Women's empowerment has gained significant recognition in recent years. There is a growing acceptance now amongst development experts that improvements in the standard of health care and access to the same can be realized through improvements in social determinants of health. One such major pathway of improving the social determinants of health is the process of women's empowerment.
Women's empowerment has five components: women's sense of self-worth; their right to have and to determine choices; their right to have access to opportunities and resources; their right to have the power to control their own lives, both within and outside the home; and their ability to influence the direction of social change to create a more just social and economic order, nationally and internationally (United nations definition). Women’s autonomy is associated with better health seeking behavior, which in turn, is expected to lead to improved maternal and child health outcomes (Basu 1992).
Over half a million women from the developing world die each year of causes related to pregnancy and childbirth. A large number of these deaths can be prevented by access to quality health care. Lower rates of maternal and child mortality were observed among women with more decision-making power in India (Das Gupta 1990). ‘Empowerment of women’, is therefore, an important approach adopted in the Tenth Five Year Plan (2002-2007) for development of women in India. Five year plans are formulated by the Indian government to develop the Indian economy.
They are framed, executed and monitored by the Planning Commission of India. Women's employment plays a major role in enhancing their autonomy. This paper aims to study the relationship of women's employment status, an important component in enhancing women's empowerment and further improving their access to health care services in India. Conceptual Model: The conceptual model used in this study aims to determine the association of women's employment status and their access to health care services.
This model proposes that empowering women through employment can improve access to health care services. The model shows that employment of women has a positive association in increasing their access to cash and in decision making about their own health care. These components further increase their freedom of movement to go to the health facility and thereby increasing their access to health care. The model also proposes that employment of women can help in decreasing their need to ask for permission to seek health care and thereby not inhibiting their freedom of movement.
The model suggests that autonomy of the women is improved by their employment status and hence improving their access to health care services. Demographics (Employment status) (+) (+) Decision making participation (+) Access to cash (+) (+) (-) (+) (+) (-) (+) Access to health services (-) (+) Needs permission to access Freedom of movement (-) Various studies have demonstrated that there is a strong association between women's autonomy and their utilization of health care services.
Women's autonomy, as measured by the extent of a woman's freedom of movement, appears to be a major determinant of maternal health care utilization (Bloom, 2001). Many previous studies conducted in other developing countries have found maternal education to be an important determinant of maternal health care utilization (Elo 1992, Raghupathy 1996). Paid employment appears to empower married women towards participation in decision making (Acharya 2010) and also increase their access to health care (Chakraborty, 2003).
Some studies also have demonstrated that employment of women can reduce their utilization of health care and also have a detrimental effect on their health (Furuta, 2006) A large number of research articles have been published to explore dimensions of women’s autonomy and their relationship to utilization of maternal health care. Women’s autonomy is studied in a multidimensional nature. The analyses on health-seeking behavior during pregnancy and childbirth suggest that certain dimensions of women’s autonomy may be more important to healthcare utilization than others (Bloom 2001).
Women’s employment status in several studies was used as a determinant of women’s autonomy. This paper aims to determine if employment status of women is associated with improved access to health care. This study will help in determining whether employment status is one such dimension of women’s autonomy which is more important to healthcare utilization. Recognition of such dimensions can help us in developing and promoting programs empowering women in that specific dimension.
One of the challenges in studying this topic is that female employment is likely to be both a cause and a consequence of autonomy and empowerment. Women lacking empowerment may be barred from seeking employment—so employment could be one indicator of female empowerment. At the same time, employment itself is likely to enhance autonomy—by providing financial resources. Another challenge while studying female employment is that not always they are paid in cash, sometimes they are paid in kind.
There is strong evidence suggesting that females being paid in cash enjoy better household status and decision making power whereas women who are employed but do not earn cash are less likely than women not employed to participate in decision making. References: 1. Basu, A. M. Culture, the Status of Women and Demographic Behavior - Illustrated with the Case of India. Oxford: Clarendon; 1992 2. Monica Das Gupta (1990): Death Clustering, Mothers' Education and the Determinants of Child Mortality in Rural Punjab, India, Population Studies: A Journal of Demography, 44:3, 489-505 3.
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