Skip to main content
PLOS One logoLink to PLOS One
. 2024 Mar 29;19(3):e0301501. doi: 10.1371/journal.pone.0301501

Assessing the pattern of key factors on women’s empowerment in Bangladesh: Evidence from Bangladesh Demographic and Health Survey, 2007 to 2017–18

Sahera Akter 1,*, Md Solayman Hosen 1,#, Md Shehab Khan 1,#, Bikash Pal 1
Editor: Mohammad Nayeem Hasan2
PMCID: PMC10980244  PMID: 38551958

Abstract

Background

With half a female population, empowering women can be a key factor in our country’s global advancement. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how different socio-economic and demographic factors associated with women’s empowerment evolve over the past decade in Bangladesh (from BDHS 2007 to BDHS 2017–18).

Methods

Data from four waves of Bangladesh Demographic and Health Survey (BDHS, 2007 to BDHS, 2017–18) were used in this study. We put forth two domains—household decision-making and attitudes toward domestic violence—to assess women’s empowerment. Principal component analysis (PCA) was employed to create women’s empowerment index. To assess the unadjusted association between the selected covariates and women’s empowerment, Pearson Chi-square test and ANOVA F test have been used, while adjusted association has been analyzed through proportional odds model (POM).

Results

In BDHS 2017–18, women from urban areas experienced ‘high’ empowerment than women in rural areas (56.08% vs. 45.69%). A notable change has been observed in the distribution of women’s empowerment index by education over the survey years. Findings also showed that in all the survey years, division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head have been found to have significant association with women’s empowerment index. For instance, women who completed secondary education in 2007, 2011, 2014, and 2017–18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, age at first marriage, spousal age gap, NGO membership etc. emerged as a contributing factor in specific survey years.

Conclusion

Our study affirmed that, over a ten-year period, women were more likely to protest against physical violence and to participate in various decision-making regarding their personal and social life. Empowerment is notably higher among women in urban residents, those with secondary education, 1–2 children, media exposure, and employment. Policy recommendations should emphasize targeted measures to raise awareness and empower uneducated, unemployed, economically disadvantaged, and physically oppressed women.

Introduction

Women’s empowerment is a pivotal focus in global development, recognized as essential for sustainable economic growth and poverty reduction [1]. Defined as an interactive process facilitating personal and communal change, empowerment enables individuals to impact institutions affecting their lives and communities [2]. Specifically, women’s empowerment denotes their full participation in economic, political, and social spheres [2,3], critical for comprehensive social and economic development.

In developing countries, gender inequality poses a significant challenge [4], violating human rights and impeding both women’s empowerment and national development. The Global Gender Gap Index, incorporating educational attainment, health, political empowerment, and economic participation, highlights Bangladesh’s standing as the 65th country out of 156, indicating persistent gender inequality [5]. Notably, Bangladesh excels in women’s political empowerment, with women well-represented in national legislatures [6]. Despite these strides, challenges persist, as evidenced by the prevalence of gender bias and violence against women, particularly in less-developed countries.

Aligned with international commitments such as the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and the Sustainable Development Goals (SDGs), Bangladesh has made notable efforts to eradicate gender-based discrimination and violence [79]. The importance of women’s empowerment is underscored by the global Sustainable Development Goal 5, aiming to end gender imbalance and violence against females by 2030 [10]. Additionally, the third Millennium Development Goal emphasizes progress toward closing the gender gap and enhancing women’s political and economic influence [8].

In Bangladesh, despite these commitments, challenges persist. Gender-based violence, especially within households, remains a concern, affecting approximately 54.2% of married women [11]. The sheer size of the female population, constituting 50.46% of the total, accentuates the potential for substantial societal progress through increased women’s empowerment [12].

