Domains Of Empowerment Research Articles

The status of women’s empowerment in the aquaculture sector in Kenya

PurposeWomen’s empowerment remains a key development challenge in Kenya. The purpose of this study is to attempt to understand the status of women’s empowerment and the key contributors to their disempowerment in Kenya’s aquaculture sector.Design/methodology/approachA cross-sectional survey was conducted on 534 male and female fish farmers from 300 households drawn from six counties in Kenya (Kakamega, Kisumu, Kisii, Kiambu, Meru and Nyeri). The Abbreviated Women’s Empowerment in Agriculture Index (A-WEAI) was adapted to Abbreviated Women’s Empowerment in Fisheries and Aquaculture Index (A-WEFI) to suit the aquaculture and fisheries sub-sector. The adapted A-WEFI was then used to estimate and the status of women’s and men’s using five domains of empowerment (5DE) and a gender parity index (GPI). Data were analysed using descriptive statistics, Cramer’s V and sensitivity analysis as test statistics.FindingsAbout 86% of the men and 80% of the women were classified as empowered. The mean score of the 5DE was 0.93 and 0.95 for women and men, respectively. In addition, 82% of the households achieved gender parity, suggesting that for such households, empowerment of men was no greater than that of women. Overall, the results suggest no major differences between the empowerment of women and men. Findings suggest areas of improvement in empowerment: when observed separately, women report lack of agency in production, resource, time-use and allocation and leadership.Originality/valueThis paper adapts the A-WEAI to the fisheries and aquaculture context, in bid to bridge the gap in standard women’s empowerment measurement methods in this area. Also, there are limited empirical studies on the multifaceted empowerment of women in aquaculture in Kenya. The findings are meant to serve as a point of reference for policymakers, as they develop gender-responsive intervention programmes, and in implementing gender mainstreaming in Kenya.

Domains of Empowerment among Nursing students

Nursing has seen the emergence of the term "empowerment" in its lexicon. As the largest healthcare professional group, nurses play a vital role in encouraging patients to take action toward achieving both health and sustained development aspirations. The nursing profession is faced with a range of challenges that necessitate an immediate need to invest in healthcare workers. New nurses with superior qualifications are essential to handle these tribulations. It is imperative that student nurses be endowed with the necessary means and resources in order to meet these difficulties during their professional trajectories. So descriptive study was conducted to spot light on the areas of empowerment among the student nurses during their training period. 146 samples were recruited by purposive sampling technique. Tool has two parts demographic variables and domains of empowerment (Communication, stewardship, access to information and resources, training opportunities, research and clinical competence). Data was collected by Google forms. The results showed that student nurses have the ability to communicate effectively and have access to information and resources; however, they require further development of multilingual skills. Stewardship, training opportunities, research, and clinical competency were found to be areas needing improvement as the mean score for most statements was lower than average.

Intimate partner violence and malnutrition among women of reproductive age in Western Africa: A geostatistical analysis.

Intimate partner violence (IPV) is a public health issue, and the experience varies among population sub-groups in Africa. In the West African sub-region, IPV perpetrated against women remains high and is exacerbated by the pertaining cultural milieu. It affects women's health, wellbeing, and nutritional status. We examined the association between women's lifetime experiences of physical, sexual, and emotional IPV and undernutrition by quantifying the association at smaller geographical settings in West African countries. We used a bivariate probit geostatistical technique to explore the association between IPV and undernutrition, combining data from the latest Demographic and Health Survey conducted in ten Western African countries. Bayesian inference relies on Markov chain Monte Carlo simulation. The findings demonstrate spatial clustering in the likelihood of experiencing IPV and being underweight in the regions of Mali, Sierra Leone, Liberia and neighboring Cote d'Ivoire, Ghana, Togo, Benin, Cameroon, and Nigeria. The pattern of clustering was somewhat similar when physical violence was combined with underweight and emotional violence combined with underweight. The findings also indicate protective effects of education, wealth status, employment status, urban residence, and exposure to mass media. Further, the likelihood of experiencing IPV and the likelihood of being underweight or thin declined with age and age-gap between the woman and her partner. The findings provide insight into the location-specific variations that can aid targeted interventions, and underscore the importance of empowering women holistically, in the domains of education, socio-economic and socio-cultural empowerment, in addressing women's vulnerability to IPV and malnutrition (underweight and thinness). Furthermore, IPV prevention programmes will need to address gender inequality and cultural factors such as male dominance that may heighten women's risk of experiencing IPV.

