Household Decision-making Autonomy Research Articles

Empowering women through a gender-responsive seed multiplication program in Northern Malawi

Limited access to quality seeds remains a major challenge to improving agricultural productivity and resilience to climate change in sub-Saharan Africa, especially in Malawi. Over the past decade, local seed multiplication programs have emerged as a promising solution to enhance farmers’ access to quality seeds in resource-poor regions. Some of such projects have incorporated gender-responsive tools to bridge the gender inequality gap in the seed system. Yet there is a dearth of research examining the impacts of seed multiplication programs on farmers’ livelihoods and in promoting gender equality in smallholder communities. This dearth of research has resulted in the underrepresentation of seed multiplication in agricultural policy. To address this void in the literature, we conducted interviews with 40 participants and three project officers from a gender-responsive seed multiplication initiative launched in 2011/12. Through a feminist political ecology lens, we investigated the program’s impact on gender equality and smallholder farmers’ livelihoods. Our results highlight prominent benefits farmers derived from the program; including livelihood diversification, seed and food security, improvements in women’s household decision-making autonomy, changing gender and social norms, and improvements in women’s leadership opportunities. However, challenges like climate change and constrained market access threaten these gains. Given these insights, we argue that gender-responsive seed initiatives can deliver on gender equality while simultaneously improving smallholder farmers livelihoods. While we advocate for the integration of gender-responsive seed multiplication initiatives into agricultural policy frameworks in Malawi, addressing market accessibility and promoting climate-resilient agricultural practices is crucial to realizing these gains.

Exploring the link between household structure and women's household decision-making autonomy in Mauritania.

Governments in sub-Saharan African countries aim to increase married women's household decision-making autonomy as it remains a critical determinant of desirable health behaviours such as healthcare utilisation, antenatal care visits, and safer sex negotiation. However, very few studies explore how household structure (i.e., monogamous or polygamous) is associated with married women's household decision-making autonomy. Our paper seeks to address this gap. Using the 2019-20 Mauritania Demographic and Health Survey, a nationally representative dataset, and applying logistic regression analysis, we explore how married women's household structure is associated with their household decision-making autonomy. We find that 9% of married women are in polygamous marriages, while 63% and 65% are involved in decision-making about their health and large household purchases, respectively. Additionally, 76% and 56% are involved in decision-making about visiting family or relatives and household expenditures. After accounting for socio-economic and demographic factors, we find that compared to women from monogamous households, those from polygamous households are less likely to participate in decision-making about their health (OR=0.65, p < 0.001), making large household purchases (OR=0.65, p < 0.001), visiting family or relatives (OR=0.72, p < 0.001), and household expenditure (OR=0.58, p < 0.001). Based on our findings, we recommend the urgent need to review and re-evaluate policies and approaches seeking to promote gender equality and women's autonomy in Mauritania. Specifically, it may be critical for intervention programmes to work around reducing power imbalances in polygamous household structures that continue to impact married women's household decision-making autonomy adversely. Such interventions should centre married women's socio-economic status as a central component of their empowerment strategies in Mauritania.

Ending violence against women: Help-seeking behaviour of women exposed to intimate partner violence in sub-Saharan Africa.

