, and decision-making have an independent positive association with the utilisation of quality antenatal care. Thus, efforts directed towards empowering women could be an effective strategy to improve utilisation of quality antenatal care in Pakistan.

scholarly journals Women’s empowerment and fertility decision-making in 53 low and middle resource countries: a pooled analysis of demographic and health surveys

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e045952
Author(s):  
Rezwanul Haque ◽  
Khorshed Alam ◽  
Syed Mahbubur Rahman ◽  
Syed Afroz Keramat ◽  
Mohammed Khaled Al-Hanawi
Keyword(s):  
Decision Making ◽  
Women's Empowerment ◽  
Wife Beating ◽  
Women’S Empowerment ◽  
Women Empowerment ◽  
Fertility Desire ◽  
Household Decision ◽  
Number Of Children ◽  
Household Decision Making ◽  
Ideal Number

ObjectiveWomen’s empowerment and its association with fertility preference are vital for central-level promotional health policy strategies. This study examines the association between women’s empowerment and fertility decision-making in low and middle resource countries (LMRCs).DesignThis cross-sectional study uses the Demographic and Health Survey database.Settings53 LMRCs from six different regions for the period ranging from 2006 to 2018.ParticipantsThe data of women-only aged 35 years and above is used as a unit of analysis. The final sample consists of 91 070 married women.MethodsWe considered two outcome variables: women’s perceived ideal number of children and their ability to achieve preferred fertility desire and the association with women empowerment. Women empowerment was measured by their participation in household decision-making and attitude towards wife-beating. The negative binomial regression model was used to assess women’s perceived ideal number of children, and multivariable logistic regression was used to evaluate women’s ability to achieve their preferred fertility desire.ResultsOur study found that empowered women have a relatively low ideal number of children irrespective of the measures used to assess women empowerment. In this study, the measures were participation in household decision-making (incidence rate ratio (IRR): 0.92, 95% CI: 0.91 to 0.93) and attitude towards wife-beating (IRR: 0.96, 95% CI: 0.95 to 0.97). In the LMRCs, household decision-making and negative attitude towards wife-beating have been found associated with 1.12 and 1.08 times greater odds of having more than their ideal number of children.ConclusionOur findings suggest that women’s perceived fertility desire can be achieved by enhancing their empowerment. Therefore, a modified community-based family planning programme at the national level is required, highlighting the importance of women’s empowerment on reproductive healthcare as a part of the mission to assist women and couples to have only the number of children they desire.

scholarly journals Women's empowerment and fertility preferences of married women: analysis of demographic and health survey’2016 in Timor-Leste

2022 ◽  
Vol 9 (2) ◽  
pp. 237-261
Author(s):  
Nandeeta Samad ◽  
◽  
Pranta Das ◽  
Segufta Dilshad ◽  
Hasan Al Banna ◽  
...  
Keyword(s):  
Decision Making ◽  
Health Survey ◽  
Women's Empowerment ◽  
Married Women ◽  
Fertility Rate ◽  
Demographic And Health Survey ◽  
Women’S Empowerment ◽  
Women Empowerment ◽  
Fertility Preferences ◽  
Timor Leste

<abstract> <p>A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women's empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women's empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women's reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women's empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.</p> </abstract>

scholarly journals Effect of BISP’S Unconditional Cash Transfer Program on Women Empowerment in Gilgit Baltistan

2021 ◽  
Vol 4 (1) ◽  
pp. 131-144
Author(s):  
Fatima Ghazi ◽  
Muhammad Abo ul Hassan Rashid ◽  
Saif Ur Rehman Saif Abbasi ◽  
Hassan Raza
Keyword(s):  
Decision Making ◽  
Domestic Violence ◽  
Women's Empowerment ◽  
Cash Transfer ◽  
Women’S Empowerment ◽  
Transfer Program ◽  
Snowball Sampling ◽  
Household Decision ◽  
Household Decision Making ◽  
Unconditional Cash Transfer

Benazir Income Support Program (BISP) is a targeted unconditional cash transfer program initiated to provide financial support to poor and vulnerable women for smoothing and cushioning the negative effects of slow economic growth. The present study aims to find out the effect of unconditional cash transfer BISP on women’s empowerment. We analyze women’s empowerment through exploring the effect of unconditional cash transfer on household decision making, their independence, status of women in the community and their freedom from domestic violence. We interviewed 20 beneficiaries among which 10 respondents belonged to district Gilgit whereas the remaining 10 were the residents of district Nagar the data was analyzed using thematic analysis. Purposive sampling was used for data collection and respondents were traced through snowball sampling technique. The findings aver that BISP has improved the household decision making of women, increased women independence at limited level and decreased domestic violence, however, minimal effect was observed on women’s status in society.

