Theses and Dissertations

Advisor

Ralston, Margaret

Committee Member

Brown, Dustin C.

Committee Member

Thompson, Diego

Committee Member

Leap, Braden

Date of Degree

5-16-2025

Original embargo terms

Visible MSU Only 2 Years

Document Type

Dissertation - Campus Access Only

Major

Sociology

Degree Name

Doctor of Philosophy (Ph.D.)

College

College of Arts and Sciences

Department

Department of Sociology

Abstract

Empowerment research has been long critiqued as lacking methodological and theoretical rigor, leading to inconsistent findings and misinterpretation. The impact of these limitations has been felt the most in Sub-Sahara Africa, where empowerment is strategically framed by development practitioners and advocates as a tool for achieving maternal and child health outcomes. To address some of these concerns, I develop a multidimensional, and theoretically grounded measure of empowerment using Principal Component Analysis and data from the most recent Demographic and Health Surveys (DSH) for 25 countries in Sub-Sahara Africa (SSA). I situate this new measure of empowerment within household and national-level social contexts. Building on the results from the new empowerment measure; I conduct two interrelated studies to validate the effect of these empowerment domains on maternal and child health among mother-child dyad. I find that women’s access to resources, a precondition for the empowerment process, was the most important empowerment factor. Access to resources showed a statistically significant association across all outcome variables, including child survival, number of antenatal visits (ANC), the timing of first ANC, and three forms of malnutrition (Wasting, stunting and underweight) in SSA. I note that two dimensions of empowerment; instrumental agency, and intrinsic agency, had selective effect on maternal and child health indicators across social contexts. Household differences accounted for a greater portion of the country variation on maternal and child health indicators. Factors such as place of residence, country gender parity in health, education, and standard of living had inconsistent and sometimes insignificant effects on maternal and child health outcomes. A notable finding from this research is that nearly a decade after the World Health Organization revised its global recommendation on antenatal care, compliance among SSA countries is lacking. This calls for urgent investigations to unravel the reason behind the nonresponse to these new recommendations and the potential role of empowerment in improving the current national response to the revised WHO recommendations on prenatal care.

Sponsorship (Optional)

Marion T. Loftin Writing Fellowship Fund

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