Numerous studies have explored potential variables influencing women’s empowerment in Bangladesh and globally [1317]. For instance, studies using data from DHS 2010 and BDHS 2014 proposed indicators like women’s participation in household decision-making and opinions concerning wife abuse [13,14]. Further, a study emphasized primary components of women’s empowerment, including employment status, self-worth, self-confidence, decision-making ability, and awareness [15]. An evidence-based analysis suggested indicators such as personal freedom, household decision-making, domestic financial decisions, and political independence, exploring the impact of social media, education, community cultural values, women’s employment, and household participation rate on women’s empowerment [16]. Another study focused on women’s empowerment through access to health information, finding that urban-dwelling, educated, working, middle-aged women had better decision-making abilities [17].

This study aims to identify factors contributing to women’s empowerment in Bangladesh, filling a gap in existing literature. Unlike prior studies, our research uniquely utilizes four waves of BDHS data (2007, 2011, 2014, and 2017–18) to assess temporal changes in covariates impacting women’s empowerment. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how these factors evolve over the past decade in Bangladesh. Through a comprehensive analysis of evolving factors, we strive to contribute valuable insights into the dynamic landscape of women’s empowerment in Bangladesh.

Data and methodology

Data

Data from the nationally representative Bangladesh Demographic and Health Survey (BDHS) have been extracted for conducting analysis on women’s empowerment. To explore the changes in women’s empowerment for one decade, we have used data from four waves of BDHS, collected in 2007, 2011, 2014, and 2017–18. These were nationally representative cross-sectional surveys based on a two-stage stratified sample of households. The details of the survey design are described in detail elsewhere [1822].

In general, in the first stage, a certain number of enumeration areas, EAs (EAs varied for different BDHS) were selected with probability proportional to EA size and with independent selection in each sampling stratum. In the second stage of selection, a fixed number—30 households per cluster—were selected with an equal probability of systematic selection from the newly created household listing. In these surveys, only ever-married women of age 15–49 were interviewed, an exception was found for BDHS 2011 in which ever-married women aged 12–49 were interviewed. But making it analogous to other datasets, we have only taken information about the women who belong to reproductive age 15–49. Missing observations have been eliminated, leaving us with a total of 8931, 16274, 16350, and 18723 observations, respectively.

Ethics approval and consent to participate

The Institutional Review Board of ICF International, Rockville, Maryland, USA (Macro International is now known as ICF International) reviewed and gave their approval to The Demographic and Health Surveys (DHS) Program. 2007, 2011, 2014, and 2017–18 Bangladesh DHS were categorized under that approval. Furthermore, the 2011 and 2017–18 Bangladesh DHS also received approval from another ethical committee: The Bangladesh Medical Research Council. These BDHS were implemented under the authority of the National Institute of Population Research and Training (NIPORT) of the Government of the People’s Republic of Bangladesh with financial support from USAID/Bangladesh. Prior to asking, informed consent was obtained from each survey participant. Respondents who refused to consent were not included in the survey.

