Participation In Household Decision Research Articles

Women’s involvement in decision-making and association with reproductive health behaviors: findings from a cross-sectional survey in Niger

BackgroundThough women in Niger are largely responsible for the familial health and caretaking, prior research shows limited female autonomy in healthcare decisions. This study extends current understanding of women’s participation in decision-making and its influence on reproductive health behaviors.MethodsCross-sectional survey with married women (15–49 years, N = 2,672) in Maradi and Zinder Niger assessed women’s participation in household decision-making in health and non-health issues. Analyses examined [1] if participation in household decision-making was associated with modern contraceptive use, antenatal care (ANC) attendance, and skilled birth attendance at last delivery and [2] what individual, interpersonal, and community-level factors were associated with women’s participation in decision-making.ResultsOnly 16% of the respondents were involved—either autonomously or jointly with their spouse—in all three types of household decisions: (1) large purchase, (2) visiting family/parents, and (3) decisions about own healthcare. Involvement in decision making was significantly associated with increased odds of current modern contraceptive use [aOR:1.36 (95% CI: 1.06–1.75)] and four or more ANC visits during their recent pregnancy [aOR:1.34 (95% CI: 1.00-1.79)], when adjusting for socio-demographic characteristics. There was no significant association between involvement in decision-making and skilled birth attendance at recent delivery. Odds of involvement in decision-making was significantly associated with increasing age and household wealth status, listening to radio, and involvement in decision-making about their own marriage.ConclusionWomen’s engagement in decision-making positively influences their reproductive health. Social and behavior change strategies to shift social norms and increase opportunities for women’s involvement in household decision making are needed. For example, radio programs can be used to inform specific target groups on how women’s decision-making can positively influence reproductive health while also providing specific actions to achieve change. Opportunities exist to enhance women’s voice either before women enter marital partnerships or after (for instance, using health and social programming).

Association between women’s empowerment and contraceptive failure in Indonesia: 2017 IDHS data analysis

Background: Contraceptive failure has negative consequences, including unwanted pregnancies and abortions, which can cause maternal morbidity and mortality. Contraceptive failure is influenced by individual factors such as the user and the quality of the contraceptive method/device. One of the individual factors is the cultural factor which can be seen from the empowerment of women in improving the quality of health, including the use of contraception. There is no study which has discussed women’s empowerment as the determination of contraceptive failure. Purpose: Therefore, this study aims to analyze the association of women’s empowerment in contraception failure in Indonesia. Methods: The data source used is the results of the 2017 IDHS (Indonesia’s Demographic and Health Survey) with the unit of analysis from the period of using contraceptives to women who get pregnant while using contraceptives. The dependent variable is the duration of contraceptive usage. The main independent variable is women’s empowerment as measured by four indicators, namely asset ownership in the name of the wife, ability of decision-making in the household, ability to earn cash by working, and attending at least junior high school. Data were analyzed using the survival analysis method. Results: The results of the analysis show that the four factors of women’s empowerment have a significant negative association with contraceptive failure after controlling for socioeconomic, demographic, and environmental factors. Conclusion: Variables that are positively associated with contraceptive failure are participation in household decisions, education, residence status, and internet usage. Variables that are negatively associated with contraceptive failure are asset ownership, working status, and number of children.

The Transformative Role of Information and Communication Technologies in Shaping Gender Norms and Empowering Women: Evidence From Pakistan and Nepal.

This study explores how information and communication technologies (ICTs) influence transforming attitudes toward intimate partner violence (IPV) and women's empowerment in Pakistan and Nepal. By analyzing data from married women using recent Demographic and Health Surveys, the research reveals that owning multiple ICTs is associated with decreased experiences of physical IPV and reduced acceptance of wife-beating. Notably, increased ownership of ICTs corresponds to heightened participation in household decisions. Furthermore, regular internet use further diminishes the likelihood of experiencing physical IPV and justifying wife-beating. These findings underscore ICTs' potential to empower women, reshape gender norms, and enhance decision-making autonomy. The study advocates for gender-inclusive policy interventions that leverage the transformative influence of ICTs in fostering positive sociocultural changes.