Adaptation of the sexual and reproductive empowerment scale for adolescents and young adults in Kenya.

Measuring empowerment is critical to understanding the level of control adolescents and young adults (AYA) have over their sexual and reproductive health (SRH) behaviors, and could provide a key window into addressing their unique SRH needs. We adapted the Sexual and Reproductive Empowerment (SRE) scale for AYA for use in an East African context. This multi-method qualitative study sampled 15-23 year-old female adolescents and young adults in Kisumu, Kenya. We conducted in-depth interviews (n = 30) and analyzed transcripts with an inductive, constant comparison approach. Empowerment domains were integrated with Kabeer's (1999) framework in a conceptual model, which we referenced to revise the original and develop new scale items. Items underwent expert review, and were condensed and translated through team-based consensus-building. We evaluated content validity in cognitive interviews (n = 25), during which item phrasing and word choice were revised to generate an adapted SRE scale. Participants (n = 55) had a median age of 18 (range 16-23), and 75% were under 19 years. We categorize three types of adaptations to the SRE scale: new item generation, item revision, and translation/linguistic considerations. We developed nine new items reflecting AYA's experiences and new domains of empowerment that emerged from the data; new domains relate to self-efficacy in accessing sexual and reproductive health care, and how material needs are met. All items were revised and translated to echo concepts and language relevant to participants, navigating the multilingualism common in many African countries. Centering the voices of female Kenyan AYA, this study provides insight into measuring the latent construct of adolescent sexual and reproductive empowerment in an East African setting, and supports the adapted SRE scale's content validity for Kenya. We detail our multi-method, theory-driven approach, contributing to limited methods guidance for measure adaptation across contexts and among diverse adolescent populations.

Maternal empowerment and gender equality for child undernutrition: a multilevel study in Africa

Abstract Backgrounds Women's empowerment is a complex construct that requires a multi-level conceptualization, yet its association with child undernutrition has been restricted to single-level analysis and the existing evidence are mixed. Methods We pooled recent Demographic and Health Surveys from 28 sub-Saharan African countries (N = 137,699 children <5 years old). Undernutrition was defined as stunting, underweight, and wasting. Maternal empowerment at individual-level was assessed using three domains of Survey-based Women's EmPowERment (SWPER) index: attitude to violence, social independence, and decision-making with each domain divided into terciles. As for country-level gender inequality, Gender Inequality Index (GII) was used. Three-level logistic regression was conducted to examine the joint associations of SWPER and GII with child anthropometric failures as well as their interactions, adjusting for sociodemographic covariates. Results Compared to children of mothers with high-level of empowerment, children of mothers with low-level of empowerment had higher odds of stunting for all domains of SWPER (Ranging ORs=1·15 to 1·21). A similar pattern was observed for underweight and wasting. GII also increased the probability of underweight and wasting. Our interaction analyses indicates that for social independence and decision-making domain, the gap in probabilities of stunting between high versus low-level of empowerment was widest in countries with highest GII. Conclusions In countries with stricter gender norms, achieving mother's social independence and decision-making power are found to be the strategies that should be prioritized in the first place to reduce their children's anthropometric failures. Policies and interventions aimed at promoting maternal empowerment should be carefully tailored to the specific national context to effectively address child undernutrition in sub-Saharan Africa. Key messages • Advanced our understandings of the role of maternal empowerment on child undernutrition by discovering that each domain of empowerment differently functions across larger social contexts. • In countries with stricter gender norms, achieving mother's social independence and decision-making power should be prioritized in the first place to improve their children's nutrition.

