ABSTRACT
Background: Few studies have examined the influence of women's participation in farmer groups on female and male empowerment, which is considered essential to improving nutrition. Objectives: The study aimed to 1) assess the empowerment of Ghanaian women farmers, 1 adult male family decision-maker per household, and the household gender equality; and 2) investigate the relation of empowerment and household gender equality with women's participation in farmer-based organizations (FBOs), women's and men's nutritional status, and household food security. Methods: A cross-sectional study investigated secondary outcomes using baseline data from a nutrition-sensitive agriculture intervention implemented through FBOs in rural Ghana. Existing FBOs in 8 communities were selected based on 6 criteria (e.g., participation level, readiness to change). Female FBO (n = 166) and non-FBO (n = 164) members together with a male family member (n = 205) provided data on individual and household characteristics; empowerment was measured across 11 indicators with the project-level Women's Empowerment in Agriculture Index. Generalized linear mixed models tested the associations of empowerment and household gender equality with FBO membership, nutritional status, and household food security. Results: Women's FBO membership was associated with an increased likelihood of women's empowerment [adjusted odds ratio (aOR): 3.25; 95% CI: 1.97, 5.33] and household gender parity (aOR: 2.82; 95% CI: 1.39, 5.84) but not men's empowerment. Household food insecurity, but not nutritional status, was positively associated with women's FBO participation and individual empowerment indicators (financial services). Food insecurity was negatively associated with the women's empowerment indicator related to attitudes about domestic violence [adjusted ß coefficient (aß): -0.78; 95% CI: -1.35, -0.21] and men's overall empowerment (aß: -0.79; 95% CI: -1.58, -0.01). Conclusions: Understanding the complexity in which FBO participation, empowerment, nutritional status, and food security are linked is critical in designing interventions that promote gender equality and improved nutrition.This trial was registered at clinicaltrials.gov as NCT03869853.
ABSTRACT
Background. Though internal migration in Ghana has become increasingly common in recent years, research has not focused on the gendered experiences and perceptions of migration and the association with sexual and reproductive health risks for male and female migrants. Method. A qualitative study using semistructured interviews among migrant market workers and market leaders working in Agbogbloshie in Accra, Ghana, was completed in April 2018. Interview domains for the migrant interviews included the following: expectations of migration, current working and living conditions, sexual and reproductive health, access to health care, and self-reported health status. Qualitative data were analyzed using a combination of inductive and deductive coding in MAXQDA. Results. Data indicate that migrant workers have a variety of perceptions surrounding their migration experience. In the urban destination, migrants face a number of challenges that negatively affect their health, including poor accommodation, safety concerns, and low levels of social support. Reported risks to sexual and reproductive health were unsafe sexual encounters, such as low condom use and sexual assault. Discussion. The negative sexual and reproductive health outcomes among migrant populations in urban poor settings are a result of a confluence of factors, including perceptions of destination locations, working and living conditions, social support, and gender norms. A complex systems approach to understanding the sexual health of migrants is warranted. Conclusion. Findings from this research illustrate the complexity of health risks among migrants in Agbogbloshie. Further research is needed to explore the increased vulnerability of migrants compared with nonmigrants in urban poverty and the long-term implications of sexual and reproductive health risks in vulnerable migrant communities.