Intimate partner violence among women in Togo: a generalised structural equation modeling approach

ObjectiveThis study aimed to assess the magnitude and identify associated factors with intimate partner violence (IPV) in Togo.DesignCross-sectional study.SettingTogo.ParticipantsWomen of reproductive age (15–49 years).Primary outcomeIntimate partner violence.MethodsThis study used data...

Empower HER Health: A Comparative Study on Women's Empowerment and Gender-Based Violence in Karnataka and India Using NFHS 4 And 5

Introduction: Women's empowerment is crucial for gender equality. This study, utilizing NFHS 4 and 5 data, assesses GBV and women's empowerment, including health indicators in Karnataka and India, aiming to evaluate achievements and challenges impacting women's lives for gender equality. Materials and Methods: This study retrospectively analyzed NFHS 4 (2015–16) and NFHS 5 (2019–21) data for India and Karnataka, covering health, Gender-based Violence, education, economic and social-political empowerment. Data analysis used MS Excel 365 and Datawrapper tools. Results: Karnataka's female population increased by 7% (NFHS4 to NFHS5), surpassing India's 1%. Health indicators improved, including menstrual hygiene, family planning, prenatal and postnatal care, and reduced early marriages. Educational attainment, economic involvement, mobile phone ownership, and women's participation in household decisions increased. However, Karnataka saw a notable rise in GBV cases among young women, with spousal violence at 44.4% and sexual violence at 11% (NFHS5). Conclusion: This study depicts the evolution of women's empowerment and gender-based violence in Karnataka, India. Results show improvements in health, education, economic involvement, and specific empowerment indicators. However, the documented rise in GBV cases in Karnataka highlights the need for targeted interventions. Karnataka's experience can be a blueprint for achieving gender equality and women's empowerment in India.

Homemakers’ Participation in Household Decision Making

Purpose: This study is conducted to identify homemakers’ participation in household decision making who are the member of community-based organization.
 Methods: The study was conducted in ward no. 30 of Pokhara Metropolitan City, where the ward represents the smallest unit of local government. The study interviewed homemaker women who were participating in Community-based Organization. The primary data were collected from purposively sampled 120 homemaker women using structured closed ended questionnaires schedule. The collected data are processed and analysed in SPSS software where the test of association (The Chi square test) was performed to find the relationship among the variables of household decision making, together with social-economic and demographic variables.
 Findings: The findings show that homemakers included in study have actively participating in household decision making. The Chi square test result indicates that there is no association between age and number of children with level of homemakers’ participation in household decision making. Also, other demographic variables such as marital status, caste or ethnicity, education, and family type have no significance association with household decision making.
 Conclusion: From this study we can say that the participation level of the women in household decision making who are the member of community-based organization is high. The participation of women in community-based organization like women’s group, saving and cooperatives, community committees empower the women and support to build confident in household decision making.
 Keywords: Homemaker, Participation, Decision Making, Women, Community Based Organisation.
 Paper type: Research Paper

Women's decision-making power and the adoption of liquefied petroleum gas for cooking in Cameroon

The low-level of women's decision-making power could be the determining cause of the minimal adoption of clean cooking fuel in Africa, needing deep exploration. This study surveys the gendered nature of household adoption of liquefied petroleum gas for cooking in Cameroon. Specifically, it assesses the effect of women's decision-making power in the household on LPG adoption. Using data from the 2018 Cameroon Demographic and Health Survey, we estimated several standard and recursive bivariate probit models. We accounted for the endogeneity of women's autonomy in the LPG adoption model by using women's control over land as an instrument. Our results show that women's participation in household decisions increases the household probability of adopting LPG for cooking. In addition, women's land rights increase women's final say on large household purchases. Therefore, policies enhancing land rights equity have the potential to increase women's decision-making power, therefore increasing adoption of LPG.