Resonant Leadership: A Catalyst for Job Empowerment Among Palestine Technical University Kadoorie Employees

The study aimed to identify the role of resonant leadership in promoting job empowerment among the employees of Palestine Technical University Kadoorie, with different variables: educational qualification, gender, staff, and experiences. The researcher designed a questionnaire addressed to employees consisting of 32 items distributed on four domains: resonant leadership (mindfulness, hope, empathy) and (career empowerment). The study used descriptive method. The sample consisted of 73 employees from PTUK, Ramallah branch, who were chosen randomly. The results showed that the employees' responses were moderately on all domains. The results showed that there are no differences in the employees' point of view according to the educational qualification variable in all domains, and there are differences in the employees' opinions according to the gender variable in the domains of mindfulness, hope, and job empowerment in favor of male. The existence of differences in the opinions of employees, according to the variable of staff, in the domain of hope, empathy, and job empowerment in favour of academic employees. There are differences in the opinions of employees according to their experiences in the domains of (mindfulness and hope (in favour of employees with mindfulness (less than 5 years). The results also showed that there is a statistically significant positive correlation between resonant leadership and job empowerment. The study suggests that senior leaders and employees at PTUK should prioritize the use of resonant leadership to achieve job empowerment. It suggests ways to implement this approach among senior leaders and employees, which can benefit organizations seeking to enhance employee empowerment through effective leadership practices.

Women empowerment domains and unmet need for contraception among married and cohabiting fecund women in Sub-Saharan Africa: A multilevel analysis based on gender role framework.

Low women empowerment, is a known contributing factor to unmet needs for contraception by limiting access to health services through negative cultural beliefs and practices. However, little is known about the association between unmet needs and domains of women empowerment in Sub-Saharan African (SSA) countries. Hence, this study aimed at assessing the influence of women empowerment domains on the unmet need for contraception in the region using the most recent Demographic and Health Survey (DHS) data (2016-2021). The data for the study was derived from the appended women's (IR) file of eighteen SSA countries. A weighted sample of 128,939 married women was analyzed by STATA version 16. The Harvard Institute's Gender Roles Framework, which comprised of influencer, resource, and decision-making domains was employed to identify and categorize the covariates across three levels. The effects of each predictor on the unmet need for spacing and limiting were examined using a multivariable multilevel mixed-effect multinomial logistic regression analysis. Adjusted relative risk ratio (aRRR) with its corresponding 95% confidence interval was used to declare the statistical significance of the independent variables. The pooled prevalence of unmet needs for contraception was 26.36% (95% CI: 24.83-30.40) in the region, with unmet needs for spacing and limiting being 16.74% (95% CI: 16.55, 17.02) and 9.62% (95% CI: 9.45, 12.78), respectively. Among variables in the influencer domain, educational level, family size of more than five, parity, number of children, attitude towards wife beating, and media exposure were substantially linked with an unmet need for spacing and limiting. Being in the poorest wealth quintile and enrollment in health insurance schemes, on the other hand, were the two variables in the resource domain that had a significant influence on unmet needs. The overall decision-making capacity of women was found to be the sole significant predictor of unmet needs among the covariates in the decision-making domain. Unmet needs for contraception in SSA countries were found to be high. Reproductive health program planners and contraceptive service providers should place due emphasis on women who lack formal education, are from low-income families, and have large family sizes. Governments should collaborate with insurance providers to increase health insurance coverage alongside incorporating family planning within the service package to minimize out-of-pocket costs. NGOs, government bodies, and program planners should collaborate across sectors to pool resources, advocate for policies, share best practices, and coordinate initiatives to maximize the capacity of women's decision-making autonomy.

