The role of self-efficacy in women's autonomy for health and nutrition decision-making in rural Bangladesh.
Agency
Agriculture
Measurement
Preference
Women’s empowerment
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
01 Feb 2024
01 Feb 2024
Historique:
received:
17
07
2023
accepted:
03
01
2024
medline:
1
2
2024
pubmed:
1
2
2024
entrez:
31
1
2024
Statut:
epublish
Résumé
Agency - including the sub-domains of intrinsic agency, instrumental agency, and collective agency - is a critical component of the women's empowerment process. Self-efficacy (a component of intrinsic agency) may operate as a motivational influence for women to make choices according to their own preferences or goals, such that higher self-efficacy would be associated with more autonomous decision-making (a key component of instrumental agency). We examine these relationships using mixed methods. We developed a series of decision-making autonomy indices, which captured alignment between the woman's reported and preferred roles in health and nutrition decisions. Using ordinal logistic regression, we assessed the relationship between generalized self-efficacy and decision-making autonomy. There was a consistently positive association across all categories of decision-making, controlling for a number of individual and household-level covariates. In a sub-sample of joint decision-makers (i.e., women who reported making decisions with at least one other household member), we compared the association between generalized self-efficacy (i.e., one's overall belief in their ability to succeed) and decision-making autonomy to that of domain-specific self-efficacy (i.e., one's belief in their ability to achieve a specific goal) and decision-making autonomy. Across all decision-making categories, domain-specific self-efficacy was more strongly associated with decision-making autonomy than generalized self-efficacy. In-depth interviews provided additional context for interpretation of the regression analyses. The results indicate the importance of the role of self-efficacy in the women's empowerment process, even in the traditionally female-controlled areas of health and nutrition decision-making. The development of the decision-making autonomy index is an important contribution to the literature in that it directly recognizes and captures the role of women's preferences regarding participation in decision-making.
Sections du résumé
BACKGROUND
BACKGROUND
Agency - including the sub-domains of intrinsic agency, instrumental agency, and collective agency - is a critical component of the women's empowerment process. Self-efficacy (a component of intrinsic agency) may operate as a motivational influence for women to make choices according to their own preferences or goals, such that higher self-efficacy would be associated with more autonomous decision-making (a key component of instrumental agency).
METHODS
METHODS
We examine these relationships using mixed methods. We developed a series of decision-making autonomy indices, which captured alignment between the woman's reported and preferred roles in health and nutrition decisions. Using ordinal logistic regression, we assessed the relationship between generalized self-efficacy and decision-making autonomy.
RESULTS
RESULTS
There was a consistently positive association across all categories of decision-making, controlling for a number of individual and household-level covariates. In a sub-sample of joint decision-makers (i.e., women who reported making decisions with at least one other household member), we compared the association between generalized self-efficacy (i.e., one's overall belief in their ability to succeed) and decision-making autonomy to that of domain-specific self-efficacy (i.e., one's belief in their ability to achieve a specific goal) and decision-making autonomy. Across all decision-making categories, domain-specific self-efficacy was more strongly associated with decision-making autonomy than generalized self-efficacy. In-depth interviews provided additional context for interpretation of the regression analyses.
CONCLUSIONS
CONCLUSIONS
The results indicate the importance of the role of self-efficacy in the women's empowerment process, even in the traditionally female-controlled areas of health and nutrition decision-making. The development of the decision-making autonomy index is an important contribution to the literature in that it directly recognizes and captures the role of women's preferences regarding participation in decision-making.
Identifiants
pubmed: 38297259
doi: 10.1186/s12889-024-17663-2
pii: 10.1186/s12889-024-17663-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
338Subventions
Organisme : Bill & Melinda Gates Foundation
ID : INV-008977
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-008977
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-008977
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-008977
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-008977
Pays : United States
Organisme : Bill & Melinda Gates Foundation
ID : INV-008977
Pays : United States
Informations de copyright
© 2024. The Author(s).
Références
Hossain M. Is there any interaction effect of mothers’ education and their bargaining power on children’s nutritional status? Evidence from rural Bangladesh. World Dev Perspect. 2020;1(18):100179.
Rahman MM, Saima U, Goni MA. Impact of Maternal Household Decision-Making Autonomy on Child Nutritional Status in Bangladesh: Asia Pacific Journal of Public Health. 2015 [Cited 2020 Nov 25]; Available from: https://journals.sagepub.com/doi/10.1177/1010539514568710 .
Sharma A, Kader M. Effect of Women’s Decision-Making Autonomy on Infant’s Birth Weight in Rural Bangladesh. ISRN Pediatr. 2013 [Cited 2020 Nov 25];2013. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3893833/ .
Santoso MV, Kerr RB, Hoddinott J, Garigipati P, Olmos S, Young SL. Role of Women’s Empowerment in Child Nutrition Outcomes: A Systematic Review. Adv Nutr. 2019;10(6):1138–51.
pubmed: 31298299
pmcid: 6855975
Heckert J, Olney DK, Ruel MT. Is women’s empowerment a pathway to improving child nutrition outcomes in a nutrition-sensitive agriculture program?: Evidence from a randomized controlled trial in Burkina Faso. Soc Sci Med. 2019;233:93–102.
pubmed: 31195195
pmcid: 6642337
Kabeer N. Resources, agency, achievements: reflections on the measurement of women’s empowerment. Dev Change. 1999;30(3):435–64.