Grow the pie, or have it? Using machine learning to impact heterogeneity in the Ultra-poor graduation model

ABSTRACT The ‘Ultra-poor Graduation’ model, though highly effective in poverty alleviation, costs substantially more than alternative poverty alleviation approaches. One possible way of improving the cost-effectiveness of the model is to analyse the treatment effect heterogeneity and identify the participants who do not gain much from the programme and better customise the interventions to their needs. Applying recently developed machine learning methods on a large-scale RCT dataset from Bangladesh, we identify and characterise the program participants who benefit and who do not. We find significant variation in impact on assets where the top quintile gainers experience asset growth of 337% while asset growth is only 189% for the bottom quintile. Heterogeneity in impact on household expenditures is found to be present but of lower magnitude than that of assets. Importantly, the machine learning techniques we apply reveal contrasts in characteristics of beneficiaries who made the most in assets vs. consumption. The most benefitted households in per-capita wealth outcome were relatively older, were more dependent on wage income, had less involvement in self-employment activities, and had lower participation in household decision-making at baseline. In contrast, the top quintile gainers of household expenditure are younger, earn less from wages, depend more on self-employment income, and have higher participation in household decision-making. The results identify beneficiary characteristics that can be used in targeting households either to maximise impact on the desired dimension and/or to customise interventions for balancing the asset and consumption trade-off.

The role of social accountability in changing service users’ values, attitudes, and interactions with the health services: a pre-post study

This study evaluated the effects of community engagement through social accountability on service users’ values, attitudes and interactions. We conducted a pre–post study of the community and provider driven social accountability intervention (CaPSAI) over a 12-month period among 1,500 service users in 8 health facilites in Ghana and in Tanzania (n = 3,000).In both countries, there were significant improvements in women’s participation in household decision-making and in how service users’ perceive their treatment by health workers. In both settings, however, there was a decline in women’s knowledge of rights, perception of service quality, awareness of accountability mechanisms and collective efficacy in the community. Though CaPSAI intervention set out to change the values, attitudes, and interactions between community members and those providing contraceptive services, there were changes in different directions that require closer examination.

A Critical Review on Gender Based Violence in Nigeria: Media Dimension

During the Covid-19 pandemic, women and girls around the world have been subjected to sexual and physical violence, which has never happened before. Women are killed in the name of honor in Asia and the Middle East, while girls in West Africa are subjected to genital mutilation in the name of tradition. Because the perpetrators believe that sex with virgins will cure them of their disease, young girls in Southern Africa are raped and infected with HIV/AIDS. According to the findings, the majority of Nigerian women have been victims of gender-based violence, such as incest, rape, physical abuse, verbal abuse, denial of food, forced marriage, and early child marriage. The findings of the study also revealed that age, employment, educational attainment, witnessing a mother being beaten as a child, family type, duration of union, participation in household decision-making, employment status relative to woman, differences in educational qualification between a male partner and woman, attitudes toward wife-beating among men and women, and male right to discipline or control females are all factors that contribute to gender-based violence. Sexually transmitted diseases, unwanted pregnancies, unsafe abortions, physical injuries, immediate psychological reactions such as shock, shame, guilt, and anger; and long-term psychological outcomes such as depression, post-traumatic stress disorder, suicidal ideation, lack of sexual pleasure, and fears are all health consequences of gender-based violence. The study concludes that gender-based violence has a negative impact not only on women and their reproductive health but also on Nigeria's economy and progress.

Magnitude and determinants of women's participation in household decision making among married women in Ethiopia, 2022: Based on Ethiopian demographic and health survey data