Women Empowerment through Cooperative: A Case Study of Ichangu Mahila Jagriti Multipurpose Cooperative Limited

Women empowerment involves participation of women in political structures and formal decision-making and economic decision-making which is achieved through education, raising awareness, literacy, and training. Co-operatives in general and specifically women-led co-operatives, have played an important role in women empowerment. This study aims to identify the contribution of Ichangu Mahila Jagriti Multipurpose Co-operative Limited (IMJCL) located in Nagarjun municipality Kathmandu on economic, socio-cultural and political aspects of women empowerment who became its member. The study was conducted in Nagarjun municipality Kathmandu among the 124 women inheritors with 10 years of experiences and cooperative activities were randomly selected using lottery method for data collection. Primary data was collected via structured questionnaire, focus group discussion and key informant interviews. For the data analysis paired sample t-test was applied in three different domains of empowerment: economic, socio-cultural and political dimensions. The finding showed there was positive impact on women empowerment with significant difference in socio-cultural, economic and political empowerment of its member. The study shows there were significant changes after involvement in different programmes of IMJCL. Finally, its finding focusses on the crucial role of cooperative in the overall empowerment of women. Extension of cooperative organizations is indispensable for the nation.

Women's empowerment and child nutrition in a context of shifting livelihoods in Eastern Oromia, Ethiopia.

Agriculture, and particularly livestock and animal source foods, has been closely linked to improvements in human nutrition. Production, income, and women's empowerment improve household food security and child nutritional outcomes in interacting ways. Khat production in Eastern Ethiopia is changing the economic and livelihood landscape for communities that have traditionally relied upon small-scale mixed agriculture and livestock production. How this shifting livelihood landscape and the empowerment of women in these communities are affecting nutritional outcomes has not been investigated. Using cross-sectional data collected during formative research for the Campylobacter Genomics and Environmental Enteric Dysfunction (CAGED) project, we developed models to examine the roles of livelihood activities, including livestock production, staple crop production, and khat production, and women's empowerment in child nutrition outcomes. Survey participants were randomly selected mothers of children aged 10-15 months from Haramaya district, Eastern Hararghe, Oromia, Ethiopia. Nested logistic regression models were performed for each nutrition outcome: children's animal source food consumption, children's dietary diversity, and child stunting, wasting, and underweight. Explanatory variables included those for livelihood (tropical livestock unit, crop production, and khat production ladder) and women's empowerment (as indicated by domains of the Women's Empowerment in Agriculture Index), and covariates including child sex, mother's age, mother's education, assets, income, and kebele. Results indicated that khat production and tropical livestock units were not significantly associated with any of the child nutrition outcomes. However, results did indicate that the odds of reporting child animal source food consumption in households where the mother was empowered in the leadership domain was 3.33 times that in households where the mother wasn't (p < 0.05). In addition, the odds of having a stunted child in households where the mother was empowered in the time domain was 2.68 times that in households where the mother wasn't (p < 0.05). The results from this study both support and complicate the existing literature on the associations between women's empowerment in agriculture and child nutrition outcomes, underscoring the important role that livelihood, contextual factors, and location may have on the complex relationship between empowerment domains and nutritional outcomes.

Women's Empowerment: Evidence from the Corn-Tortilla Value Chain in the Central Valley’s Region and the Isthmus of Tehuantepec, Oaxaca, Mexico.

This article explores the level of Women’s Empowerment (W’E) from six empowerment domains: decision-making, autonomy, access and control of resources, community participation, and participation in business management, within the context of the corn-tortilla value chain. A semi-structured questionnaire was used to collect data through the survey method and participant observation. The sample consisted of 136 women producers from two municipalities, 67 from Santa María Xadani in the Isthmus of Tehuantepec and 69 from San Antonio de la Cal in the Central Valleys of Oaxaca, Mexico. The results highlight that women exercise five of the six explored domains of empowerment, two with high levels and three with medium levels of empowerment. The women’s income from selling their corn tortillas is used to buy food, raw materials, and health services. Much of their time is spent on corn tortilla production and marketing, and household activities. Finally, this study makes implications for public policy to contribute with the generation of strategies that raise the levels of W’E in agrifood systems in rural contexts. JEL Codes: I31, J16, P42, Q01, R11 Received: 13/01/2023. Accepted: 24/05/2023. Published: 26/06/2023.

