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Increased women's empowerment and regional inequality in Sub-Saharan Africa between 1995 and 2015.

ABSTRACT: Women's empowerment is a fundamental human right but attempts to measure progress in this area have been limited. We used 142 nationally representative surveys to quantify empowerment in six domains (Intimate Partner Violence, Family Planning, Reproductive Healthcare, Employment, Education, and Decision-Making) for first-level subdivisions of all countries in Sub-Saharan Africa for three years (1995, 2005, and 2015). The possible value for each domain ranged between zero (worst) and one (best). The median value for employment decreased by 0.02, but it increased between 0.09 and 0.16 for the other domains. The average empowerment score increased from 0.44 to 0.53, but it remained low for Education (0.34). While progress was clear and consistent, it was uneven within and between countries, and Sahelian West Africa fell further behind. The expanded understanding of geographic variation and trends in women's empowerment that we provide should be instrumental in efforts to improve women's lives.

SUBMITTER: Rettig EM

PROVIDER: S-EPMC9473440 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Increased women's empowerment and regional inequality in Sub-Saharan Africa between 1995 and 2015.

Rettig Erica M EM Hijmans Robert J RJ

PloS one 20220914 9

Women's empowerment is a fundamental human right but attempts to measure progress in this area have been limited. We used 142 nationally representative surveys to quantify empowerment in six domains (Intimate Partner Violence, Family Planning, Reproductive Healthcare, Employment, Education, and Decision-Making) for first-level subdivisions of all countries in Sub-Saharan Africa for three years (1995, 2005, and 2015). The possible value for each domain ranged between zero (worst) and one (best). ...[more]

PMID: 36103466

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Project description:BackgroundChild undernutrition remains a major global health issue, particularly in sub-Saharan Africa (SSA). Given the important role mothers play in early childhood health and development, we examined how individual-level women's empowerment and country-level Gender Inequality Index (GII) are jointly related with child undernutrition in SSA.MethodsWe pooled recent Demographic and Health Surveys from 28 SSA countries. For 137,699 children <5 years old, undernutrition was defined using anthropometric failures (stunting, underweight, wasting). Women's empowerment was assessed using three domains of Survey-based Women's EmPowERment (SWPER) index: attitude to violence, social independence, and decision-making; and country-level gender inequality was measured using GII from United Nations Development Programme. Three-level logistic regression was conducted to examine the joint associations of SWPER and GII as well as their interactions with child anthropometric failures, after adjusting for sociodemographic covariates.ResultsOverall, 32.85% of children were stunted, 17.63% were underweight, and 6.68% had wasting. Children of mothers with low-level of empowerment for all domains of SWPER had higher odds of stunting (attitude to violence: OR=1.15; 95% CI, 1.11-1.19; social independence: OR=1.21; 95% CI, 1.17-1.25; decision-making: OR=1.16; 95% CI, 1.12-1.20), and consistent results were found for underweight and wasting. Independent of women's empowerment, country-level GII increased the probability of underweight (ranging ORs=1.46; 95% CI, 1.15-1.85 to 1.50; 95% CI, 1.18-1.90) and wasting (ranging ORs=1.56; 95% CI, 1.24-1.97 to 1.61; 95% CI, 1.27-2.03). Significant interaction was found between women's empowerment and country-level GII for stunting and underweight (p<0.05).ConclusionsIn SSA countries with greater gender inequality, improving women's social independence and decision-making power in particular can reduce their children's risk of anthropometric failures. Policies and interventions targeted at strengthening women's empowerment should consider the degree of gender inequality in each country.

Project description:BackgroundIn November 2016, the WHO four-visit focused antenatal care (FANC) model adopted in sub-Saharan Africa (SSA) was reverted to eight contacts or more as a response to reducing the global perinatal and maternal deaths and in achieving the sustainable development goal (SDG) 3. Women's empowerment, which connote the social standing, position and the ability of women to make life decisions and choices has been associated with the maternal health seeking behaviour and outcomes. This study examined the association between women's empowerment and the WHO ANC model of eight visits or more, and early first antenatal visit among pregnant women. In addition, we explored the association between women's empowerment and the WHO FANC model to allow for comparison for countries that have not adopted the recent WHO ANC model.MethodsThe most recent (2018) Demographic and Health Survey (DHS) datasets conducted in SSA were used for analyses. We used all available indicators of women's empowerment captured in the DHS. The 30 variables on women's empowerment were classified into eight components using exploratory factor analysis. We fitted separate ordinal logistic regression to assess association between antenatal care utilization (number of visits and time of first antenatal visit) and women empowerment factors while adjusting for other covariates. Analysis was performed with STATA 15.0 and adjusted for complex survey design, p-value< 0.05 were used for interpretation of results.ResultsThe proportion of women who attended eight or more ANC visits were 1.4, 2.7 and 3.5% in Zambia, Guinea and Mali, respectively. Zambia had the lowest prevalence of 8 or more ANC visits also had the highest prevalence of at least 4 visits (63.8%) and early first ANC visit (38.2%), while Nigeria with the highest prevalence of women with at least 8 visits (17.7%) had the lowest prevalence (17.6%) of women that attended ANC visit in their first trimester. Women's empowerment was associated with more ANC visits and attending first ANC visit in the first trimester. However, these association with the women empowerment components varied significantly across the four SSA countries.ConclusionThis study highlights the significant impact of women's empowerment as a key factor for improving maternal health outcomes in SSA. It is imperative that government and development partners invest more on empowerment of women as part of strategic intervention to improve maternal health outcomes.

Project description:Sub-Saharan Africa represents 69% of the total number of individuals living with HIV infection worldwide and 72% of AIDS deaths globally. Pulmonary infection is a common and frequently fatal complication, though little is known regarding the lower airway microbiome composition of this population. Our objectives were to characterize the lower airway microbiome of Ugandan HIV-infected patients with pneumonia, to determine relationships with demographic, clinical, immunological, and microbiological variables and to compare the composition and predicted metagenome of these communities to a comparable cohort of patients in the US (San Francisco). Bronchoalveolar lavage samples from a cohort of 60 Ugandan HIV-infected patients with acute pneumonia were collected. Amplified 16S ribosomal RNA was profiled and aforementioned relationships examined. Ugandan airway microbiome composition and predicted metagenomic function were compared to US HIV-infected pneumonia patients. Among the most common bacterial pulmonary pathogens, Pseudomonas aeruginosa was most prevalent in the Ugandan cohort. Patients with a richer and more diverse airway microbiome exhibited lower bacterial burden, enrichment of members of the Lachnospiraceae and sulfur-reducing bacteria and reduced expression of TNF-alpha and matrix metalloproteinase-9. Compared to San Franciscan patients, Ugandan airway microbiome were significantly richer, and compositionally distinct with predicted metagenomes that encoded a multitude of distinct pathogenic pathways e.g secretion systems. Ugandan pneumonia-associated airway microbiome is compositionally and functionally distinct from those detected in comparable patients in developed countries, a feature which may contribute to adverse outcomes in this population. Please note that the data from the comparable cohort of patients in the USUS data was published as supplemental material of PMID: 22760045 but not submitted to GEO The 'patient_info.txt' contains 12 clinical, 7 immunological and 3 microbiological variables for each patient.

Dataset Information

Increased women's empowerment and regional inequality in Sub-Saharan Africa between 1995 and 2015.

Publications

Increased women's empowerment and regional inequality in Sub-Saharan Africa between 1995 and 2015.

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