Intimate partner violence is a serious public health problem that transcends cultural boundaries in sub-Saharan Africa. Studies have reported that violence characteristics and perception are strong predictors of help-seeking among women. We assessed the prevalence and factors associated with help-seeking among female survivors of intimate partner violence in sub-Saharan Africa. We pooled data from the most recent Demographic and Health Surveys (DHS) of eighteen sub-Saharan African countries. The data were extracted from the women's files in countries with datasets from 2014 to 2021. A weighted sample of 33,837 women in sexual relationships: married or cohabiting who had ever experienced intimate partner violence within the five years preceding the survey were included in the analysis. Percentages with 95% confidence interval (CI) were used to present the results of the prevalence of help-seeking for intimate partner violence. We used a multilevel binary logistic regression analysis to examine the factors associated with help-seeking among survivors of intimate partner violence. The results were presented using adjusted odds ratio (AOR) with their respective 95% CI. Statistical significance was set at p<0.05. Out of the 33,837 women who had ever experienced intimate partner violence in sub-Saharan Africa, only 38.77% (95% CI = 38.26-39.28) of them sought help. Ethiopia had the lowest prevalence of women who sought help after experiencing intimate partner violence (19.75%; 95% CI = 17.58-21.92) and Tanzania had the highest prevalence (57.56%; 95% CI = 55.86-59.26). Marital status, educational level, current working status, parity, exposure to interparental violence, women's autonomy in household decision-making, mass media exposure, intimate partner violence justification, wealth index, and place of residence were associated with help-seeking behaviour of intimate partner violence survivors. The low prevalence of help seeking among women who have experienced intimate partner violence in sub-Saharan Africa calls for the intensification of formal and informal sources of assistance. Education can play a critical role in empowering girls, which may increase future help-seeking rates. Through media efforts aimed at parental awareness, the long-term benefits of females enrolling in school could be achieved. However, concentrating solely on individual measures to strengthen women's empowerment may not bring a significant rise in help-seeking as far as patriarchal attitudes that permit violence continue to exist. Consequently, it is critical to address intimate partner violence from the dimensions of both the individual and violence-related norms and attitudes. Based on the findings, there should be public awareness creation on the consequences of intimate partner violence. Respective governments must increase their coverage of formal support services to intimate partner violence survivors especially those in rural communities.

Is women's household decision-making autonomy associated with their higher dietary diversity in Bangladesh? Evidence from nationally representative survey.

In Bangladesh, a low-quality repetitive diet characterized by starchy staple foods is typical, leading to disorders associated with micronutrient deficiencies, particularly among mothers and their children. The purpose of the study was to validate the link between women's decision-making autonomy and higher dietary diversity score. Participants were ever married women aged 15-49 years old with comprehensive dietary information (n = 17,842), selected from the Bangladesh Demographic and Health Survey, 2014. The dietary diversity score (DDS) was obtained from a 24-h recall of dietary intake from nine food groups, categorized into lower DDS (DDS ≤ 4) and higher DDS (DDS ≥ 5). Descriptive analysis, bivariate and multivariate logistic regression were conducted using STATA version 15. Almost all women consumed starchy foods, flesh (83.86%), and fruits (67.30%). Using logistic regression, the odds of achieving dietary diversity score were higher among women who participated in household purchases (OR 2.40; 95% CI: 1.52-3.83; p = 0.022). Women who had higher and secondary education were 2.72 (95% CI: 1.49-3.02; p = 0.025) and 1.31 (95% CI: 0.58-2.18; p = 0.029) times more likely to achieve higher DDS than women having no education, as well as women in the richest quintile (OR 6.49; 95% CI: 4.12-8.5; p = 0.037) compared to women in the lowest quintile. This study highlighted the association of several socioeconomic conditions of ever married women and their dietary diversity score in Bangladesh. Therefore, promoting the women's education status, improving the socioeconomic conditions, and prioritizing their decisions are recommended for the attainment of higher dietary diversity score.

Http://www.pertanika.upm.edu.my/pjssh/browse/regular-issue?article=JSSH-8608-2022

Ensuring gender equality and empowering women is crucial, as they play a significant role in driving economic and societal development. This study examines women’s empowerment levels in Malaysia and Indonesia, two neighbouring countries with a predominantly Muslim population. Data were obtained from the Fifth Malaysian Population and Family Survey 2014 and the Indonesia Demographic and Health Survey 2017. A total of 5,175 Malaysian and 34,467 Indonesian married women aged 15–49 were selected for this study. The variables used include women’s autonomy in household decision-making (a proxy for women’s empowerment), educational level, work status, place of residence, number of children, and women’s age. Findings reveal that Malaysia has a higher proportion of women with tertiary education than Indonesia (25.2% versus 14.7%). However, the proportion of women who were employed was lower in Malaysia than in Indonesia (45.4% versus 57.0%). Concerning household decision-making participation, approximately 46% of Malaysian women participated in all household decisions, as compared to 73% among Indonesian women. Binary logistic regression analysis indicates that all selected independent variables, except the place of residence, were significantly associated with women’s autonomy in household decision-making in both countries at the multivariate level. Women’s socio-economic characteristics greatly influence their status in the household and decision-making autonomy. Enhancing women’s education and employability can empower them and strengthen their decision-making autonomy.