IntroductionWomen's strong decision-making abilities are essential to reducing maternal mortality rates. Because women's involvement in decision-making would increase uptake for healthcare services like maternal healthcare, which includes prenatal care (ANC), postnatal care (PNC), and facility delivery. Studies have revealed that women's decision-making autonomy is low, particularly in underdeveloped nations like Ethiopia. Investigating potential factors that may influence women's participation in household decision-making is the primary goal of this study project. MethodsSecondary data analysis was carried out using data from the 2016 Ethiopian Demographic and Health Survey (EDHS). For the final analysis we used a weighted sample of 10,223 currently married women. All the frequencies and the percentages in the result section are weighted. The model's fitness was assessed using the Hosmer-Lemeshow test. It is the best fit (p value = 0.19). Variables with p values ≤ 0.2 in the bi-variable binary logistic regression analysis were included in the multivariable binary logistic regression analysis. The Adjusted Odds Ratio (AOR) with 95% confidence interval (95% CI) was computed. Variables with a P-value of less than 0.05 in the multi variable binary logistic regression analysis were declared as statistically significant predictors of the outcome variable. ResultThe overall magnitude of women's participation in decision making among was 70.55% (CI: 69.65, 71.42). Residence (rural; AOR: 0.83, 95% CI: 0.70, 0.980), educational status (None educated; AOR: 0.43, 95% CI: 0.30, 0.62, primary education AOR: 0.49, 95% CI: 0.34, 0.69), religion (protestant AOR: 0.72, 95% CI: 0.64, 0.81), Muslim; AOR: 0.87, 95% CI: 0.78, 0.96, Others; AOR: 0.66, 95% CI: 0.50, 0.87), wealth index (poor; AOR: 0.70, 95% CI: 0.63, 0.79, middle; AOR: 0.75, 95% CI: 0.66, 0.85), working status (Not working; AOR: 0.73, 95% CI: 0.66, 0.80), husband working status (husband not working; AOR:1.69, 95% CI: 1.43, 2.0) and sex of household head (female heads; AOR: 1.29, 95% CI: 1.08, 1.54) were statistically significant factors. ConclusionGenerally women's participation in household decision making in our study was high (70.55%). It is highly affected by socio demographic and economic characteristics of women and husbands characteristics. This study indicates that educating women, improving their economic status through employment opportunities, empowering women to be head of household will enhance their participation on household decision making.

Does the Absence of Men from the Household Increase Girls’ Shares in EducationExpenditures? Evidence from Rural Pakistan

This article investigates the impact of men’s migration on expenditure by left-behind households on children’s education, focusing on the gendered distribution of this expenditure. Using longitudinal survey data of rural households in Pakistan, the effect of men’s migration on the share of households’ education expenditure spent on girls is estimated using the fixed-effects model (FEM). Results suggest that in households from which men migrate for periods longer than six months, the share of education expenditures spent on girls is up to 31 percent higher than that of the average household in the sample. There is no evidence of a significant impact on households’ total education expenditure due to this migration. Overall, in households where men are absent, the distribution of education expenditure tilts in favor of girls. A possible mechanism behind the increase in girls’ shares is the greater participation of women in household decisions in the absence of men. HIGHLIGHTS In Pakistan, rural households from which men have migrated have higher expenditure on girls’ schooling. Men’s outmigration plausibly expands women’s participation in household decisions. Women’s role in expenditure decisions may improve and increase investments in girls’ education. Higher participation of women in household decisions potentially reduces gender inequality.

Women's empowerment, children's nutritional status, and the mediating role of household headship structure: Evidence from sub-Saharan Africa.

We aimed to examine the association between women's empowerment and childhood nutritional status while accounting for the mediating role of household headship structure. Cross-country, cross-sectional quantitative data from the most recent Demographic and Health Surveys (2015-2018) were used. Women's empowerment was measured as a composite index of participation in household decision-making, attitude towards domestic violence, and asset ownership. Childhood nutrition status was measure as anaemia (haemoglobin concentration < 110g/L), stunting (height-for-age z-scorescore <-2) and the co-occurrence of anaemia and stunting. Applying the Lewbel two-stage least squares, women's migration status was used as an instrumental variable. We used data on 25,665 woman-child dyads from eight sub-Saharan African countries: Burundi (2016), Ethiopia (2016), Guinea (2018), Malawi (2016), Mali (2018), Zimbabwe (2015), Uganda (2016), and Tanzania (2015). The women were in their reproductive ages (15-49 years) and children were under 5 years old. The findings showed that an increase in women's empowerment index reduces children's likelihood of being anaemic and having a co-occurrence of anaemia and stunting [coeff (SE), -0.114 (0.025) and -0.072 (0.032), respectively]. Specifically, an increase in asset ownership or decision-making dimensions of empowerment significantly reduces the likelihood of anaemia and the co-occurrence of anaemia and stunting among children. Children of empowered women from male-headed households were more likely to be anaemic and be concurrently anaemic and stunted compared to their counterparts whose mothers were from female-headed households. Interventions designed to improve childhood nutrition through women's empowerment approaches need to consider asset ownership and instrumental agency of women while acknowledging the mediating effect of household headship typology.