Outcome variable

Construction of women’s empowerment indices

In the conceptual framework (Fig 1), we considered a total of nine questions which were classified into two broad dimensions; household decision-making and attitudes toward wife beating [1924]. BDHS collected information on household decision-making: (1) their own health care, (2) major household purchases, (3) their child’s health care (this information is missing in BDHS 2017–18 data), and (4) visits to their family or relatives. For the above decisions, we made four binary variables (yes/no) where “yes” was defined for the responses of “respondent alone”, “respondent and husband/partner” or “respondent and other person”, and “no” for otherwise. This index is positively related to women’s empowerment and for analysis purposes, these questions were recoded (i.e., 1 for “yes” and 0 for “no”). The second index, containing five indicators, was used to gauge women’s attitudes toward wife beating. Women were asked if they thought a husband had the right to hit his wife if she (1) refused to have sex with him, (2) left the house without his consent, (3) neglected the children, (4) argued with him, or (5) burned the food. The response “yes” to the above questions means that she believes wife-beating is justified and “no” means she rejects wife-beating for that particular reason. As this index is negatively related to women’s empowerment, for the analysis purposes, these questions were recoded oppositely from the first indicator (i.e., 1 for “no” & 0 for “yes”). For creating the women’s empowerment index (WEI), principal component analysis (PCA) has been used with all nine indicators (4 decisions and 5 reasons) [14,18]. Principal components (PCs), with their unique variance features, are normalized linear combinations of random (original) variables. Variance of a principal component is the eigenvalue associated with it. Ratio of kth eigenvalue to the sum of all the eigenvalues represents the proportion of variation explained by the kth component [25]. Here, in this study, after PCA, nine PCs (for BDHS 2007 and 2017–18, eight PCs) have been generated among which the first principal component was regarded as the women’s empowerment score (WES) since most of the variations in the data were explained by it. The WES was further broken down into 3 equal portions based on quantiles; labeled low, middle, and high for domains below the first, in between the first and second, and above the second quantile, respectively. Finally, our preferred outcome metric is the score index with three ordered categories (i.e., low, medium, and high), where these categories indicate order-wise how empowered a woman is (i.e., low means women have low empowerment) [14,18].

Fig 1. Conceptual framework for women’s empowerment.

Fig 1

Covariates

On the basis of some previous works of literature, the covariates included in this study are age at first marriage, spousal age gap, respondent’s education level, education gap, respondent’s current working status, number of living children, religion, number of household members, division, place of residence, media exposure, NGO membership, wealth index, husband’s occupation, relationship with household head, and sex of household head [14,2630]. All of these variables could not be directly extracted from the survey. We had to construct many of these with the help of directly available variables. The definition and their measurements (including categories) of variables are given in Table 1.

Table 1. Definition and measurements of the variables based on BDHS data (from 2007 to 2017–18).

Covariates Measurements
Division Original dataset had eight divisions: Barisal, Chittagong, Dhaka, Khulna, Mymensingh (missing in 2007, 2011, and 2014 BDHS data as then it was not declared as a division), Rajshahi, Rangpur (was not declared as a division at the time of 2007 BDHS), Sylhet [1922].
Place of residence This variable was categorized as: urban and rural [1922].
Age at first marriage Age at first marriage was categorized into two categories as: below 18 years and 18 or 18+ years [14,27].
Spousal age gap Spousal age gap was measured by taking the difference between spousal ages [14].
Respondent’s education level
Four categories were created by the survey as: no education, primary, secondary, and higher [14,1922].
Education gap The difference between the education levels of the spouses was divided into three categories—no gap, wife with lower education, and wife with higher education [14,27].
Number of living children Number of living children was categorized into four categories: no child, 1–2, 3–4, and 4+ children [1922,27].
Difference between sons and daughters This variable was made by deducting the total number of daughters from the total number of sons. Negative results indicate a gap in which there are more daughters, positive numbers indicate more sons, and zero means simply no difference between daughter and son [14].
Number of household members Categorized into three categories: 1–4 members, 5–7, and 7+ members [1922].
Wealth index The original dataset had five categories: poorest, poorer, middle, richer, and richest [1922].
Religion Islam, Hinduism, Buddhism, and Christianity comprised the four categories of religion in the original dataset. However, for the sake of the study, the religion has been reclassified into two groups: Muslim (Islam) and non-Muslim (Hinduism, Buddhism, and Christianity) [18,19].
Media exposure A woman is exposed to the media if she has access to either of the media sources (Categories: Yes/No) based on the variables of watching TV, listening to the radio, and reading newspapers and magazines [14,26,2830].
NGO membership Women’s NGO membership was divided into two groups: "yes" if they are members of any one of the following organizations: Grameen Bank, BRAC, BRDB, ASHA, Proshika, Mother’s Club, or other NGOs; and "no" if they are not [14,28,29]. However, because NGO activities are considerably declining in Bangladesh, data on these aspects was missing from the most recent BDHS 2017–18 data. The fact that the government offers more facilities than NGOs could be one of the causes [30].
Working status Working status had two categories: yes and no [14,1922,26].
Husband’s occupation Husband’s occupation was categorized into seven categories as farmer, labor, service, large business, small business, unemployed and other [14].
Relationship with household head Survey created eleven categories as: head, wife, daughter, daughter-in-law, grand-daughter, mother, mother-in-law, sister, other relative, adopted/foster child and other [1922].
Sex of household head Sex of household head was divided into two groups: male and female [1922].