scholarly journals The Effect of Women’s Empowerment in the Utilisation of Family Planning in Western Ethiopia: A Structural Equation Modelling Approach

2021 ◽  
Vol 18 (12) ◽  
pp. 6550
Author(s):  
Muluken Dessalegn Muluneh ◽  
Lyn Francis ◽  
Mhiret Ayele ◽  
Sintayehu Abebe ◽  
Misrak Makonnen ◽  
...  
Keyword(s):  
Decision Making ◽  
Family Planning ◽  
Structural Equation ◽  
Contraceptive Use ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
Household Decision ◽  
Planning Methods ◽  
Western Ethiopia ◽  
Family Planning Methods

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.

scholarly journals Women’s empowerment is associated with maternal nutrition and low birth weight: Evidence from Bangladesh Demographic Health Survey

2020 ◽  
Author(s):  
Alamgir Kabir ◽  
Md Mahbubur Rashid ◽  
Kamal Hossain ◽  
Md Arifuzzaman Khan ◽  
Shegufta Shefa Sikder ◽  
...  
Keyword(s):  
Decision Making ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Maternal Nutrition ◽  
Women's Empowerment ◽  
Wealth Quintile ◽  
Women’S Empowerment ◽  
Demographic Health Survey ◽  
Maternal Undernutrition

Abstract Background The burden of maternal undernutrition and low birth weight (LBW) incurs enormous economic costs due to their adverse consequences. Women’s empowerment is believed to be one of the key factors for attaining maternal and child health and nutritional goals. Our objective was to investigate the association of women’s empowerment with maternal undernutrition and LBW. Methods We used nationally representative data from the Bangladesh Demographic Health Survey for 2011 and 2014. We analysed 27,357 women and 9,234 mother-child pairs. A women’s empowerment index (WEI) was constructed using principal component analysis with five groups of indicators: a) education, b) access to socio-familial decision making, c) economic contribution and access to economic decision making, d) attitudes towards domestic violence and e) mobility. We estimated odds ratios as the measure of association between the WEI and the outcome measures using generalized estimating equations to account for the cluster level correlation. Results The overall prevalence of maternal undernutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal undernutrition and LBW with a dose-response relationship. The adjusted odds of having a LBW baby was 32% [AOR (95% CI):0.68 (0.57, 0.82)] lower in the highest quartile of the WEI relative to the lowest quartile. Household wealth significantly modified the effect of the WEI on maternal nutrition.; in the highest wealth quintile, the odds of maternal undernutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of undernutrition was only 18% [AOR (95% CI): 0.82 (0.67, 1.00)] lower comparing the highest WEI quartile with the lowest WEI quartile. However, the absolute differences in prevalence of undernutrition between the highest and lowest WEI quartiles were similar across wealth quintiles (6-8%). Conclusions This study used a comprehensive measure of women’s empowerment and provides strong evidence that low levels of women’s empowerment is associated with maternal undernutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved public health.

scholarly journals 22A Survey-Based Women's Empowerment Index for Low- and Middle-Income Countries: The SWPER Goes Global

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Fernanda Ewerling ◽  
Anita Raj ◽  
Cesar G Victora ◽  
Franciele Hellwig ◽  
Carolina VN Coll ◽  
...  
Keyword(s):  
Decision Making ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
African Countries ◽  
Middle Income ◽  
Household Decision ◽  
Middle Income Countries ◽  
World Regions ◽  
Country Rankings ◽  
Low And Middle Income

Abstract Background In 2017, a survey-based women's empowerment index (SWPER) was proposed for African countries, including three domains: social independence, decision making and attitude to violence. We explored the applicability of the SWPER in national health surveys from countries in other world regions. Methods We used data from the latest Demographic and Health Survey for 62 low- and middle-income countries (LMICs) since 2000, and adapted the indicator so that it could be used for any LMIC. Adaptations included the exclusion of women's working status and recategorization of the household decision-making related items. We compared the loading patterns obtained from principal components analysis for each country separately with those obtained in a pooled dataset with all countries combined. Country rankings based on the score of each SWPER domain were correlated with their rankings in the Gender Development Index (GDI) and the Gender Inequality Index (GII). Results Most countries presented similar patterns regarding item loadings for the three SWPER empowerment domains. Correlations between the country-specific and global individual-level scores were 0.89 or higher for all countries. Correlations between the country rankings according to SWPER and GDI were, respectively, 0.74, 0.71 and 0.67 for social independence, decision-making, and attitude to violence domains. The correlations were equal to 0.82, 0.67, and 0.44, respectively, with GDI. Conclusions The SWPER global is a suitable common measure of women's empowerment for LMICs, addressing the need for a single consistent survey-based indicator of women's empowerment and allowing wider comparisons across countries and world regions.