A study of rice farming community in Aceh Besar

Women have a great contribution and potential in supporting agricultural and rural development through their active role in the production and household economic activities. This study aims to understand the level of empowerment of women farmers in the lowland rice community in Kecamatan Lhong, Kabupaten Aceh Besar. This study uses a WEAI approach that focuses on five domains of empowerment. A total of 30 respondents have been surveyed using questionnaires and direct interviews. The results show that the capacity to build and empower women in farming production activities is moderate with the lowest sub-domain being the allocation of productive time.

The individual empowerment Index (IEI): A new approach for empowerment measures

Over the last three decades, many research works have been conducted to define and measure the complex and composite concept of empowerment. However, an individual empowerment tool is still needed, to be applied for any disadvantaged group, women, youths (male or female), poor, etc., or any economic sector, and which can be more suitable for rigorous impact assessment studies. This paper contributes to the growing empowerment literature by providing a new multi-domain, survey-based empowerment measurement tool, the individual empowerment index (IEI). The IEI is unique in its characterization and construction. It combines individual empowerment scores in six empowerment domains: production, household livelihood, resources, income, leadership, and time allocation. It is a flexible and survey-based empowerment parameter that can be generated at individual, household community or country levels, or for any target social category. The IEI is constructed through a specific methodology based on a scale survey with an ordinal variable principle and a general process for construction of domain indicators. A key advantage of the IEI is that different household members (even husband and wife) can have different IEIs and statuses. Findings from applying the IEI approach to data collected from 1120 West-African lowland rice farmers show that lowland rice farmers globally achieved on average 71% of their full empowerment potential with only 40% of them found to be globally empowered. Female farmers were found to have lower control over their lives and were less than male farmers to be empowered. IEI estimates and comparison between WIEI and other women empowerment indexes estimates show reasonable correspondence despite the difference in the methodology and can hold for the validity of the IEI. The new IEI is a suitable tool and is recommended for quantitative and rigorous impact assessment and monitoring of programs and projects empowerment indicators.

Assessing Rural Community Empowerment through Community Internet Centre: Using Asset Mapping and Surveys Method

This paper assesses community empowerment through Community Internet Centre. Community empowerment is a process of the outcome made by the community to take action and change or improve the community's quality of life. Hence, adopting Information and Communication Technology would bridge the digital divide in rural areas. The digital divide affected rural community development through numerous barriers that widened the gap between urban and rural communities, consequently generating an imbalance in community development. The community internet center can bridge the digital divide among urban and rural communities. Asset mapping and surveys have been measured to assess rural community empowerment dimensions through distributed questionnaires to eight Community Internet Centres in rural areas of Kelantan. The findings indicate that the Internet Centre is a medium to encourage community empowerment. The Internet Centre bridges the digital divide among communities by providing Information and Communications Technology community building in rural areas. Hence, the center drives community empowerment and improves the quality of life in rural communities. Thus, Community Internet Centre prepared an appropriate platform for empowering the rural community. This is evidence based on the outcome of findings which resulted in three domains of community empowerment: (1) community participation, (2) ownership, and (3) information services. Nevertheless, community participation determined the outcomes of the roles played by the center to empower a community. Further study needs to be conducted in other groups of samples and gaining other perspectives from managerial of the internet center to get different views of the internet center program.

Gender inequality, women's empowerment, and adolescent birth rates in 363 Latin American cities