Association between women’s household decision-making autonomy and health insurance enrollment in sub-saharan Africa

BackgroundOut of pocket payment for healthcare remains a barrier to accessing health care services in sub-Saharan Africa (SSA). Women’s decision-making autonomy may be a strategy for healthcare access and utilization in the region. There is a dearth of evidence on the link between women’s decision-making autonomy and health insurance enrollment. We, therefore, investigated the association between married women’s household decision making autonomy and health insurance enrollment in SSA.MethodsDemographic and Health Survey data of 29 countries in SSA conducted between 2010 and 2020 were analyzed. Both bivariate and multilevel logistic regression analyses were carried out to investigate the relationship between women’s household decision-making autonomy and health insurance enrollment among married women. The results were presented as an adjusted odds ratio (AOR) and the 95% confidence interval (CI).ResultsThe overall coverage of health insurance among married women was 21.3% (95% CI; 19.9-22.7%), with the highest and lowest coverage in Ghana (66.7%) and Burkina Faso (0.5%), respectively. The odds of health insurance enrollment was higher among women who had household decision-making autonomy (AOR = 1.33, 95% CI; 1.03–1.72) compared to women who had no household decision-making autonomy. Other covariates such as women’s age, women’s educational level, husband’s educational level, wealth status, employment status, media exposure, and community socioeconomic status were found to be significantly associated with health insurance enrollment among married women.ConclusionHealth insurance coverage is commonly low among married women in SSA. Women’s household decision-making autonomy was found to be significantly associated with health insurance enrollment. Health-related policies to improve health insurance coverage should emphasize socioeconomic empowerment of married women in SSA.

Household Poverty-Wealth and Decision-Making Autonomy as Predictors of Reproductive and Maternal Health Services Utilization among Rural Women in Nigeria: Evidence from a National Survey.

Adequate reproductive and maternal healthcare services utilization are significant in reducing maternal deaths, however, the prevalence rate of contraceptive use remains low, with inadequate maternal health services utilization among rural women in Nigeria. This study examined the influence of household poverty-wealth and decision-making autonomy on reproductive and maternal health services utilization among rural women in Nigeria. The study analyzed data from a weighted sample of 13,151 currently married and cohabiting rural women. Descriptive and analytical statistics including multivariate binary logistic regression were conducted using Stata software. An overwhelming majority of rural women (90.8%) have not used modern contraceptive methods, with poor utilization of maternal health services. About 25% who delivered at home received skilled postnatal checks during the first 2 days after childbirth. Household poverty-wealth significantly reduced the likelihood of using modern contraceptives (aOR: 0.66, 95% CI: 0.52-0.84), having at least four ANC visits (aOR: 0.43, 95% CI: 0.36-0.51), delivering in a health facility (aOR: 0.35, 95% CI: 0.29-0.42) and receiving a skilled postnatal check (aOR: 0.36, 95% CI: 0.15-0.88). Women's decision-making autonomy regarding their healthcare significantly increased the use of modern contraceptives and the number of ANC visits, while women's autonomy on how their earnings are spent positively influenced the use of maternal healthcare services. In conclusion, the use of reproductive and maternal health services among rural women was associated with household poverty-wealth and decision-making autonomy. Government should formulate more pragmatic policies that will create awareness and promote universal access to reproductive and maternal healthcare services.

Women’s Decision-Making and Movement Autonomy in Tanzania

ABSTRACT Women, like men, maintain simultaneous membership in the household, the conjugal unit, the community, and at the individual levels. Using the latest 2015/2016 Demographic and Health Survey (DHS), which is nationally representative, this study incorporates well-supported covariates in the existing literature in a multivariate regression analysis, to measure the relative importance of four domains of factors hypothesized to affect women’s autonomy in household decision-making. These factors are (1) women’s individual characteristics, (2) husband’s/partner’s characteristics, (3) household characteristics, and (4) community-level characteristics. Women’s autonomy was confirmed to be low in Tanzania, more so for the decision authority in purchasing large household items than authority around their own healthcare, decisions to visit family and friends, and the use of their own earnings. Research findings show that women with greater autonomy are more likely to be older, educated, earn their own income, be cohabitating, live in polygamous situations, reside in urban areas, and be married to educated husbands/partners with a higher socioeconomic status. In addition, the study results provide some insight into intrahousehold dynamics, acknowledging the disadvantaged position of women in extended families compared to women in nuclear households. The study results directly inform the Sustainable Development Goals’ (SDGs) monitoring indicators—particularly on the proportion of women with autonomy in decision-making, an indicator under SDG no. 5 and inform education-related policy recommendations.

