The SWPER index for women's empowerment in Africa: development and validation of an index based on survey data

Abstract

SummaryBackgroundThe Sustainable Development Goals strongly focus on equity. Goal 5 explicitly aims to empower all women and girls, reinforcing the need to have a reliable indicator to track progress. Our objective was to develop a novel women's empowerment indicator from widely available data sources, broadening opportunities for monitoring and research on women's empowerment.MethodsWe used Demographic and Health Survey data from 34 African countries, targeting currently partnered women. We identified items related to women's empowerment present in most surveys, and used principal component analysis to extract the components. We carried out a convergent validation process using coverage of three health interventions as outcomes; and an external validation process by analysing correlations with the Gender Development Index.Findings15 items related to women's empowerment were selected. We retained three components (50% of total variation) which, after rotation, were identified as three dimensions of empowerment: attitude to violence, social independence, and decision making. All dimensions had moderate to high correlation with the Gender Development Index. Social independence was associated with higher coverage of maternal and child interventions; attitude to violence and decision making were more consistently associated with the use of modern contraception.InterpretationThe index, named Survey-based Women's emPowERment index (SWPER), has potential to widen the research on women's empowerment and to give a better estimate of its effect on health interventions and outcomes. It allows within-country and between-country comparison, as well as time trend analysis, which no other survey-based index provides.FundingBill & Melinda Gates Foundation.

Women’s empowerment in Egypt: the reliability of a complex construct

“…Several intrinsic measures like attitudes towards gender norms and tolerance of IPV are also commonly used as measures of women's empowerment globally, 8,30,31 and in Egypt specifically. 13,17,28,[32][33][34] Attitudes towards gender norms is a scale comprised of questions about whether or not women believe women should do certain things, like employment, and be treated the same as men, like equal pay.…”

Mensuração de desigualdades sociais em saúde: conceitos e abordagens metodológicas no contexto brasileiro*

“…Among composite indicators of women's and children's health, one of the most frequently used is the CCI, which was developed by the Countdown initiative in 2015. 28 This composite indicator contemplates ongoing reproductive, maternal, neonatal and child health care, evaluating family planning, skilled attendant at birth, antenatal visits, vaccines (DPT3, BCG and measles), and care for diarrhea and suspected cases of pneumonia. 28,29 Findings from inequalities monitoring point toward the need to evaluate their various dimensions.…”

“…28 This composite indicator contemplates ongoing reproductive, maternal, neonatal and child health care, evaluating family planning, skilled attendant at birth, antenatal visits, vaccines (DPT3, BCG and measles), and care for diarrhea and suspected cases of pneumonia. 28,29 Findings from inequalities monitoring point toward the need to evaluate their various dimensions. Although the original analysis in this study was focused only on a socioeconomic indicator and on the area of residence, differences between geographic areas, ethnicities, age groups and sex/gender categories should be studied.…”

Women’s empowerment is associated with maternal nutrition and low birth weight: Evidence from Bangladesh Demographic Health Survey

“…Data collected included household characteristics, demographic characteristics of the household members, anthropometry of both the women and their children under 5 years of age, social characteristics and reproductive history of the women, treatment seeking behavior, husband's socio-demographic characteristics, woman's contribution to running the household and attitudes to violence, child's immunization status, and HIV AIDS diagnoses. To construct the WEI we used most of the indicators proposed by Ewerling et al (2017) [37] and additional indicators used in other studies [23,24,27,43]. We constructed the WEI as a composite of five groups of indicators : a) education, [27,37] b) access to socio-familial decision making (contraception use, woman's health care, children's health care, and relative's home visit), [23,24,37,43] c) economic contribution and access to economic decision making (spending of their own earnings, ability to purchase large house items, and NGO membership), [23,24,37,43]…”

“…attitudes towards domestic violence (physical violence justified in the following situations: if the women goes outside without informing her husband, neglects her children, argues with husband, and refuses to have sex), [24,37] and e) mobility (visits health center alone) [23,24,43]. All the indicator variables were categorized into ordinal variables.…”