Women's health efficacy in agricultural households in Bangladesh, Guatemala and Uganda: Comparing 2012 weai pilot data across three countries

Background: We utilize new household- and individual-level data to examine the influence of family structure and socioeconomic status (SES) on women's health efficacy in agricultural communities in Bangladesh, Guatemala and Uganda. These countries are part of the Women's Empowerment in Agriculture Index (WEAI) pilot study, an initiative of USAID, Feed the Future, IFPRI, and OPHI. Agricultural households are often under-represented in cross-national surveys, so much of what we know about women's efficacy may not be applicable to rural smallholder farmers. Because the WEAI is specifically designed for application within agricultural communities, it may add a significant new dimension to scholarship on the impact of inequality on women's empowerment and health efficacy. Methods: Using the 2012 WEAI pilot data and multilevel-modeling, we examine the impact of agricultural household characteristics on women's health efficacy. Specifically, we look at how household SES, women's education and women's work affect their control over personal health decision-making, family planning, and protection from violence. Because we are studying smallholder farmer households, we use multiple indicators for SES including wages, condition of dwelling, household hunger, water source, sewage source, and access to electricity. Results: We predict that women smallholder farmers: (1) of higher socioeconomic status, (2) who can read and write, and (3) who are wage-earners will have greater health efficacy than those of lower socioeconomic status who are not wage-earners and have little or no education. Conclusions: We compare 2012 WEAI results across three countries and discuss implications for gender and health equity in global context.