Effect of Education on Women’s Autonomy in Financial Household Decision-making in Afghanistan

The research study explores the main factors shaping women’s autonomy in financial household decision-making in Afghanistan. This study uses data from the Central Statistics Organization of Afghanistan for 2014. The aim of the research is to conduct an empirical analysis of the main determinants of women’s autonomy in financial household decision-making covering 34 provinces of Afghanistan. The methodology employed in investigating the effect of each factor is the Multinomial Logistic estimation technique. In addition, women’s autonomy relating to expenditure on food, purchasing, and visiting family has been studied. Findings of the study reveal that education has a significant negative effect on women’s participation in financial household decision-making in Afghanistan. In most cases, agricultural employment tends to empower women in terms of financial household decision-making and their autonomy in terms of visiting family, purchasing food, and expenditure. However, other types of employment, including business employment, significantly decrease women’s autonomy in household decision-making. Also, provinces that aren't safe make it much harder for women to make their own financial decisions for their households. In terms of education, it cannot be concluded that education does not play any role in empowering women. Indeed, it plays a vital role in the overall development of the country. Awareness building program, security and health care services from government might be suggested for the bright future of the women in Afghanistan.

Effect of Education on Women's Autonomy in Financial Household Decision-making in Afghanistan

Effect of Education on Women's Autonomy in Financial Household Decision-making in Afghanistan

The effect of armed conflict on intimate partner violence: Evidence from the Boko Haram insurgency in Nigeria

Intimate partner violence (IPV) is the most common form of violence against women in both conflict and non-conflict settings but in conflict settings it often receives less attention than other forms of gender-based violence (GBV), such as conflict-related sexual violence. To examine whether increased rates of IPV are linked to conflict we use data from Domestic Violence module of the Nigerian Demographic and Health Survey (NDHS) collected in 2008 and 2013 and spatially link them to the Boko Haram (BH) actor file of the Armed Conflict Location and Events Database (ACLED). To estimate whether the BH insurgency is associated with increases in IPV we use a quasi-experimental approach, employing a kernel-based difference-in-difference model. We also examine the effect of the BH insurgency on women’s likelihood of experiencing controlling behavior from a husband or partner, women’s autonomy in household decision-making and their control over their own earnings. We find that the presence of BH increases the probability that women experience physical or sexual IPV by about 4 percentage points after controlling for known correlates of IPV; partner’s alcohol use, previous exposure to IPV and condoning IPV as a social norm. Further, we find controlling behaviors from husbands/partners – another form of IPV - are heightened in locations that are impacted by the BH insurgency. In these places women’s risk of experiencing controlling behavior increases by 14 percentage points, indicating that the BH insurgency exacerbates another form of IPV; behaviors that are often pre-cursors to physical and sexual IPV. Our results underscore the need for policy makers to prioritize programs that respond to and prevent IPV in conflict affected settings. Effective program responses can be both integrated into sectoral programs and delivered as standalone programs alongside other interventions that provide services to communities living in conflict-affected settings.

Associations of antenatal care visit with utilization of institutional delivery care services in Afghanistan: intersections of education, wealth, and household decision-making autonomy

BackgroundThe importance of antenatal care (ANC) visits in safe motherhood and childbirth is well-documented. However, less is known how social determinants of health interact with ANC visits in shaping the uptake of professional delivery care services in low-income countries. This study examines the associations of ANC visits with institutional delivery care utilization outcomes in Afghanistan. Further, we assess the extent to which ANC visits intersect with education, wealth, and household decision-making autonomy in predicting two outcomes of delivery care utilization- delivery at a health facility and delivery assisted by a skilled birth attendant.MethodsWe used data from the Afghanistan Demographic and Health Survey (AfDHS) 2015. The analytic sample included 15,590 women of reproductive age (15–49). We assessed the associations using logistic regression models, estimated the predicted probability of delivery care outcomes using statistical interactions, and presented estimates in margins plot.ResultsMultivariable adjusted analyses suggest that women who had 4 or more ANC visits were 5.7 times (95% CI = 4.78, 7.11; P < 0.05) more likely to use delivery care at a health facility and 6.5 times (95% CI = 5.23, 8.03; P < 0.05) more likely to have a delivery assisted by a skilled birth attendant compared to women who had no ANC visit. Estimates from models with statistical interactions of ANC visits with education, wealth, and decision-making autonomy suggest that women with higher social status were more advantageous in utilizing institutional delivery care services compared to women with lower levels of social status.ConclusionOur findings suggest that the associations of ANC visits with institutional delivery care services are stronger among women with higher social status. The results have implications for promoting safe motherhood and childbirth through improving women’s social status.

