WOMEN'S SOCIOECONOMIC DEVELOPMENT AND HEALTH

Columbia University Health Sciences, New York NY

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Linked publications & trials

Abstract

Throughout the developing world, there is evidence of declining rates of mortality and fertility, yet no clear understanding of the factors driving this change, nor the extent to which these health improvements are being experienced equitably by sub-sections of the population. This study uses data from Matlab, Bangladesh to explore the role of women's socioeconomic development in hastening health improvement and lessening health disparity. Its specific aims are to: 1) Consider the various determinants of health change and in particular, the relative importance of women's socioeconomic development versus health-specific interventions in explaining this change; 2) Evaluate socioeconomic and gender disparities in a variety of health outcomes and assess whether these inequities have been increasing or decreasing over the course of the decade; and 3) Specify the mechanisms through which women's socioeconomic development influences health behaviors and outcomes. The study benefits from access to one of the most established and accurate sources of demographic data in the developing world. Established in 1966, the Demographic Surveillance System (DSS) in Matlab monitors vital events on a population of over 200,000 by means of bimonthly household visits. Linked to the DSS registration system, the study employs a four-cell research design. The four cells are comprised of a sample of communities located in areas in which a women-focused NGO development program is operating; a sample population that is receiving intensive health outreach activities; a cell consisting of communities in which both women's socioeconomic development and health outreach activities are conducted; and a "comparison cell" where only government services are being provided. In 1992, baseline data were collected prior to the initiation of women's socioeconomic development activities on a random sample of 11,343 households. This survey was repeated in August 1998 to enable the assessment of the rate and magnitude of health change between and within the four cell design. A factorial design is employed to analyze these differences over time. In addition to the quantitative survey, the study will analyze qualitative data that monitor the experience of a sub-sample of women involved in socioeconomic development activities to shed further light on the mechanisms underlying health change.