Determinants of Women\u27s Health Care Utilization, Child Survival and Child Immunization in Ghana: The Role of Empowerment

Over the last few decades, the field of research examining the social and cultural factors influencing the health outcomes of women and children has burgeoned significantly. Some of this research has focused on women\u27s empowerment: attempting to conceptualize notions of empowerment and to understand how factors of empowerment and its proxies, affect the health of women and their children. It is argued that establishing such connections will open up new avenues of possibilities to policy-makers. There is some inconsistency in the work in this field related to the measures of empowerment and differing definitions of the problem. Therefore, it was the objective of this dissertation to review the extent of the literature set in sub-Saharan Africa and to investigate the association between empowerment and health outcomes in Ghana specifically. Data for this dissertation came from a systematic review of the empowerment research between 1995 and 2017 and from the 2014 Ghana Demographic and Health Survey, a nationally representative survey of the Ghanaian population. The review of the literature suggested that empowerment research, set in sub-Saharan Africa, is a growing field of study with some 74 publications specifically examining the associations between various empowerment factors and health outcomes in the areas of family planning, health care utilization and disease knowledge and testing, among others. In Ghana, aspects of household decision-making, perceptions of spousal abuse and spousal age differences were associated with women\u27s utilization of health care. Similarly, maternal age, education, and domicile were associated with the child health outcomes of vaccination status and under-five mortality. Despite these findings, the majority of empowerment measures utilized in this analysis were not significantly associated with the health outcomes of Ghanaian women and their children. This dissertation also briefly discussed limitations of the analysis and future steps to be taken in this area of research.