Determinant of Intimate partner violence Family: parametric Statistics of the influence of household decision-making autonomy and Family Income Status

The study is an analysis of the relationship between household decision-making autonomy, family income status and intimate partner violence in Calabar South, Cross River State, Nigeria. Adopting the exchange/social control theory, the study applied the survey research design in gathering data from 383 respondents from Calabar South, using a structured interview questionnaire. Elicited data was analyzed using simple lineal regression at 0.05 alpha Level. Result revealed that household decision making autonomy and family income status has significant influence on intimate partner violence in Calabar South Local Government Area The study thereby calls for the development of evidence-based culturally appropriate interventions that address the issue of unequal power relations between men and women

Increase of Urban Women’s Work Participation and Quality of Employment in Paid-Domestic Work: A Survey in Delhi-NCR and Kolkata-Asansol

A rise in female work participation in the urban sector creates a vacancy for care work at the household level and triggers a second round of job creation for females. In order to explore whether this process gives rise to decent employment for the female domestic workers (FDWs), a primary survey was conducted among domestic workers in the cities of Delhi, Noida, Kolkata and Asansol. The workers surveyed are, by and large, in low-wage, precarious employment, without social security and have an exhausting routine of work inside and outside the home. Apart from the lack of job security, sickness and disease also add to the uncertainty. Given the double burden of income-earning work and own domestic work, the FDW is crucially dependent on her health and strength, and often incurs health-related expenditure. But they contribute to their household income and have some autonomy in household decision-making. The informal working conditions for these workers, the need for social security and their low wage levels are all areas that need serious attention from policy-makers. Health insurance and pension plans would benefit the domestic workers, given that their work involves a requirement for robust health and the strength that youth brings with it.

Women's Health Insurance Status in Senegal West Africa

Senegalese women of childbearing age continue to be disproportionately affected by communicable and noncommunicable disease, yet still face reduced health care access despite the expanding coverage of universal health insurance schemes. There is need to understand the role of women's socio-demographic positioning and household decision-making autonomy on their health care insurance participation.

Women's autonomy in household decision-making and safer sex negotiation in sub-Saharan Africa: An analysis of data from 27 Demographic and Health Surveys.

Women's ability to negotiate the conditions and timing of sex is key to several reproductive health outcomes including family planning and prevention of sexually transmitted infections. We investigated the association between women's autonomy in household decision-making and safer sex negotiation (SSN) in sub-Saharan Africa (SSA). This was a cross-sectional analysis of data from the Demographic and Health Survey (DHS) of 27 countries in SSA. Data were analyzed using Stata version 16.0 using descriptive statistics, chi square test, and logistic regression models. Statistical significance was set at p < 0.05 at 95% confidence interval. The pooled prevalence of SSN in the 27 countries was 77.1%. Compared to women with low autonomy in household decision-making, those with medium (aOR = 1.30; CI = 1.23–1.37) and high levels of autonomy in household decision-making (aOR = 1.28; CI = 1.17–1.40) were more likely to have greater SSN. Those with primary (aOR = 1.35; CI = 1.28–1.41) and secondary/higher education level of education (aOR = 1.68; CI = 1.58–1.79) had higher odds of SSN, compared to those with no formal education. Women who were working had higher odds of SSN (aOR = 1.44; CI = 1.37–1.51) than those who were not working. Women in the middle (aOR = 0.93; CI = 0.87–0.99) and richer (aOR = 0.92; CI = 0.85–0.98) wealth status had lower odds of SSN, compared to those in the poorest wealth status. Women's autonomy in household decision-making is a significant predictor of SSN. Women autonomy in household decision-making programs and interventions should be intensified to achieve Sustainable Development Goals 3.7 and 5 which seek to achieve universal access to sexual and reproductive health services and ensure gender equality and empower all women and girls by 2030.