BackgroundGender inequality is high in Latin America (LA). Empowering girls and young women and reducing gender gaps has been proposed as a pathway to reduce adolescent pregnancy. We investigated the associations of urban measures of women's empowerment and gender inequality with adolescent birth rates (ABR) in 366 Latin American cities in nine countries. MethodsWe created a gender inequality index (GII) and three Women Achievement scores reflecting domains of women's empowerment (employment, education, and health care access) using censuses, surveys, and political participation data at city and sub-city levels. We used 3-level negative binomial models (sub-city-city-countries) to assess the association between the GII and scores, with ABR while accounting for other city and sub-city characteristics. ResultsWe found within country heterogeneity in gender inequality and women's empowerment measures. The ABR was 4% higher for each 1 standard deviation (1-SD) higher GII (RR 1.04; 95%CI 1.01,1.06), 8% lower for each SD higher autonomy score (RR 0.92; 95%CI 0.86, 0.99), and 12% lower for each SD health care access score (RR 0.88; 95%CI 0.82,0.95) after adjustment for city level population size, population growth, homicide rates, and sub-city population educational attainment and living conditions scores. ConclusionOur findings show the key role cities have in reducing ABR through the implementation of strategies that foster women's socioeconomic progress such as education, employment, and health care access.

Exploring the Role of Community Empowerment in Urban Poverty Eradication in Kuala Lumpur, Malaysia

The main purpose of this study was to holistically understand the role of empowerment in urban poverty eradication of the Indian community in the urban areas of the Klang Valley, Malaysia. The poverty eradication effectiveness was tested by analysing community empowerment domains and MyKasih programme run by a non-governmental organisation. There are numerous studies conducted to understand the issues of poverty in Malaysia. However, few studies have so far focused on the minority community in Malaysia. Moreover, there is no recent study to test the effectiveness of any governmental or NGO’s poverty eradication efforts on this minority community. This study utilised a qualitative approach and an in-depth interview was used to gather the data. The respondents were single mothers living in a poverty-stricken area in the capital city of Malaysia.

How women's empowerment influences fertility-related outcomes and contraceptive practices: A cross-sectional study in Mozambique.

Women's empowerment could be a crucial step for tackling gender inequality and improve women's reproductive health and rights in Mozambique. This study aims to examine how different domains of women's empowerment influence fertility-related outcomes and contraceptive practices in Mozambique. We used the 2015 Demographic Health Survey (DHS) conducted in Mozambique from which a sample of 2072 women aged 15 to 49 years were selected and included in this analysis. A principal component analysis was performed, and the components retained were identified as the domains of empowerment. These were: Beliefs about violence against women, Decision-making, and Control over sexuality and safe sex. A multinomial logistic regression was run to estimate the association between levels of empowerment for each domain and the study outcomes. Crude and adjusted odds ratio (OR) were calculated, with 95% confidence intervals (95% CI). Beliefs about violence against women and Control over sexuality and safe sex were positively associated with having 1 to 4 children. Control over sexuality and safe sex also increased likelihood of women wanting to space childbearing over more than 2 years. Decision-making increased the odds of women not wanting more children. Middle to high empowerment levels for Control over sexuality and safe sex also increased the chances of using any type of contraceptive method and using it for longer periods. All domains, from the middle to high levels of empowerment, decreased the chances of women not wanting to use contraception. Our study confirmed the multidimensional nature of empowerment showing that each domain had a different effect over specific fertility and contraceptive outcomes and reinforced the importance of a domain approach for estimating and understanding empowerment. It also revealed the critical role of Control over sexuality and safe sex domain for improving women's ability to decide over fertility and contraceptive practices in Mozambique.

Giving voice to informal caregivers of community-dwelling older adults: A systematic review of empowerment interventions.

Taking care for older adults can place informal caregivers at risk for developing health problems. Therefore, interventions aiming to empower informal caregivers have been developed. Empowerment refers to a health promotion process including strategies to improve informal caregivers' self-care behaviours, stress-management and caregiving skills. In literature, empowerment-oriented interventions often target subsamples of informal caregivers defined through the care receiver's condition. These interventions, however, do not adequately capture the complexity of care needs and might even exclude informal caregivers taking care for older people without a specific diagnosis or with a subthreshold condition. Therefore, the aim of this systematic review is to provide an overview of the content and effectiveness of empowerment-oriented interventions directed at informal caregivers of community-dwelling older adults. Following the PRISMA guidelines, a systematic review was performed by searching the following databases: PubMed, PsycINFO, EMBASE and Web of Science. From a total of 6798 unique publications, 13 intervention studies, of which seven randomised controlled trials, were eligible for inclusion. According to the Mixed Methods Appraisal Tool, eight studies scored poor. The intervention studies under review represented different domains of empowerment, with cultivation of positive feelings being the most prevalent one. Social participation and physical health received little attention in interventions. Although no adverse intervention effects were observed, the studies reported mixed results with 57 positive and 47 neutral effects. The limited number and poor quality of studies emphasise the need for future research investigating the effectiveness of empowerment-oriented interventions targeting informal caregivers of older adults.