Association between women’s empowerment and diarrhoea in children under five years: evidence from the 2017/18 Benin Demographic and Health Survey

2021 ◽  
pp. 1-20
Author(s):  
Betregiorgis Zegeye ◽  
Dina Idriss-Wheeler ◽  
Sanni Yaya
Keyword(s):  
Decision Making ◽  
Health Survey ◽  
Women's Empowerment ◽  
Married Women ◽  
Demographic And Health Survey ◽  
Wife Beating ◽  
Women’S Empowerment ◽  
Children Under Five ◽  
Under Five ◽  
Childhood Diarrhoea

Abstract Globally, diarrhoea is the third leading cause of death for under five-children. Women’s empowerment can significantly reduce under-five mortality due to diarrhoea. This study investigated the association between women’s empowerment and childhood diarrhoea in Benin using data from the 2017/18 Benin Demographic and Health Survey. A total of 7979 currently married women were included in the study. A logistic regression model was used to control for possible confounders. The prevalence of diarrhoea among children under five years of age was 13.6%. About 36.3% of the currently married women decided either alone or together with their husband on their own health, purchase of large household items and visiting family/relatives. Close to 65.4% of currently married women disagreed with all five reasons to justify wife-beating. The children of mothers who had decision-making power were less likely to have diarrhoea (aOR = 0.74, 95% CI: 0.57–0.96) than the children of mothers who had no decision-making power. Moreover, the children of mothers who disagreed with all five reasons to justify wife-beating (aOR = 0.79, 95% CI: 0.65–0.96) were less likely to have diarrhoea than the children of mothers who accepted wife-beating as a part of life. Women’s age, educational level, wealth index and region were associated with childhood diarrhoea in Benin. The role of women’s empowerment, as determined by decision-making power and wife-beating attitude, was found to be significantly associated with the risk of childhood diarrhoea in Benin, after adjusting for other variables. Therefore, it is essential for policymakers in Benin to reinforce strategies and interventions focusing on women’s empowerment to avert childhood mortality caused by diarrhoea. This includes improving household economic status, women’s education and decision-making power and enhancing awareness of women’s human and democratic rights.

scholarly journals Women empowerment and minimum daily meal frequency among infants and young children in Ghana: analysis of Ghana demographic and health survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Louis Kobina Dadzie ◽  
Joshua Amo-Adjei ◽  
Kobina Esia-Donkoh
Keyword(s):  
Health Survey ◽  
Positive Association ◽  
Women's Empowerment ◽  
Well Being ◽  
Women’S Empowerment ◽  
Women Empowerment ◽  
Meal Frequency ◽  
Significant Positive Association ◽  
Large Household ◽  
Health And Well Being

Abstract Background The nutritional quality of food has an important impact on the health and well-being of families, especially children whose bodies need to grow, develop and reach their full physical and mental potential. Traditionally, women in Ghana provide care and nourishment for their children and families if they have the means to do so or if they are financially, legally and socially empowered. Women’s empowerment is not only important for women’s human rights, but also improves nutrition and health outcomes of both mothers and their children. Women’s empowerment is concerned with increasing ability to make strategic life choices in situations where the ability was hitherto denied. This study sought to investigate the association between women’s empowerment and minimum daily meal frequency (minimum number of meals to be consumed in a day) in Ghana. Methods The study used data from the 2014 Ghana Demographic and Health Survey (GDHS). A sample of 1640 mother-child dyad was used. Mothers ages ranged from 15 to 49 while children’s ages ranged from 6 to 23 months. Univariate and multiple linear regression techniques were applied to identify women empowerment (economic, socio-familial and legal) and sociodemographic factors associated with minimum daily meal frequency scores. Data was analyzed by the STATA statistical package software version 13.0. Statistical significance level was set at P < 0.10. Results Data from decisions on large household purchases (β = 0.351, p < 0.01) family visits (β = 0.743, p < 0.01), home ownership (β = − 0.245, p < 0.10), age of child (β = 1.387, p < 0.01), mother’s educational attainment (β = 0.496, p < 0.10) and place of residence (β = − 0.298, p < 0.10) showed significant positive association with minimum daily meal frequency in Ghana. Conclusion Minimum daily meal frequency was largely influenced by economic and socio-familial factors that contribute to empowerment of women. as decisions on large household purchases and family visits showed significant positive association with minimum daily meal frequency. Interventional programs should target households and mothers with lower socio-demographic characteristics such as lower educational levels and low economic status to improve minimal daily meal frequency in their children thereby ensuring better child health and well-being.

