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Title: Decision-making Power for Women and Girls: Evaluating Interventions in Sexual and Reproductive Health in Sub-Saharan Africa
Citation Type: Dissertation/Thesis
Publication Year: 2020
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Abstract: The capacity to exercise choice for women and girls is an important development objective, but evidence on how health policies and programs affect decision-making is lacking in low-resource settings. This study aims to assess three different health interventions that may improve women’s and girls’ decision-making power in key life choices in sub-Saharan Africa. The first intervention consists of legal reforms that reduce restrictions on abortion, which may allow adolescent girls and young women to stay in school longer by delaying marriage and childbearing. I use a difference-in-differences approach to analyze the impact of expanding the legal grounds for abortion on marriage, birth, and schooling rates among adolescent girls and young women in 18 countries. The second intervention addresses financial barriers that might limit women’s ability to choose their preferred contraceptive methods. I use a propensity score approach combined with machine learning techniques to evaluate how free access to a broad contraceptive method mix affects women’s contraceptive choice in eight countries with high unmet needs for family planning. The third intervention distributes HIV self-tests through women with multiple sexual partners in Kenya. I use an instrumental variable approach to assess whether disclosing HIV-negative status affects women’s decision-making in intimate partner and transactional sex relationships. Each of these three analyses is presented as a different chapter with an overview that summarizes the results. Taken together, this study leverages rigorous econometric methods, fills important evidence gaps in the literature on gender and health, and informs policies to improve women’s and girls’ well-being in low-resource settings.
Url: https://www.proquest.com/docview/2436898223?pq-origsite=gscholar&fromopenview=true
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Authors: Chang, Wei
Institution: The University of North Carolina at Chapel Hill
Department: Health Policy and Management
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Pages: 1-117
Data Collections: IPUMS Global Health - DHS, IPUMS Global Health - PMA
Topics: Reproductive and Sexual Health
Countries: Benin, Burkina Faso, Burundi, Cameroon, Democratic Republic of the Congo, Ethiopia, Ghana, Kenya, Lesotho, Madagascar, Malawi, Mali, Mozambique, Niger, Nigeria, Rwanda, Senegal, Uganda, Zimbabwe