Statistical analyses

Simple descriptive, bivariate, and multivariate statistical analyses were performed to achieve different objectives in this study. The univariate analysis was performed to investigate the individual frequency percentage of the selected two indicators comprising women’s empowerment in the four consecutive BDHS surveys. In the bivariate analysis of women’s empowerment with different selected variables, the Pearson Chi-square test and ANOVA F-test have been applied as an attempt to find out the unadjusted association between women’s empowerment and selected covariates. The covariates with p-value <0.05 has been considered significantly associated with the outcome variable and obtained significant covariates in at least any one study year have been included in the multivariable regression model. Since we have an ordinal response variable, the ordinal logistic regression model was used to find out the adjusted effects of covariates on women’s empowerment. To assess the goodness of fit for the fitted model, the likelihood ratio test (LRT) has also been used [26]. All the analyses were performed with the help of two statistical software packages: SPSS version 20, for data sorting, cleaning, etc. and STATA version 14.0, for the analysis purpose.

Ordinal logistic regression model

With qualitative response variables, binary logistic, ordinal logistic, and multinomial logistic regression models can be used for analyzing data. But when analyzing polychotomous data, the ordinal logistic regression model gives a more accurate and efficient estimate of regression coefficients where the response variable acts in an ordinal way with each predictor. In our study, we have response variable (women’s empowerment) with three ordered categories (low, medium, and high). Hence, proportional odds model (POM) has been employed in this study.

Suppose a response variable Y with categorical outcomes, denoted by 0, 1, 2,…,k, and let x˜ denote a p- dimensional vector of covariates.

If Pr[Yj|x˜]=πj is the cumulative logistic distribution function,

Then,

odds=Pr[Yj|x˜]1Pr[Yj|x˜]=πj1πj=exp(αj+x˜β˜) (1)

And the dependence of Y on x˜ for the proportional odds model has the following representation:

logit(πj)=log[πj1πj]=αj+x˜β˜=αj+β1x1+β2x2++βpxp,j=1,2,,k&i=1,2,,p (2)

where, αj is the jth intercept, x˜=(x1,x2,,xp) and β˜=(β1,β2,,βp) is the p×1 vector of unknown regression coefficients corresponding to x˜ [3134].

Results

To see how the situation involving women’s empowerment improved over the study years, the percentage distribution of variables regarding decision-making and attitudes toward violence has been utilized (Fig 2). In BDHS 2007, 86.8% of women reported having freedom of decision-making, which decreased in 2011 to 82.2%. But in 2014, it again increased about 0.9%, and hit a record high of 88.1% in 2017–18. This implies that women in Bangladesh have acquired greater autonomy in household decision-making. Conversely, the percentage of women who were against violence towards them increased about 28.9% from 2007 to an all-time high percentage of 97.7% in 2011. In the next survey year, it dropped to 71.1%. However, in 2017–18, it increased to 80.4%. While there was a spike in 2011, women’s perceptions of the justification of violence have improved across the survey years.

Fig 2. Distribution of freedom of decision-making and attitudes toward justification of violence over four waves of BDHS (2007 to 2017–18).