Women’s empowerment and current contraceptive use among married women in Punjab

Background: It is well-known fact that less empowered married women have less uptake of contraception. Indicators of women’s empowerment and demographic characteristics have strong influence on current use of contraceptive methods. The core objective of this paper is to assess the relationship between the indicators of women’s empowerment (women’s participation in household decision making, ownership of assets and control over her income) and current contraceptive use. Methods and Materials: In the PDHS2017-18, 10825 married women of reproductive age (15-49 years) were covered in the province of Punjab, Province. Association between indicators of women’s empowerment and current contraceptive use are showed by using descriptive analysis, Cross-tabulation and Chi-Square test. Multi-variate binary logistic regression is performed to assess the net effect of indicators of women’s empowerment and background characteristics on the current use of contraceptive methods. Results: Results show that women’s empowerment is a recognized tool to improve the current use of contraceptive. It is also observed that women who have not participation in household decision making, women who have not ownership of any assets and women who have not control over own income have less use of any contraceptive methods. 

Women's Employment and Intimate Partner Violence: Understanding the Role of Individual and Community Structural Drivers in Low- and Middle-Income Countries.

Empirical findings on the relationship between women's employment and intimate partner violence (IPV) in low- and middle-income countries (LMICs) are mixed. These varied findings may arise because research thus far has given insufficient attention to how individual attributes and community context shape the pathways between women's employment and IPV. Using publicly available Demographic and Health Survey (DHS) data from 20 LMIC settings (n = 168,995), we investigate (1) how women's employment is associated with past-year IPV and (2) if associations differ by household- or community-level structural drivers of IPV: women's attitudes toward IPV, women's participation in household decision-making, and relative wealth. We fit mixed-effects logistic regression models exploring the total, individual, community, and contextual effects of women's employment on past-year IPV; effect measure modification by structural drivers; and cross-level interactions between community-level structural drivers and individual employment. Our analyses reveal positive associations between total (odds ratio [OR] = 1.31; 95% CI [1.27, 1.35]), individual (OR = 1.23; 95% CI [1.19, 1.27]), community (OR = 1.06; 95% CI [1.06, 1.07]), and contextual effects (OR = 1.04; 95% CI [1.03, 1.05]) of women's employment for IPV. Only individual wealth demonstrated statistically significant effect measure modification for the relationship between individual employment and past-year IPV (ratio of OR = 0.95; 95% CI [0.92, 0.99]). These findings suggest interventions that focus only on increasing women's employment may be associated with harmful increases in the occurrence of IPV, even when these interventions enable a large proportion of women in a community to be employed. Structural interventions that change norms of women's autonomy or attitudes toward IPV at the household or community levels may be insufficient to ameliorate these negative effects, whereas interventions that increase household wealth partly may buffer these effects.

Child Labor under Cash and In-Kind Transfers

Abstract This paper studies the effects of cash versus in-kind transfers on the time allocation of children exploiting the randomized rollout of a program which transferred either cash or a basket of food to poor households in Mexico. Children in cash-recipient households experience a significantly larger decrease in paid employment and hours of work, and an increase in schooling, as compared to children in in-kind-recipient households. Both transfers are given to a female member of the household to enhance women’s participation in household decision-making. The difference between the cash and in-kind impacts on child time allocation is entirely driven by households presenting characteristics associated with lower female decision-making power. Thus, differences in child employment responses across transfer modalities are likely related to women-targeted transfers having larger effects on female empowerment when provided in cash.

