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First birth and the trajectory of women's empowerment in Egypt.

ABSTRACT: Women's empowerment is often used to explain changes in reproductive behavior, but no consideration is given to how reproductive events can shape women's empowerment over time. Fertility may cause changes in women's empowerment, or they may be mutually influencing. Research on women's empowerment and fertility relies on cross-sectional data from South Asia, which limits the understanding of the direction of association between women's empowerment and fertility in other global contexts. This study uses two waves of a panel survey from a prominent Middle Eastern country, Egypt, to examine the trajectory of women's empowerment and the relationship between first and subsequent births and empowerment over time.Using longitudinal data from the 2006 and 2012 Egyptian Labor Market Panel Survey, a nationally representative sample of households in Egypt, for 4660 married women 15 to 49 years old, multilevel negative binomial, ordinary least squares, and logistic regression models estimate women's empowerment and consider whether a first and subsequent births are associated with empowerment later in life. Women's empowerment is operationalized through four measures of agency: individual household decision-making, joint household decision-making, mobility, and financial autonomy.A first birth and subsequent births are significantly positively associated with all measures of empowerment except financial autonomy in 2012. Women who have not had a birth make 30% fewer individual household decisions and 14% fewer joint household decisions in 2012 compared to women with a first birth. There is also a positive relationship with mobility, as women with a first birth have more freedom of movement compared to women with no births. Earlier empowerment is also an important predictor of empowerment later in life.Incorporating the influence of life events like first and subsequent births helps account for the possibility that empowerment is dynamic and that life course experiences shape women's empowerment. This and the notion that empowerment builds over time helps portray women's lives more completely, demonstrates the importance of empowerment early in the life course, and addresses issues of temporality in empowerment fertility research.

SUBMITTER: Samari G

PROVIDER: S-EPMC5688501 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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First birth and the trajectory of women's empowerment in Egypt.

Samari Goleen G

BMC pregnancy and childbirth 20171108 Suppl 2

<h4>Background</h4>Women's empowerment is often used to explain changes in reproductive behavior, but no consideration is given to how reproductive events can shape women's empowerment over time. Fertility may cause changes in women's empowerment, or they may be mutually influencing. Research on women's empowerment and fertility relies on cross-sectional data from South Asia, which limits the understanding of the direction of association between women's empowerment and fertility in other global ...[more]

PMID: 29143631

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Project description:In 2006, fertility in Egypt reached a two-decade low of 3 births per woman; however, by 2008, the demographic transition reversed, and fertility has remained higher at 3.5 births per woman. Low educational achievement is linked to high fertility. Education is also important in the process of women's empowerment, suggesting that educational achievement lowers fertility through gains in women's agency. However, no studies test this pathway, and evidence on the relationship between education and fertility in Middle Eastern settings is limited. Using longitudinal data from the 2006 and 2012 Egyptian Labor Market Panel Survey (ELMPS), a nationally representative sample of households in Egypt, for 4336 married women aged 15-49 years, this study estimates several linear and mediation regression models of number of births and considers whether women's empowerment explains the relationship between education and number of births. Women's empowerment is operationalized through three measures of instrumental agency: individual household decision making, joint household decision making, and mobility and one measure of intrinsic agency-gender beliefs and attitudes. Higher educational achievement has significant adjusted associations with lower fertility. However, measures of women's agency have mixed mediation associations for education and fertility. Greater individual household decision making and belief in egalitarian gender norms partially mediate the relationship between education and fertility, while greater joint decision making suppresses the relationship. Contrary to expectation, women who have more instrumental agency through more individual and joint household decisions have higher fertility than those who make fewer household decisions. However, women who demonstrate intrinsic agency through greater egalitarian gender beliefs have lower fertility than those who believe in inequitable gender norms. Empowerment programs should focus on improvements in women's education and changing women's intrinsic agency in Egypt, to lower fertility.