Women's empowerment and the will to change: Evidence from Nepal

A static and apolitical framing of women's empowerment has dominated the development sector. In contrast, we assess the pertinence of considering a new variable, the will to change, to reintroduce dynamic and political processes into the way empowerment is framed and measured. This article uses a household survey based on the Women's Empowerment in Agriculture Index (WEAI) and qualitative data collected in Nepal to analyze how critical consciousness influences women's will to change the status quo and the role of visible agency, social structures, and individual determinants in those processes. A circular process emerges: women with higher visible agency and higher critical consciousness are more willing to gain agency in some, but not all, of the WEAI empowerment domains. This analysis advances current conceptualizations of empowerment processes: the will to change offers valuable insights into the dynamic, relational and political nature of women's empowerment. These findings support the design of development programs aiming at increasing visible agency and raising gender critical consciousness and argue for improving the internal validity of women's empowerment measurement tools.

Thematic Analysis and Mapping of Reproductive Empowerment Scales: A Tool for Family Planning Self-Care Programming and Research.

<h3>Key Messages</h3> There is an evidence gap in the relationship between self-care and reproductive empowerment; understanding this relationship using validated scales is necessary to improve the design, implementation, and scale-up of family planning self-care interventions. We summarize 5 validated scales that measure reproductive empowerment-related concepts and offer a thematic analysis to help family planning programmers and researchers assess which scales best fit their needs for family planning self-care programming. Communication, decision making, and partner influence are the most measured domains among the scales we examined; however, measures of other reproductive empowerment domains are available and may be of interest to programs depending on their context and focus.

Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis

Historically, water and sanitation programs have focused on women’s instrumental value in improving conditions and behaviors. No reviews have synthesized evidence on water and sanitation and women’s and girls’ empowerment. This review a) identified empirical water and sanitation research that engaged empowerment and/or empowerment-related domains; b) reported empowerment-related terminology used, research locations, methods leveraged, if water and/or sanitation was the focus; and c) synthesized evidence. A conceptual model of women’s and girls’ empowerment, which includes three interrelated domains (agency, resources, institutional structures), informed the search and analysis. We searched MEDLINE, EMBASE, CABI Global Health, PsycINFO, CINAHL and AGRICOLA for peer-reviewed sources presenting research on water and/or sanitation and either empowerment and/or related terms from the model (4 May 2020). We identified 12,616 publications; 257 were included, representing over 1,600,000 participants. We used the Mixed-Methods Appraisal Tool (MMAT) and followed the ‘best-fit framework synthesis’ analysis approach, using the model domains and sub-domains as codes. We inductively identified two additional sub-domains relevant to water and sanitation: privacy and freedom of movement. Thematic analysis guided synthesis of coded text. The majority of research took place in Asia (46%; 117) or Africa (40%; 102), engaged adults (69%; 177), and was published since 2010; (82%; 211). The greatest proportion of studies focused on water (45%; 115). Over half of studies used the term empowerment, yet only 7% (17) provided a clear definition or conceptualization. Agency was the least commonly engaged domain (47%; 122); the Resources domain was dominant (94%; 241). Measures for assessing empowerment are limited. Inclusion of only peer-reviewed sources in English is a main limitation. Well-conceptualized water and sanitation research that engages women’s and girls’ empowerment is limited. A more comprehensive ‘transformative WASH’ that includes gender-transformative approaches to challenge and reduce systemic constraints on women’s and girls’ resources and agency is long overdue.