- Title
- Women’s rights-based approach to gender equality for reducing maternal and child mortality
- Creator
- Bagade, Tanmay
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Background: Maternal and child mortality remains unacceptably high in low- and middle-income countries. In 2018, the global average of the maternal mortality ratio was 216 per 100,000 live births and the under-five child mortality rate stood at 42.5 per 1000 live births. This accounts to 830 maternal deaths and 15,000 under-five deaths per day globally. An estimated 200 million women’s demand for contraception is unmet due to lack of access or availability of contraception or lack of reproductive health autonomy. Women’s autonomy further affects healthcare use for self-care and child’s healthcare needs. A women’s rights approach to reduce maternal mortality ratio and under-five child mortality rate has shown promising results. However, inconsistency and unclear frameworks of the measures of gender equality have restricted the scope of gender equality policies to equality in education and non-discrimination. Gender equality is much more than these two factors, which emphasises the need to explore the women’s rights paradigm from a broader and global perspective. Therefore, the overarching aim of this thesis was to analyse the effect of gender equality on maternal and child mortality from a global perspective using a women’s rights approach. Methods: A systematic review investigated the current evidence of the influence of gender equality and contraception on maternal and child mortality. Two quantitative studies used structural equation modelling to investigate the effect of gender equality on maternal and under-five child mortality. Gender development indices were critically analysed in the fourth study. The findings of the two quantitative studies and the critical analysis of gender development indices helped to identify the key variables of gender equality. Using these variables, principal component analysis was used to design a new gender development index, the Newcastle Gender Development Index for Health in the final study. The index was validated with a widely used United Nations Development Programme’s Gender Inequality Index. Findings: In the systematic review, analysis of three included studies found that improved income status, secondary education attainment, lower prevalence of intimate partner violence and contraception use among women were associated with a reduction in under-five child mortality. The review highlighted gaps in the literature and the need to further investigate maternal and child mortality using a gender equality approach. The analysis of 521 gender-sensitive variables from 193 countries identified that increasing primary, secondary and tertiary education attainment, waged and salaried employment, female employers and women’s representation in leadership roles were associated with improved gender equality. A subgroup analysis also indicated that the prevalence of child marriage and intimate partner violence was strongly associated with decreased gender equality. Gender equality was significantly associated with the maternal mortality ratio and the under-five mortality rate. A critical analysis of 10 gender development indices indicated that currently there is no gold standard for the measurement of gender development, and all global indices currently published have limitations. For example, gender-based violence has been inadequately included in gender development indices despite being a significant indicator of women’s wellbeing. The health dimension of gender development was found to be weak across all available indices. As a result, a new index, the Newcastle Gender Development Index for Health, was designed in the final study using complete data from 90 countries for the following variables: secondary education attainment of women, waged and salaried employment, intimate partner violence and representation of women in leadership roles and parliament. Intimate partner violence was negatively associated with gender equality; therefore, countries with lower rates of intimate partner violence ranked significantly higher, despite showing a lack of progress in the other four variables (i.e., women’s secondary education attainment, prevalence of paid employment and participation in leadership and parliament). Similarly, countries with higher rates of intimate partner violence ranked lower even if they showed progress in other indicators of gender equality. The shift in ranking was chiefly attributed to the prevalence of intimate partner violence. Conclusion: The thesis adds significantly to the body of research relevant to the current era of sustainable development goals. The development of the Newcastle Gender Development Index of Health demonstrated that the primary focus globally should be to improve women’s secondary education, paid employment opportunities and leadership and parliament representation, and reduce gender-based violence. Intimate partner violence is the most crucial determinant of gender inequality, and countries must prioritise policies to reduce violence against women. Although designed with health outcomes in mind, the applicability of the Newcastle Gender Development Index of Health can be used to assess gender equality more generally. The Newcastle Gender Development Index of Health can be compared with other indices of human development to find new evidence. The study also highlighted that economic superiority alone does not mean that a country has progressed in improving gender equality. Using a women’s rights-based approach to reduce maternal and child mortality will significantly facilitate the attainment of the sustainable development goal targets.
- Subject
- gender equality; equity; gender based violence; index; gender development; domestic violence; intimate partner violence; global health; maternal; child; under five; mortality; womens rights; human rights; autonomy; womens health
- Identifier
- http://hdl.handle.net/1959.13/1470434
- Identifier
- uon:48468
- Rights
- This thesis is currently under embargo and will be available from 17.03.2024. Copyright 2021 Tanmay Bagade
- Language
- eng
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