Raj A. Women and girls’ health agency: Operationalizing the “Can-Act-Resist” of the women’s empowerment process. EClinicalMedicine. 2020 [Cited 2020 Nov 25];20. Available from: https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30031-6/abstract .
Jones RE, Haardörfer R, Ramakrishnan U, Yount KM, Miedema SS, Roach TD, et al. Intrinsic and instrumental agency associated with nutritional status of East African women. Soc Sci Med. 2020;16(247):112803.
Yount KM, Cheong YF, Maxwell L, Heckert J, Martinez EM, Seymour G. Measurement properties of the project-level Women’s Empowerment in Agriculture Index. World Dev. 2019;1(124):104639.
Gammage S, Kabeer N, Rodgers Y van der M. Voice and Agency: Where Are We Now? Feminist Economics. 2016;22(1):1–29.
Rowlands J. Questioning Empowerment: Working with women in Honduras. Oxford: Oxfam; 1997 [Cited 2023 Mar 21]. Available from: https://policy-practice.oxfam.org/resources/questioning-empowerment-working-with-women-in-honduras-121185/ .
Donald A, Koolwal G, Annan J, Falb K, Goldstein M. Measuring women’s agency. Feminist Econ. 2020;26(3):200–26.
Bandura A. Self-efficacy mechanism in human agency. Am Psychol. 1982;37(2):122–47.
Bandura A. Self-Efficacy: The Exercise of Control. New York: W.H. Freeman and Company; 1997.
Strecher VJ, DeVellis BM, Becker MH, Rosenstock IM. The role of self-efficacy in achieving health behavior change. Health Educ Q. 1986;13(1):73–92.
pubmed: 3957687
Kjeldsberg C, Shrestha N, Patel M, Davis D, Mundy G, Cunningham K. Nutrition-sensitive agricultural interventions and gender dynamics: a qualitative study in Nepal. Matern Child Nutr. 2018;14(3):e12593.
pubmed: 29573370
pmcid: 6866196
Malapit H, Quisumbing A, Meinzen-Dick R, Seymour G, Martinez EM, Heckert J, et al. Development of the project-level Women’s Empowerment in Agriculture Index (pro-WEAI). World Dev. 2019;1(122):675–92.
Chen G, Gully SM, Eden D. Validation of a New General Self-Efficacy Scale. Organ Res Methods. 2001;4(1):62–83.
Eden D. Pygmalion, Goal Setting, and Expectancy: Compatible Ways to Boost Productivity. Acad Manag Rev. 1988;13(4):639–52.
Grether T, Sowislo JF, Wiese BS. Top-down or bottom-up? Prospective relations between general and domain-specific self-efficacy beliefs during a work-family transition. Pers Individ Differ. 2018;15(121):131–9.
Shelton SH. Developing the Construct of General Self-Efficacy1: Psychological Reports. 2018 [Cited 2020 Nov 25]; Available from: https://journals.sagepub.com/doi/10.1177/003329419006600301 .
Miyoshi A. The stability and causal effects of task-specific and generalized self-efficacy in college1. Japan Psychol Res. 2012;54(2):150–8.
Begum S, Sen B. Maternal Health, Child Well-Being and Chronic Poverty: Does Women’s Agency Matter? Bangladesh Dev Stud. 2009;32(4):69–93.
Cunningham K, Ruel M, Ferguson E, Uauy R. Women’s empowerment and child nutritional status in South Asia: a synthesis of the literature. Matern Child Nutr. 2015;11(1):1–19.
pubmed: 24850533
Acosta M, van Wessel M, van Bommel S, Ampaire EL, Twyman J, Jassogne L, et al. What does it Mean to Make a ‘Joint’ Decision? Unpacking Intra-household Decision Making in Agriculture: Implications for Policy and Practice. J Dev Stud. 2020;56(6):1210–29.
Quisumbing A, Ahmed A, Hoddinott J, Pereira A, Roy S. Designing for empowerment impact in agricultural development projects: experimental evidence from the Agriculture, Nutrition, and Gender Linkages (ANGeL) project in Bangladesh. World Dev. 2021;1(146):105622.
Seymour G, Peterman A. Context and measurement: An analysis of the relationship between intrahousehold decision making and autonomy. World Dev. 2018;1(111):97–112.
Ibrahim S, Alkire S. Agency and empowerment: a proposal for internationally comparable indicators. Oxford Dev Stud. 2007;35(4):379–403.
de Brauw A, Gilligan DO, Hoddinott J, Roy S. The Impact of Bolsa Família on Women’s Decision-Making Power. World Dev. 2014;1(59):487–504.
Akter S, Rutsaert P, Luis J, Htwe NM, San SS, Raharjo B, et al. Women’s empowerment and gender equity in agriculture: a different perspective from Southeast Asia. Food Policy. 2017;1(69):270–9.