The Relationship between Maternal Participation in Household Decision-Making and Birth Attendant Selection: Evidence from Indonesia Demographic and Health Survey

BACKGROUND: The decreasing maternal mortality rate (MMR) is an important indicator in achieving health development. The Ministry of Health has mandated delivery assistance by competent health personnel to achieve the MMR targets set out in the UN sustainable development goals. AIM: This study aims to determine the relationship between maternal participation in household decision-making and the selection of birth attendant in Indonesia. METHODS: The study uses secondary data from the 2017 Indonesia demographic and health survey, as part of a cross-sectional and large-scale national survey. The study involved ever-married women of reproductive age (15–49 years) and had given birth in the last 5 years prior to the survey (n = 14,193). RESULTS: Of all birth attendants, 4,630 (32.6%) were non-health workers and 9,563 (67.4%) were health workers. Midwives account for the largest proportion of the health workers (61.8%). Decisions in healthcare, household expenses, visits to family/relatives’ decisions are significantly associated with birth attendant selection. However, husband’s income use decision had no significant relationship with birth attendant selection. The final multivariate model found that grand multipara mothers had a 1.9 times higher risk of choosing non-health birth attendants than primipara mothers (OR = 1.90, 95% CI = 1.60–2.25). CONCLUSION: Findings demonstrated the importance of improving health education for men and women as well as women’s decision-making autonomy. Health workers (especially midwives) should improve knowledge and communication between couples in choosing skilled birth attendants, especially for mothers with grand multiparity.

Measuring Women's Empowerment in Collective Households

Measuring women's empowerment within families is challenging. Social scientists often rely on close-ended survey questions on women's participation in household decisions, domestic abuse, and autonomy to measure women's power and agency. Recent advances in family economics have allowed researchers to identify and estimate structural measures of women's power and resource control based on the collective household model. We provide a brief overview of this literature. We then apply machine learning techniques to answer the following questions: How do such measures compare to women's responses to close-ended survey questions? Which survey questions are most predictive of model-based estimates of women's empowerment?

Women autonomy and demand for maternal health services in Nigeria: Evidence from the Nigeria Demographic and Health Survey.

Improving women autonomy can be vital in determining the uptake of healthcare services, especially in a patriarchal society with gender rights concerns. Using the 2013 Nigeria Demographic and Health Survey and employing Zero Inflated Negative Binomial regression, the effect of household decision-making power with considerations to women autonomy on the demand for maternal health services in Nigeria was examined. The result of the analysis suggests that women autonomy in deciding expenditures on household healthcare services, and autonomy in deciding their income expenditures significantly increases the likelihood of demand for maternal healthcare services. On the other hand, when the husband/partner makes sole decision, as well as joint decision making concerning expenditure on household healthcare services and expenditure of woman's income reduces the likelihood of demand for maternal healthcare services in the country. This reduction was however much more when husband alone takes the decision than when decisions were taken jointly. Other socioeconomic variables like higher maternal education, and household wealth, also increased the demand for maternal healthcare services. We recommend that government should put in place policies that will help increase women's participation in household decision-making through the sensitization and capacity building initiatives such as improved educational quality for women.

“Dear Brother Farmer”: Gender-Responsive Digital Extension in Tunisia during the COVID-19 Pandemic

Providing farmers with essential agricultural information and training in the era of COVID-19 has been a challenge that has prompted a renewed interest in digital extension services. There is a distinct gender gap, however, between men’s and women’s access to, use of, and ability to benefit from information and communication technologies (ICTs). The overall purpose of this research is to examine how digital extension can address gender inequality in rural areas in the context of the COVID-19 crisis by designing and evaluating the gendered impacts of a digital extension intervention delivered to 624 farmers (363 men and 261 women) (which included phone distribution, radio and SMS messages, and sharing of information prompts) in northern Tunisia. In order to assess the effectiveness of gender-responsive digital extension that targets husband and wife pairs, as opposed to only men, we employed logistic regression and descriptive statistics to analyze a sample of 242 farmers (141 women and 141 men). We find that phone ownership facilitated women’s access to their social network, as well as agricultural information and services, ultimately improving their participation in household decision making and agricultural production. We find that gender-responsive digital extension is effective for men and especially women in terms of usefulness, learning, and adoption. We identified education level and cooperative membership as important factors that determine the impact of digital extension services on farmers and demonstrate the positive impact of radio programming. We recommend strengthening phone access for women, targeting information (including through non-written ways) to both husbands and wives, using sharing prompts, and more rigorous extension for knowledge-intensive topics such as conservation agriculture and rural collectives.