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The long-term impact of community mobilisation through participatory women's groups on women's agency in the household: A follow-up study to the Makwanpur trial

Author

Listed:
  • Lu Gram
  • Jolene Skordis-Worrall
  • Dharma S Manandhar
  • Daniel Strachan
  • Joanna Morrison
  • Naomi Saville
  • David Osrin
  • Kirti M Tumbahangphe
  • Anthony Costello
  • Michelle Heys

Abstract

Women’s groups practicing participatory learning and action (PLA) in rural areas have been shown to improve maternal and newborn survival in low-income countries, but the pathways from intervention to impact remain unclear. We assessed the long-term impact of a PLA intervention in rural Nepal on women’s agency in the household. In 2014, we conducted a follow-up study to a cluster randomised controlled trial on the impact of PLA women’s groups from 2001–2003. Agency was measured using the Relative Autonomy Index (RAI) and its subdomains. Multi-level regression analyses were performed adjusting for baseline socio-demographic characteristics. We additionally adjusted for potential exposure to subsequent PLA groups based on women’s pregnancy status and conduct of PLA groups in areas of residence. Sensitivity analyses were performed using two alternative measures of agency. We analysed outcomes for 4030 mothers (66% of the cohort) who survived and were recruited to follow-up at mean age 39.6 years. Across a wide range of model specifications, we found no association between exposure to the original PLA intervention with women’s agency in the household approximately 11.5 years later. Subsequent exposure to PLA groups was not associated with greater agency in the household at follow-up, but some specifications found evidence for reduced agency. Household agency may be a prerequisite for actualising the benefits of PLA groups rather than a consequence.

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  • Lu Gram & Jolene Skordis-Worrall & Dharma S Manandhar & Daniel Strachan & Joanna Morrison & Naomi Saville & David Osrin & Kirti M Tumbahangphe & Anthony Costello & Michelle Heys, 2018. "The long-term impact of community mobilisation through participatory women's groups on women's agency in the household: A follow-up study to the Makwanpur trial," PLOS ONE, Public Library of Science, vol. 13(5), pages 1-22, May.
    • Handle: RePEc:plo:pone00:0197426
    DOI: 10.1371/journal.pone.0197426
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    References listed on IDEAS

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    1. Lu Gram & Joanna Morrison & Jolene Skordis-Worrall, 2019. "Organising Concepts of ‘Women’s Empowerment’ for Measurement: A Typology," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 143(3), pages 1349-1376, June.
    2. Yoeli, Heather & Dhital, Ranjita & Hermaszewska, Susannah & Sin, Jacqueline, 2022. "A meta-ethnography of participatory health research and co-production in Nepal," Social Science & Medicine, Elsevier, vol. 301(C).

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