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种姓和部落差异:理解印度妇女赋权和健康结果。

Disparity by caste and tribe: Understanding women's empowerment and health outcomes in India.

机构信息

Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.

出版信息

Soc Sci Med. 2024 Aug;354:117074. doi: 10.1016/j.socscimed.2024.117074. Epub 2024 Jun 27.

Abstract

AIM

Women's empowerment status varies greatly in India according to caste, class, ethnicity and region. This paper aims to investigate the caste/tribe disparity in women's empowerment by region, the main correlates of each domain of empowerment, and the association of women's empowerment with nutritional and health care access outcomes, specifically anaemia, menstrual hygiene, and institutional delivery.

METHODOLOGY

Using National Family Health Survey-5 (2019-2021) data, we have created a modified survey-based women's empowerment index (SWPER) using principal component analysis with Oblique varimax rotation. The first four components are interpreted as an attitude to violence, freedom of movement, decision-making power and social independence. Several multivariate regression models were used to understand the factor associated with empowerment and the association of women's empowerment with different health outcomes.

RESULTS

The results indicate that women from the forward castes are the most empowered in most domains except decision-making. However, after controlling other background variables, the forward castes women are found to be the most empowered in attitude to violence, whereas Scheduled Castes and Scheduled Tribes women were found to be the most empowered women in decision-making. With regards to social independence, deprived castes women are more empowered than the forward castes women. The likelihood of empowerment in social independence domain increases with increasing wealth. There are wide regional variations in empowerment level between different social groups. Caste/tribe identity plays a significant role in determining health outcomes in India. Among all empowerment domains, social independence emerges as the most significant associated factor with improved health across all caste/tribe groups.

CONCLUSION

The path to women's empowerment in India must recognize the intersectionality of caste/tribe identities, and address regional disparities. Social independence emerges as a critical determinant across all caste/tribe groups for improving health. Measures should be taken to empower women through the underlying factors of social independence.

摘要

目的

印度女性的赋权状况因种姓、阶级、种族和地区而异。本文旨在研究按地区划分的种姓/部落之间的女性赋权差异、赋权各领域的主要相关因素,以及女性赋权与营养和医疗保健获取结果(特别是贫血、月经卫生和机构分娩)之间的关联。

方法

我们使用 2019-2021 年国家家庭健康调查-5(NFHS-5)的数据,使用主成分分析和斜交方差旋转创建了一个改良的基于调查的女性赋权指数(SWPER)。前四个分量解释为对暴力的态度、行动自由、决策权和社会独立性。我们使用了几个多元回归模型来了解与赋权相关的因素以及女性赋权与不同健康结果之间的关联。

结果

结果表明,除决策外,前种姓的女性在大多数领域最具赋权。然而,在控制其他背景变量后,发现前种姓的女性在对暴力的态度方面最具赋权,而在册种姓和在册部落的女性在决策方面最具赋权。就社会独立性而言,贫困种姓的女性比前种姓的女性更赋权。社会独立性领域的赋权可能性随着财富的增加而增加。不同社会群体之间的赋权水平存在广泛的地区差异。种姓/部落身份在决定印度的健康结果方面起着重要作用。在所有赋权领域中,社会独立性是所有种姓/部落群体中与改善健康最相关的因素。

结论

印度女性赋权的道路必须认识到种姓/部落身份的交叉性,并解决地区差异。社会独立性是所有种姓/部落群体改善健康的关键决定因素。应采取措施通过社会独立性的潜在因素赋予女性权力。

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