Fig 2

Table 2 outlines the percentage distribution of the women’s empowerment index (WEI) by selected covariates over the survey years. It reveals that women living in urban areas experienced ‘high’ empowerment than their counterparts in rural areas in four waves of BDHS. For instance, urban (vs. rural) women who reported a high level of empowerment were 39.56% (vs. 29.01%), 36.90% (vs. 26.89%), 36.76% (vs. 29.12%), and 56.08% (vs. 45.69%), respectively, from 2007 survey to 2017–18 survey. Over the survey years, a notable change has been observed in the distribution of WEI by education. To be specific, the highest percentage of women with secondary education getting ‘high’ empowered was recorded in 2017–18 BDHS

Table 2. Women’s empowerment index (WEI) by demographic and socioeconomic characteristics, BDHS 2007 to BDHS 2017–18.

Covariates BDHS 2007 BDHS 2011 BDHS 2014 BDHS 2017–18
Low Medium High Low Medium High Low Medium High Low Medium High
Division
Dhaka 26.36% 36.26% 37.37% 29.24% 37.21% 33.55% 26.14% 34.21% 39.65% 21.42% 25.74% 52.84%
Chittagong 39.81% 30.53% 29.66% 37.88% 34.52% 27.61% 33.86% 31.70% 34.43% 24.60% 26.20% 49.20%
Barisal 41.86% 34.29% 23.85% 32.17% 33.84% 33.99% 40.82% 32.60% 26.58% 29.32% 26.86% 43.83%
Khulna 27.50% 35.12% 37.37% 26.74% 41.36% 31.91% 36.30% 33.77% 29.93% 23.60% 27.26% 49.15%
Mymensingh - - - - - - - - - 20.75% 20.02% 59.23%
Rajshahi 26.12% 38.19% 35.68% 40.66% 37.11% 22.23% 33.12% 38.91% 27.97% 24.87% 25.78% 49.36%
Rangpur - - - 27.86% 32.91% 39.24% 29.71% 37.83% 32.46% 22.66% 27.51% 49.83%
Sylhet 46.61% 22.71% 30.68% 40.43% 36.20% 23.37% 41.09% 31.54% 27.37% 27.16% 31.78% 41.06%
p-value <0.001 <0.001 <0.001 <0.000
Place of residence
Urban 27.75% 32.69% 39.56% 26.07% 37.03% 36.90% 27.96% 35.28% 36.76% 19.58% 24.35% 56.08%
Rural 37.22% 33.77% 29.01% 37.24% 35.87% 26.89% 36.90% 33.98% 29.12% 26.77% 27.54% 45.69%
p-value <0.001 <0.001 <0.001 <0.001
Age at first marriage
Age<18 35.23% 33.48% 31.28% 34.46% 35.92% 29.62% 35.16% 34.35% 30.49% 25.46% 25.94% 48.61%
Age≥18 26.92% 32.85% 40.23% 29.53% 37.48% 32.99% 29.69% 34.66% 35.65% 20.50% 27.59% 51.91%
p-value <0.001 <0.001 <0.001 <0.001
Spousal age gap
Mean 9.79 9.34 9.38 9.34 9.03 9.13 9.19 8.79 8.91 8.44 8.36 8.45
(SD) (7.43) (6.96) (7.05) (5.74) (5.42) (5.31) (6.04) (5.46) (5.46) (5.35) (5.21) (5.36)
p-valueA 0.001 <0.001 <0.001 0.055
Education level
No education 37.08% 33.27% 29.64% 37.10% 35.50% 27.40% 37.82% 31.17% 31.01% 27.66% 23.14% 49.20%
Primary 37.10% 32.75% 30.15% 37.14% 34.29% 28.57% 36.51% 34.32% 29.17% 26.27% 25.37% 48.35%
