IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v258y2020ics0277953620303051.html
   My bibliography  Save this article

‘I am the master key that opens and locks’: Presentation and application of a conceptual framework for women's and girls' empowerment in reproductive health

Author

Listed:
  • Karp, Celia
  • Wood, Shannon N.
  • Galadanci, Hadiza
  • Sebina Kibira, Simon Peter
  • Makumbi, Fredrick
  • Omoluabi, Elizabeth
  • Shiferaw, Solomon
  • Seme, Assefa
  • Tsui, Amy
  • Moreau, Caroline

Abstract

Rationale: A renewed focus on women's and girls' empowerment in the era of Sustainable Development Goals reflects the belief that empowerment is central to health and development. Sexual and reproductive health (SRH) outcomes, including pregnancy and contraceptive use, may contribute to and result from empowerment. However, enhanced understanding of how women become empowered for SRH requires clear conceptualization of empowerment. Objective: We aimed to assess the applicability of a proposed framework for women's and girls' SRH empowerment (WGE-SRH) in sub-Saharan Africa. We sought to understand what shapes and motivates preferences for childbearing and contraception, exploring how women and girls navigate external pressures or rewards to exercise and achieve their reproductive goals. Methods: Grounded in the WGE-SRH framework, we conducted a qualitative study in four distinct contexts (Ethiopia, Kano and Anambra States in Nigeria, and Uganda). We implemented and analyzed 120 in-depth interviews and 38 focus group discussions with 440 women and men and translated results to refine the WGE-SRH framework. Results: Findings demonstrate the salience of women's internal motivations, including the social value and joys of motherhood, in shaping existence of reproductive choices. However, existence of choice was limited by couples' economic situations, pressures from providers, partners, and family members, and women's fears of contraceptive side effects or relationship dissolution. Despite these constraints, many found ways to exercise their reproductive choices through negotiation with partners, third party involvement in reproductive discussions, non-verbal communication, and covert use of contraception. Conclusions: The WGE-SRH framework is useful for exploring SRH empowerment, embracing the multilevel, dynamic nature of empowerment, as a process transitioning from existence of choice (autonomy) to exercise of choice (self-efficacy, decision-making, negotiation), and, ultimately, to achievement of choice. Future research and programs related to SRH empowerment should distinguish between existence and exercise of choices to promote the health and well-being of women and girls.