Spangler K, Christie ME. Renegotiating gender roles and cultivation practices in the Nepali mid-hills: unpacking the feminization of agriculture. Agric Hum Values. 2020;37(2):415–32.
Carlson GJ, Kordas K, Murray-Kolb LE. Associations between women’s autonomy and child nutritional status: a review of the literature. Matern Child Nutr. 2015;11(4):452–82.
pubmed: 24521434
Lwamba E, Shisler S, Ridlehoover W, Kupfer M, Tshabalala N, Nduku P, et al. Strengthening women’s empowerment and gender equality in fragile contexts towards peaceful and inclusive societies: a systematic review and meta-analysis. Campbell Syst Rev. 2022;18(1):e1214.
pubmed: 36913184
pmcid: 8904729
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55:68–78.
pubmed: 11392867
Peterman A, Schwab B, Roy S, Hidrobo M, Gilligan DO. Measuring women’s decisionmaking: Indicator choice and survey design experiments from cash and food transfer evaluations in Ecuador, Uganda and Yemen. World Dev. 2021;1(141):105387.
Wendt AS, Sparling TM, Waid JL, Mueller AA, Gabrysch S. Food and Agricultural Approaches to Reducing Malnutrition (FAARM): protocol for a cluster-randomised controlled trial to evaluate the impact of a Homestead Food Production programme on undernutrition in rural Bangladesh. BMJ Open. 2019;9(7):e031037.
pubmed: 31278109
pmcid: 6615849
Heckert J, Martinez EM, Seymour G, Pereira A, Roy S, Kim SS, et al. Development and validation of a health and nutrition module for the project-level Women’s Empowerment in Agriculture Index (pro-WEAI+HN). Matern Child Nutr. 2023;19(2):e13464.
pubmed: 36482835
Waid JL, Wendt AS, Sinharoy SS, Kader A, Gabrysch S. Impact of a homestead food production program on women’s empowerment: Pro-WEAI results from the FAARM trial in Bangladesh. World Dev. 2022;1(158):106001.
Sinharoy SS, Waid JL, Haardörfer R, Wendt A, Gabrysch S, Yount KM. Women’s dietary diversity in rural Bangladesh: Pathways through women’s empowerment. Matern Child Nutr. 2018;14(1):e12489.
pubmed: 28766878
Ananth CV, Kleinbaum DG. Regression models for ordinal responses: a review of methods and applications. Int J Epidemiol. 1997;26(6):1323–33.
pubmed: 9447413
Rutstein SO, Johnson K. The DHS Wealth Index. Calverton, Maryland: ORC Macro; 2004. (DHS Comparative Reports No. 6). Available from: https://dhsprogram.com/pubs/pdf/cr6/cr6.pdf
Armstrong BG, Sloan M. Ordinal Regression Models for Epidemiologic Data. Am J Epidemiol. 1989;129(1):191–204.
pubmed: 2910061
Dupuis S, Hennink M, Wendt AS, Waid JL, Kalam MA, Gabrysch S, et al. Women’s empowerment through homestead food production in rural Bangladesh. BMC Public Health. 2022;22(1):134.
pubmed: 35045859
pmcid: 8772198
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.
Maiorano D, Shrimankar D, Thapar-Björkert S, Blomkvist H. Measuring empowerment: Choices, values and norms. World Dev. 2021;1(138):105220.
Qanti SR, Peralta A, Zeng D. Social norms and perceptions drive women’s participation in agricultural decisions in West Java Indonesia. Agric Hum Values. 2022;39(2):645–62.
Klein E. Women’s agency and the psychological domain: Evidence from the Urban Fringe of Bamako Mali. Feminist Econ. 2016;22(1):106–29.
Nussbaum MC. Women and Human Development: The Capabilities Approach. Cambridge: Cambridge University Press; 2000 [Cited 2023 Mar 21]. (The Seeley Lectures). Available from: https://www.cambridge.org/core/books/women-and-human-development/58D8D2FBFC1C9E902D648200C4B7009E
Knowles C. Beyond adaptive preferences: Rethinking women’s complicity in their own subordination. Eur J Philos. 2022;30(4):1317–34.
Rotter JB. Generalized expectancies for internal versus external control of reinforcement. Psychol Monographs. 1966;80(1):1–28.
Schyns B, von Collani G. A new occupational self-efficacy scale and its relation to personality constructs and organizational variables. Eur J Work Organ Psychol. 2002;11(2):219–41.
Hannan A, Heckert J, James-Hawkins L, Yount KM. Cognitive interviewing to improve women’s empowerment questions in surveys: Application to the health and nutrition and intrahousehold relationships modules for the project-level Women’s Empowerment in Agriculture Index. Matern Child Nutr. 2020;16(1):e12871.
pubmed: 31288300
Jones R, Haardörfer R, Ramakrishnan U, Yount KM, Miedema S, Girard AW. Women’s empowerment and child nutrition: the role of intrinsic agency. SSM Popul Health. 2019;9:100475.
pubmed: 31993480
pmcid: 6978483