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Increasing literate and illiterate women's met need for contraception via empowerment: a quasi-experiment in rural India.

León FR, Lundgren R, Sinai I, Sinha R, Jennings V - Reprod Health (2014)

Bottom Line: Married women ages 15-49 who lived in the intervention and control blocks were sampled and interviewed before and after the intervention by a professional research firm.Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased by the intervention; similar was the case among illiterate, but not literate, women regarding decisions related to childbearing.Generalizations to other settings, however, may be limited by cultural differences.

View Article: PubMed Central - PubMed

Affiliation: Institute for Reproductive Health, Georgetown University, Washington, DC, USA. Rebecka.Lundgren@georgetown.edu.

ABSTRACT

Background: Virtually all the evidence on the relationship between women's empowerment and use of contraception comes from cross-sectional studies that have emphasized macrosocial factors.This analysis tested whether literate and illiterate women are empowered by an intervention designed to provide information addressing technical and gender concerns and expand contraceptive choice, and evaluated the effects of women's decision-making power on contraceptive behavior.

Methods: The data came from a three-year quasi-experiment conducted in two comparable, yet not equivalent, rural blocks in Jharkhand, India. At the intervention block, a new contraceptive method was introduced at Ministry of Health health centers, providers were trained to offer family planning information and services which took into consideration gender power dynamics, and promotional messages and information about contraception were disseminated community-wide. Married women ages 15-49 who lived in the intervention and control blocks were sampled and interviewed before and after the intervention by a professional research firm. Data analyses included generalized linear models with interactions and covariate control.

Results: Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased by the intervention; similar was the case among illiterate, but not literate, women regarding decisions related to childbearing. Concerning met need for contraception, the change for women with relatively more power who were illiterate was greater in the intervention than in the control area.

Conclusion: The findings suggest that women were empowered by outreach visits that addressed gender dynamics and that their empowerment contributed to their met need for contraception. Generalizations to other settings, however, may be limited by cultural differences.

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Women’s normative beliefs concerning who should do what at home, by decision area.
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Fig1: Women’s normative beliefs concerning who should do what at home, by decision area.

Mentions: Table 1 presents descriptive statistics which reveal a moderately high level of met need in rural Jharkhand as well as an increase from pretest to posttest in the intervention area, Ormanjhi, but not in Burmu, the control area. Regarding the covariates, the results show that literacy, watching TV, proportion of Muslims, and family planning visits received, all increased from pretest to posttest in both groups and thus these changes can be regarded as parts of maturation processes in rural Jharkhand. The proportion of women working increased in the control but not in the intervention site; since the difference between blocks at the pretest was significant (χ2 = 7.564, p < .000), this dynamic may be understood as the women from Burmu catching up with their neighbors. The fact that the proportion of Muslims was greater in Burmu at the pretest (χ2 = 10.319, p < .000) may be relevant in this respect, considering their general employment level (35% working, versus 57% among Hindus). Visits to health centers significantly decreased in Ormanjhi but not in Burmu. The results shown in Figure 1, which refer to the combined intervention and control samples, suggest that a practical, egalitarian model of domestic decision-making prevails in rural Jharkhand: while making decisions about small purchases appears to be within women’s autonomous decision-making purview, the other four are ones in which joint decisions with the husband are expected.Table 1


Increasing literate and illiterate women's met need for contraception via empowerment: a quasi-experiment in rural India.

León FR, Lundgren R, Sinai I, Sinha R, Jennings V - Reprod Health (2014)

Women’s normative beliefs concerning who should do what at home, by decision area.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4221697&req=5

Fig1: Women’s normative beliefs concerning who should do what at home, by decision area.
Mentions: Table 1 presents descriptive statistics which reveal a moderately high level of met need in rural Jharkhand as well as an increase from pretest to posttest in the intervention area, Ormanjhi, but not in Burmu, the control area. Regarding the covariates, the results show that literacy, watching TV, proportion of Muslims, and family planning visits received, all increased from pretest to posttest in both groups and thus these changes can be regarded as parts of maturation processes in rural Jharkhand. The proportion of women working increased in the control but not in the intervention site; since the difference between blocks at the pretest was significant (χ2 = 7.564, p < .000), this dynamic may be understood as the women from Burmu catching up with their neighbors. The fact that the proportion of Muslims was greater in Burmu at the pretest (χ2 = 10.319, p < .000) may be relevant in this respect, considering their general employment level (35% working, versus 57% among Hindus). Visits to health centers significantly decreased in Ormanjhi but not in Burmu. The results shown in Figure 1, which refer to the combined intervention and control samples, suggest that a practical, egalitarian model of domestic decision-making prevails in rural Jharkhand: while making decisions about small purchases appears to be within women’s autonomous decision-making purview, the other four are ones in which joint decisions with the husband are expected.Table 1

Bottom Line: Married women ages 15-49 who lived in the intervention and control blocks were sampled and interviewed before and after the intervention by a professional research firm.Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased by the intervention; similar was the case among illiterate, but not literate, women regarding decisions related to childbearing.Generalizations to other settings, however, may be limited by cultural differences.

View Article: PubMed Central - PubMed

Affiliation: Institute for Reproductive Health, Georgetown University, Washington, DC, USA. Rebecka.Lundgren@georgetown.edu.

ABSTRACT

Background: Virtually all the evidence on the relationship between women's empowerment and use of contraception comes from cross-sectional studies that have emphasized macrosocial factors.This analysis tested whether literate and illiterate women are empowered by an intervention designed to provide information addressing technical and gender concerns and expand contraceptive choice, and evaluated the effects of women's decision-making power on contraceptive behavior.

Methods: The data came from a three-year quasi-experiment conducted in two comparable, yet not equivalent, rural blocks in Jharkhand, India. At the intervention block, a new contraceptive method was introduced at Ministry of Health health centers, providers were trained to offer family planning information and services which took into consideration gender power dynamics, and promotional messages and information about contraception were disseminated community-wide. Married women ages 15-49 who lived in the intervention and control blocks were sampled and interviewed before and after the intervention by a professional research firm. Data analyses included generalized linear models with interactions and covariate control.

Results: Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased by the intervention; similar was the case among illiterate, but not literate, women regarding decisions related to childbearing. Concerning met need for contraception, the change for women with relatively more power who were illiterate was greater in the intervention than in the control area.

Conclusion: The findings suggest that women were empowered by outreach visits that addressed gender dynamics and that their empowerment contributed to their met need for contraception. Generalizations to other settings, however, may be limited by cultural differences.

Show MeSH