Project description:BackgroundWomen in rural Bangladesh face multiple, inter-related challenges including food insecurity, malnutrition, and low levels of empowerment. We aimed to investigate the pathway towards empowerment experienced by women participating in a three-year nutrition-sensitive homestead food production (HFP) program, which was evaluated through the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized controlled trial.MethodsWe conducted 44 in-depth interviews and 12 focus group discussions with men and women in both intervention and control communities of the FAARM study site in rural, north-eastern Bangladesh. Using a modified grounded theory approach to data collection and analysis, we developed a framework to explain the pathway towards empowerment among HFP program participants.ResultsThe analysis and resulting framework identified seven steps towards empowerment: 1) receiving training and materials; 2) establishing home gardens and rearing poultry; 3) experiencing initial success with food production; 4) generating social or financial resources; 5) expanding agency in household decision-making; 6) producing renewable resources (e.g. farm produce) and social resources; and 7) sustaining empowerment. The most meaningful improvements in empowerment occurred among participants who were able to produce food beyond what was needed for household consumption and were able to successfully leverage these surplus resources to gain higher bargaining power in their household. Additionally, women used negotiation skills with their husbands, fostered social support networks with other women, and developed increased self-efficacy and motivation. Meanwhile, the least empowered participants lacked support in critical areas, such as support from their spouses, social support networks, or sufficient space or time to produce enough food to meaningfully increase their contribution and therefore bargaining power within their household.ConclusionsThis study developed a novel framework to describe a pathway to empowerment among female participants in an HFP intervention, as implemented in the FAARM trial. These results have implications for the design of future nutrition-sensitive agriculture interventions, which should prioritize opportunities to increase empowerment and mitigate the barriers identified in our study.Trial registrationFAARM is registered with ClinicalTrials.gov ( NCT02505711 ).

Project description:Women's empowerment is associated with improved child nutrition, and both underpin the achievement of multiple Sustainable Development Goals (SDGs). We examined pathways by which women's empowerment influences child nutritional status. We pooled nationally representative data from Demographic and Health Surveys (2011-2016) collected from married women with children aged 6-24 months in Ethiopia, Kenya, Rwanda, Tanzania, and Uganda (n?=?13,780). We operationalized child nutritional status using anemia, height-for-age z-score (HAZ), and weight-for-age z-score (WHZ). We operationalized women's empowerment using a validated measure comprised of three latent domains: social/human assets ("assets"), intrinsic agency (attitudes about intimate partner violence), and instrumental agency (influence in household decision making). We used structural equation models with latent constructs to estimate hypothesized pathways from women's empowerment to child nutritional status with further mediation by maternal body mass index (BMI) and stratification by wealth. Women's empowerment domains were directly and positively associated with maternal BMI (estimate±SE: assets, 0.17?±?0.03; intrinsic agency, 0.23?±?0.03; instrumental agency, 0.03?±?0.01). Maternal BMI was directly and positively associated with child HAZ (0.08?±?0.04) and child WHZ (0.35?±?0.03). Assets were indirectly associated with child HAZ and WHZ through intrinsic agency and maternal BMI. In the lowest wealth category, the direct effects from women's empowerment to child nutritional status were significant (assets and instrumental agency were associated with anemia; intrinsic agency associated with HAZ). In the highest wealth category, direct effects from women's empowerment on child nutritional status were significant (intrinsic and instrumental agency associated with WHZ). Improving women's empowerment, especially intrinsic agency, in East Africa could improve child nutrition directly and via improved maternal nutrition. These findings suggest that efforts to realize SDG 5 may have spillover effects on other SDGs. However, strategies to improve nutrition through empowerment approaches may need to also address household resource constraints.

Project description:Although women's empowerment has gained attention over the last two decades, our understanding of the associations between different dimensions of women's empowerment and different children's health outcomes is limited. This study aims to measure the extent of women's empowerment and to examine its associations with the children's health status in Ethiopia. Data were obtained from the 2016 Ethiopian Demographic and Health Survey (EDHS). The sample is restricted to a sub-sample of 10,641 women from 15 to 49 years old and their children under the age of five years. We used children's height-for-age and weight-for-height Z-scores and pneumonia and anemia experience as indicators of children's health outcome. Women's empowerment is measured by five indices reflecting their participation in decision-making, attitudes towards wife-beating by husband, barriers to health care access, asset ownership, and socio-economic variables. These indicators of empowerment were constructed using exploratory and confirmatory factor analysis. A Multiple Indicators Multiple Causes (MIMIC) model was employed to examine the relationship between women's empowerment and latent child health outcomes, after controlling for relevant covariates. Results suggests that enhancing women's empowerment in the household in terms of their socio-economic status (i.e., increasing women's access to education, information, media, and promoting saving) was associated with less likelihood of the children's being stunted or wasted (p<0.05). Higher women's empowerment in terms of household decision-making power were also associated with better children's health status measured by the children's experience of pneumonia and anemia (p<0.05). All aspects of women's empowerment are not related with children's health indicators. Women's empowerment dimensions related with child health have a varying degree of association with the different children's health indicators. Gender-specific policies focusing on increasing women's access to education, media, information, and promoting saving and their participation in the household decision making are some of the strategies for improving their children's health and wellbeing.

Dataset Information

First birth and the trajectory of women's empowerment in Egypt.

Publications

First birth and the trajectory of women's empowerment in Egypt.

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