Female autonomy in household decision-making and intimate partner violence: evidence from Pakistan

The aim of this study is to explore the links between female autonomy in household decision-making and intimate partner violence in a highly relevant yet under-studied context: Pakistan. Using a nationally representative dataset, and employing matching and partial identification estimation approaches, we show that an increase in female autonomy in household decision-making is associated with a decrease in the probability of experiencing intimate partner violence. Moreover, female autonomy is also associated with lower tolerance for intimate partner violence. Our results call for a greater focus on female autonomy in policy efforts concerned with reducing intimate partner violence.

Shared interests or sexual conflict? Spousal age gap, women's wellbeing and fertility in rural Tanzania

The marriage of older men to younger women is common across cultures. On one hand, husband-older marriage may serve the interests of both sexes, a conclusion broadly consistent with reported gender differences in mate preferences. On the other hand, men alone may benefit from such marriages at a cost to women if seniority enables men to exert dominance in conflicts of interest. Indeed, in public health large spousal age gaps are generally deemed “pathological”, both as a cause and consequence of gender inequalities harmful to women. We investigate these alternative models of spousal age gap using data from a cross-sectional survey of women in Mwanza, northwestern Tanzania (n = 993). Consistent with the notion that spousal age gaps are a product of sexual conflict, women typically married with a larger age gap than stated ideals. However, adjusting for potential confounds, spousal age gap was not associated with fertility or the risk of divorce. Furthermore, women's mental health and autonomy in household decision-making was higher in husband-older marriages compared to rare cases of same-age or wife-older marriage. Beyond this comparison, the magnitude of spousal age gaps was unrelated to either measure of women's wellbeing among the overwhelming majority of marriages where the husband was older. Together these findings suggest husband-older marriage does not influence marital stability, relatively large spousal age gaps are neither especially costly nor beneficial to women, and that alternative sociodemographic factors are more important in driving variation in women's wellbeing and reproductive success in this context. Our results support neither a model of mutual benefits, nor a pathological conceptualization of spousal age gaps. We conclude by both encouraging evolutionary human scientists to engage more fully with models of sexual conflict in future studies of marriage and mating, and suggesting that public health scholars consider more neutral interpretations of spousal age differences.

HIV misconceptions among married women in Malawi: the role of household decision-making autonomy

Married women face one of the highest HIV rates in Malawi. Although HIV misconceptions have been identified as a major contributor to HIV infection, we know very little about the association between household decision-making autonomy and HIV misconception endorsement among married women in Malawi. We used the 2015/2016 Malawi Demographic and Health Survey and applied a logistics regression technique to examine the association between household decision-making autonomy and HIV misconception endorsement among married women. The findings reveal that married women with higher levels of autonomy are less likely to endorse HIV misconceptions than those with lower levels (OR = 0.907, p < 0.001) although this difference is partly attenuated when we control for socioeconomic status such as education, household wealth, and employment (OR = 0.957, p < 0.05). We further introduce an interaction term, which points out that the impact of autonomy on misconception endorsement is significantly higher for married women in the central region than for those in the northern region (OR = 1.14, p < 0.01). Based on these findings, we provide several implications for policymakers and future research.

Factors Affecting Women’s Autonomy in Household Decision-Making among Married Women in Zambia

The main aim of the study was to examine factors that affect women’s household decision-making among married women in Zambia. This paper utilizes secondary data from the 2013 Zambia Demographic Health Survey (ZDHS). Logistic regression analysis was used to identify various factors associated with factors that affect women’s autonomy in household decision-making among married women in Zambia. The findings of the study show that married women in Zambia are more likely to participate in decision-making that involved purchases of daily household needs (86%) followed by decision making that involved visits to her family or relatives (75%) and decisions about her own health care (74%). About 66per cent of the respondents reported having participated in household major purposes. Some socio-demographic variables only influenced women in some domains and not all. For instance, age only influenced decision-making on household goods and visits to family. Rich wealthy status, living in urban areas, higher levels of education and justification of wife-beating were influential to healthcare decision-making among women. Zambian programmes and policy initiatives should develop a clear policy foundation that should be crucial to empower women to take part in decision-making processes in the household. Moreover, enhancing their access to and control over economic resources and enabling them to establish and realise their rights are also essential means to empower women to be more autonomous in decision-making.