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Publication Detail
The Impact of Participatory Women’s Groups Alone or Combined with Cash and Food Transfers on Maternal Agency in Rural Nepal
  • Publication Type:
    Conference presentation
  • Authors:
    Gram L, Morrison J, Saville N, Shrestha B, Sundar Yadav S, Manandhar D, Costello A, Skordis-Worrall J
  • Date:
  • Name of Conference:
    International Economic Association World Congress 2017
  • Conference place:
  • Conference start date:
  • Conference finish date:
Participatory women’s groups (PWGs) have proven effective in reducing maternal and neonatal mortality in many settings. Qualitative evidence have supported claims that such interventions empower women, but quantitative evaluations have been lacking. This study compared the impacts of a PWG intervention alone or combined with unconditional food or cash transfers on women’s empowerment against a control arm. Our study was embedded in a four-arm cluster-randomized controlled trial aiming to reduce low birth weight in rural Nepal. 1309 pregnant women were interviewed in their third trimester between June and August 2015 and asked about their motivations for work outside the household, domestic work, health-seeking and group participation. The main outcome was overall agency freedom measured using the Relative Autonomy Index by Deci and Ryan. Our study found increased participation rates from 34% in the PWGs only arm to 90-96% in the combined PWGs and transfer arms. Intention-to-treat estimates revealed increased overall agency freedom scores in both transfer arms (p<0.01), but only weak evidence for an impact of WGs alone (p<0.1). Disaggregation of the full index revealed no evidence for disaggregated impacts on agency freedom in outside work, domestic work, health-seeking and group participation. Agency freedom in the group participation domain was increased in all three arms compared to control (p<0.01). Since incentives were usually distributed at the end of group meetings, unless women were physically unable to attend, our effects might simply reflect the additional value attached to the receipt of incentives. Our results are surprising given frequent claims that community mobilization through popular education empowers women. The results may be due to a focus on measuring empowerment in the household as opposed to the community domain. Our results also indicate that PWGs that are resourced externally with cash or food transfers may be better positioned to increase the agency freedom of pregnant women.
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