Women’s economic empowerment and health related decision-making in rural Sierra Leone

Abstract

Maternal mortality rates during childbirth in Sierra Leone are amongst the highest globally, with 1360 maternal deaths per 100,000 live births. Furthermore, the country's neonatal mortality rate is estimated at 39 deaths per 1000 live births. There is growing recognition of the health consequences of gender inequality, but challenges in addressing it. Gendered power dynamics within households affect health outcomes, with men often controlling decisions about their family's health, including their family's use of health services. The Government's Free Health Care Initiative, which abolished user fees for pregnant women, lactating mothers and children under five is promising, however this reform alone is insufficient to meet health goals. Using in-depth interviews and focus group discussions with men and women, this study explores women's economic empowerment and health decisionmaking in rural Sierra Leone. Findings show the concept of power related to women's income generation, financial independence and being listened to in social relationships. Whilst women's economic empowerment was reported to ease marital tensions, men remained household authority figures, including regarding health decision-making. Economic interventions play an important role in supporting women's economic empowerment and in influencing gender norms, but men's roles and women's social empowerment, alongside economic empowerment, needs consideration.

Predictors of unmet need for contraception among adolescent girls and young women in selected high fertility countries in sub-Saharan Africa: A multilevel mixed effects analysis

“…These findings warrant further study to get deeper explanation. This is because, AGYW in such positions are often considered to be empowered with regards with their health issues, including the decision to use contraceptives [ 61 , 62 ]. However, it must be added that although AGYW in female-headed households and those who could take their own decisions may have the capacity to consider contraceptive use, the majority of them may still have unmet need for contraception due to barriers to access to reproductive health services among AGYW in SSA, including access and utilisation of contraceptives [ 63 – 65 ].…”

Women’s Well-Being and Rural Development in Depopulated Spain

“…Likewise, the inferiority complex that these women tend to have towards their urban counterparts, both professionally and socially speaking, is also a matter of concern. All this seems to bear out the cultural and social perception that people still have of 'rural or village women' [13], plus the greater social pressure exerted on them in these areas [46], often lowering their self-esteem and resulting in mental disorders like depression.…”

Neurocysticercosis in Northern Peru: Qualitative Insights from men and women about living with seizures

“…They are also the ones in charge of making decisions around health expenditures for individual members of the household, playing a key role in women’s health status and position within their household. For instance, studies on decisions around obstetric emergencies in rural Peru and elsewhere have documented the prominent role of male members of a family in key decisions when delivery complications started [ 31 , 32 ]. Such studies point to the importance of acknowledging the figures of authority within households to understand health-related decisions.…”