Conceptualizing pathways linking women's empowerment and prematurity in developing countries.

BackgroundGlobally, prematurity is the leading cause of death in children under the age of 5. Many efforts have focused on clinical approaches to improve the survival of premature babies. There is a need, however, to explore psychosocial, sociocultural, economic, and other factors as potential mechanisms to reduce the burden of prematurity. Women's empowerment may be a catalyst for moving the needle in this direction. The goal of this paper is to examine links between women's empowerment and prematurity in developing settings. We propose a conceptual model that shows pathways by which women's empowerment can affect prematurity and review and summarize the literature supporting the relationships we posit. We also suggest future directions for research on women's empowerment and prematurity.MethodsThe key words we used for empowerment in the search were "empowerment," "women's status," "autonomy," and "decision-making," and for prematurity we used "preterm," "premature," and "prematurity." We did not use date, language, and regional restrictions. The search was done in PubMed, Population Information Online (POPLINE), and Web of Science. We selected intervening factors-factors that could potentially mediate the relationship between empowerment and prematurity-based on reviews of the risk factors and interventions to address prematurity and the determinants of those factors.ResultsThere is limited evidence supporting a direct link between women's empowerment and prematurity. However, there is evidence linking several dimensions of empowerment to factors known to be associated with prematurity and outcomes for premature babies. Our review of the literature shows that women's empowerment may reduce prematurity by (1) preventing early marriage and promoting family planning, which will delay age at first pregnancy and increase interpregnancy intervals; (2) improving women's nutritional status; (3) reducing domestic violence and other stressors to improve psychological health; and (4) improving access to and receipt of recommended health services during pregnancy and delivery to help prevent prematurity and improve survival of premature babies.ConclusionsWomen's empowerment is an important distal factor that affects prematurity through several intervening factors. Improving women's empowerment will help prevent prematurity and improve survival of preterm babies. Research to empirically show the links between women's empowerment and prematurity is however needed

Development of the project-level Women’s Empowerment in Agriculture Index (pro-WEAI)

With growing commitment to women’s empowerment by agricultural development agencies, sound methods and indicators to measure women’s empowerment are needed to learn which types of projects or project-implementation strategies do and do not work to empower women. The Women’s Empowerment in Agriculture Index (WEAI), which has been widely used, requires adaptation to meet the need for monitoring projects and assessing their impacts. In this paper, the authors describe the adaptation and validation of a project-level WEAI (or pro-WEAI) that agricultural development projects can use to identify key areas of women’s (and men’s) disempowerment, design appropriate strategies to address identified deficiencies, and monitor project outcomes related to women’s empowerment. The 12 pro-WEAI indicators are mapped to three domains: intrinsic agency (power within), instrumental agency (power to), and collective agency (power with). A gender parity index compares the empowerment scores of men and women in the same household. The authors describe the development of pro-WEAI, including: (1) pro-WEAI’s distinctiveness from other versions of the WEAI; (2) the process of piloting pro-WEAI in 13 agricultural development projects during the Gender, Agriculture, and Assets Project, phase 2 (GAAP2); (3) analysis of quantitative data from the GAAP2 projects, including intrahousehold patterns of empowerment/disempowerment; and (4) a summary of the findings from the qualitative work exploring concepts of women’s empowerment in the project sites. The paper concludes with a discussion of lessons learned from pro-WEAI and possibilities for further development of empowerment metrics