scholarly journals Women’s empowerment is associated with maternal nutrition and low birth weight: Evidence from Bangladesh Demographic Health Survey

2020 ◽  
Author(s):  
Alamgir Kabir ◽  
Md Mahbubur Rashid ◽  
Kamal Hossain ◽  
Md Arifuzzaman Khan ◽  
Shegufta Shefa Sikder ◽  
...  
Keyword(s):  
Decision Making ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Health Survey ◽  
Maternal Nutrition ◽  
Women's Empowerment ◽  
Wealth Quintile ◽  
Women’S Empowerment ◽  
Demographic Health Survey ◽  
Maternal Undernutrition

Abstract Background : The burden of maternal undernutrition and low birth weight (LBW) incurs enormous economic costs due to their adverse consequences. Women’s empowerment is believed to be one of the key factors for attaining maternal and child health and nutritional goals. Our objective was to investigate the association of women’s empowerment with maternal undernutrition and LBW. Methods : We used nationally representative data from the Bangladesh Demographic Health Survey for 2011 and 2014. We analysed 27,357 women and 9,234 mother-child pairs. A women’s empowerment index (WEI) was constructed using principal component analysis with five groups of indicators: a) education, b) access to socio-familial decision making, c) economic contribution and access to economic decision making, d) attitudes towards domestic violence and e) mobility. We estimated odds ratios as the measure of association between the WEI and the outcome measures using generalized estimating equations to account for the cluster level correlation. Results: The overall prevalence of maternal undernutrition was 20% and LBW was 18%. The WEI was significantly associated with both maternal undernutrition and LBW with a dose-response relationship. The adjusted odds of having a LBW baby was 32% [AOR (95% CI):0.68 (0.57, 0.82)] lower in the highest quartile of the WEI relative to the lowest quartile. Household wealth significantly modified the effect of the WEI on maternal nutrition.; in the highest wealth quintile, the odds of maternal undernutrition was 54% [AOR (95% CI): 0.46 (0.33, 0.64)] lower while in the lowest wealth quintile the odds of undernutrition was only 18% [AOR (95% CI): 0.82 (0.67, 1.00)] lower comparing the highest WEI quartile with the lowest WEI quartile. However, the absolute differences in prevalence of undernutrition between the highest and lowest WEI quartiles were similar across wealth quintiles (6-8%). Conclusions: This study used a comprehensive measure of women’s empowerment and provides strong evidence that low levels of women’s empowerment is associated with maternal undernutrition as well as with delivering LBW babies in Bangladesh. Therefore, policies to increase empowerment of women would contribute to improved public health.

scholarly journals Microfinance Services and Women Empowerment in Biratnagar Metropolitan, Nepal

2020 ◽  
Vol 4 (2) ◽  
pp. 251-270
Author(s):  
Bandana Kumari Jain
Keyword(s):  
Decision Making ◽  
Financial Services ◽  
Sampling Method ◽  
Easy Access ◽  
Economic Empowerment ◽  
Women Empowerment ◽  
Household Decision ◽  
Household Decision Making ◽  
Nepali Women ◽  
Major Decision

This article examines how far microfinancing services positively affect the empowerment of Nepali women living in the eastern part of Nepal. A purposive sampling method was used and responses of 97 women were collected through structured questionnaires. The women were using microfinance services on their own and at least from the last three years. Results indicate that the use of microfinance services (credit and saving) helps women to empower. Easy access to financial services and satisfaction with the loan payment period causes no difference in the improvement of women’s empowerment. Saving service is significantly associated with women’s household decision-making, major decision-making in the domestic context, and availability of basic household needs. Microfinance services contribute to women’s socio-economic empowerment and their children’s education.

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