Suggested Citation

  • Karp, Celia & Wood, Shannon N. & Galadanci, Hadiza & Sebina Kibira, Simon Peter & Makumbi, Fredrick & Omoluabi, Elizabeth & Shiferaw, Solomon & Seme, Assefa & Tsui, Amy & Moreau, Caroline, 2020. "‘I am the master key that opens and locks’: Presentation and application of a conceptual framework for women's and girls' empowerment in reproductive health," Social Science & Medicine, Elsevier, vol. 258(C).
    • Handle: RePEc:eee:socmed:v:258:y:2020:i:c:s0277953620303051
    DOI: 10.1016/j.socscimed.2020.113086
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953620303051
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2020.113086?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Bornstein, Marta & Gipson, Jessica D. & Failing, Gates & Banda, Venson & Norris, Alison, 2020. "Individual and community-level impact of infertility-related stigma in Malawi," Social Science & Medicine, Elsevier, vol. 251(C).
    2. Upadhyay, Ushma D. & Hindin, Michelle J., 2005. "Do higher status and more autonomous women have longer birth intervals?: Results from Cebu, Philippines," Social Science & Medicine, Elsevier, vol. 60(11), pages 2641-2655, June.
    3. Lee-Rife, Susan M., 2010. "Women's empowerment and reproductive experiences over the lifecourse," Social Science & Medicine, Elsevier, vol. 71(3), pages 634-642, August.
    4. Bose, Bijetri & Heymann, Jody, 2019. "Effects of tuition-free primary education on women's access to family planning and on health decision-making: A cross-national study," Social Science & Medicine, Elsevier, vol. 238(C), pages 1-1.
    5. Naila Kabeer, 1999. "Resources, Agency, Achievements: Reflections on the Measurement of Women's Empowerment," Development and Change, International Institute of Social Studies, vol. 30(3), pages 435-464, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kathryn M. Yount & Kristin E. VanderEnde & Sylvie Dodell & Yuk Fai Cheong, 2016. "Measurement of Women’s Agency in Egypt: A National Validation Study," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 128(3), pages 1171-1192, September.
    2. Hamid Noghanibehambari & Farzaneh Noghani, 2023. "Long‐run intergenerational health benefits of women empowerment: Evidence from suffrage movements in the US," Health Economics, John Wiley & Sons, Ltd., vol. 32(11), pages 2583-2631, November.
    3. Pratley, Pierre, 2016. "Associations between quantitative measures of women's empowerment and access to care and health status for mothers and their children: A systematic review of evidence from the developing world," Social Science & Medicine, Elsevier, vol. 169(C), pages 119-131.
    4. Miedema, Stephanie Spaid & Haardörfer, Regine & Girard, Amy Webb & Yount, Kathryn M., 2018. "Women’s empowerment in East Africa: Development of a cross-country comparable measure," World Development, Elsevier, vol. 110(C), pages 453-464.
    5. Robin A. Richardson, 2018. "Measuring Women’s Empowerment: A Critical Review of Current Practices and Recommendations for Researchers," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 137(2), pages 539-557, June.
    6. Yount, Kathryn M. & Crandall, AliceAnn & Cheong, Yuk Fai, 2018. "Women’s Age at First Marriage and Long-Term Economic Empowerment in Egypt," World Development, Elsevier, vol. 102(C), pages 124-134.
    7. Nayana Bose & Shreyasee Das, 2021. "Women's Inheritance Rights and Fertility Decisions: Evidence from India," DETU Working Papers 2101, Department of Economics, Temple University.
    8. Julia Behrman & Pilar Gonalons-Pons, 2020. "Women's employment and fertility in a global perspective (1960–2015)," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 43(25), pages 707-744.
    9. Helen M. Haugh & Alka Talwar, 2016. "Linking Social Entrepreneurship and Social Change: The Mediating Role of Empowerment," Journal of Business Ethics, Springer, vol. 133(4), pages 643-658, February.
    10. Rao, Nitya, 2017. "Assets, Agency and Legitimacy: Towards a Relational Understanding of Gender Equality Policy and Practice," World Development, Elsevier, vol. 95(C), pages 43-54.
    11. DeJaeghere, Joan & Pellowski Wiger, Nancy & Le, Hue & Luong, Phuong & Ngo, Nga Thi Hang & Vu, Thanh Thi & Lee, Jongwook, 2022. "Why do aspirations matter for empowerment?: Discrepancies between the A-WEAI domains and aspirations of ethnic minority women in Vietnam," World Development, Elsevier, vol. 159(C).
    12. K. Gayathri Reddy & Varsha, P. S. & L. N. Sudheendra Rao & Amit Kumar, 2019. "Exploring dimension, perceived individual tension and capacity building measure of women empowerment in India," Asian Journal of Empirical Research, Asian Economic and Social Society, vol. 9(5), pages 111-131, May.
    13. Alice W Clark & T V Sekher, 2007. "Can Career-Minded Young Women Reverse Gender Discrimination?," Working Papers 179, Institute for Social and Economic Change, Bangalore.
    14. chatterjee, susmita, 2017. "Empowerment translated to transition," MPRA Paper 80067, University Library of Munich, Germany.
    15. Alkire, Sabina & Meinzen-Dick, Ruth & Peterman, Amber & Quisumbing, Agnes & Seymour, Greg & Vaz, Ana, 2013. "The Women’s Empowerment in Agriculture Index," World Development, Elsevier, vol. 52(C), pages 71-91.
    16. Bussolo,Maurizio & Ezebuihe,Jessy Amarachi & Munoz Boudet,Ana Maria & Poupakis,Stavros & Rahman,Tasmia & Sarma,Nayantara, 2022. "Social Norms and Gender Equality : A Descriptive Analysis for South Asia," Policy Research Working Paper Series 10142, The World Bank.
    17. Rania Salem & Yuk Fai Cheong & Kathryn M. Yount, 2018. "Is Women’s Work a Pathway to their Agency in Rural Minya, Egypt?," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 136(2), pages 807-831, April.
    18. Alice Tianbo Zhang & Sasmita Patnaik & Shaily Jha & Shalu Agrawal & Carlos F. Gould & Johannes Urpelainen, 2022. "Evidence of multidimensional gender inequality in energy services from a large-scale household survey in India," Nature Energy, Nature, vol. 7(8), pages 698-707, August.
    19. Amjad Ali & Marc Audi & Chan Bibi & Yannick Roussel, 2021. "The Impact of Gender Inequality and Environmental Degradation on Human Well-being in the Case of Pakistan: A Time Series Analysis," International Journal of Economics and Financial Issues, Econjournals, vol. 11(2), pages 92-99.
    20. Lone Badstue & Patti Petesch & Cathy Rozel Farnworth & Lara Roeven & Mahlet Hailemariam, 2020. "Women Farmers and Agricultural Innovation: Marital Status and Normative Expectations in Rural Ethiopia," Sustainability, MDPI, vol. 12(23), pages 1-22, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:258:y:2020:i:c:s0277953620303051. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.