Secondary 31.99% 34.69% 33.32% 31.74% 37.97% 30.29% 33.03% 35.44% 31.53% 24.21% 27.74% 48.05%
Higher 12.72% 30.99% 56.29% 16.47% 38.11% 45.42% 20.35% 37.98% 41.68% 15.81% 28.14% 56.05%
p-value <0.001 <0.001 <0.001 <0.001
Education gap
No difference 32.91% 32.82% 34.26% 32.57% 37.00% 30.43% 33.74% 34.14% 32.12% 23.23% 26.02% 50.75%
Higher than partner 36.17% 34.09% 29.73% 32.50% 36.06% 31.44% 34.79% 35.58% 29.63% 25.93% 27.13% 46.94%
Lower than partner 33.02% 33.73% 33.25% 36.02% 34.88% 29.10% 33.03% 33.75% 33.22% 23.93% 26.20% 49.87%
p-value 0.006 0.002 0.011 <0.001
Number of living children
No child 57.36% 18.27% 24.37% 48.58% 44.75% 6.67% 48.06% 44.25% 7.68% 34.59% 31.97% 33.44%
1–2 31.18% 34.75% 34.07% 30.59% 35.42% 33.99% 32.21% 33.60% 34.18% 22.76% 26.48% 50.76%
3–4 33.08% 33.05% 33.87% 31.75% 35.41% 32.84% 30.92% 33.59% 35.48% 22.61% 24.56% 52.83%
4+ 40.81% 31.34% 27.85% 37.51% 34.58% 27.91% 38.31% 31.00% 30.69% 26.23% 24.92% 48.85%
p-value <0.001 <0.000 <0.001 <0.001
Difference between sons and daughters
No difference 33.72% 33.30% 32.99% 35.76% 38.18% 26.06% 37.10% 36.06% 26.84% 25.28% 27.66% 47.06%
More sons 33.75% 33.25% 33.01% 31.97% 35.63% 32.40% 32.76% 33.18% 34.06% 23.47% 26.08% 50.45%
More daughters 33.52% 33.65% 32.83% 32.59% 35.26% 32.15% 32.08% 34.30% 33.62% 23.80% 25.45% 50.75%
p-value 0.998 <0.001 <0.001 <0.001
Number of household members
1–4 28.64% 34.25% 37.11% 28.47% 36.53% 35.00% 29.71% 34.46% 35.84% 20.58% 24.59% 54.84%
5–7 34.39% 33.35% 32.26% 34.80% 35.51% 29.69% 34.99% 34.02% 30.98% 25.58% 26.69% 47.73%
7+ 40.02% 32.03% 27.95% 40.49% 37.65% 21.86% 41.85% 35.43% 22.71% 30.24% 30.52% 39.24%
p-value <0.001 <0.001 <0.001 <0.001
Religion
Non-Muslim 32.03% 37.17% 30.80% 28.19% 37.38% 34.43% 29.82% 33.04% 37.14% 18.87% 27.58% 53.55%
Muslim 33.86% 32.94% 33.19% 34.01% 36.13% 29.86% 34.28% 34.57% 31.15% 24.73% 26.24% 49.03%
p-value 0.039 <0.001 <0.001 <0.001
Media exposure
No 40.64% 32.12% 27.23% 40.00% 33.11% 26.90% 40.80% 31.59% 27.60% 28.93% 24.97% 46.11%
Yes 29.85% 34.05% 36.10% 30.02% 37.86% 32.12% 29.85% 36.05% 34.10% 21.63% 27.12% 51.26%
p-value <0.001 <0.001 <0.001 <0.001
NGO membership
No 33.52% 32.51% 33.97% 34.20% 36.19% 29.61% 34.90% 33.95% 31.15%
Yes 33.94% 34.72% 31.34% 31.43% 36.46% 32.11% 31.81% 35.33% 32.85%
p-value 0.022 0.001 <0.001 -
Wealth index
Poorest 37.37% 33.88% 28.75% 39.35% 33.77% 26.88% 42.04% 32.10% 25.85% 28.40% 24.25% 47.34%
Poorer 40.9% 32.07% 27.04% 39.84% 33.63% 26.54% 38.76% 33.16% 28.08% 27.48% 25.77% 46.75%
Middle 39.58% 32.03% 28.40% 37.54% 35.50% 26.97% 35.30% 35.12% 29.59% 25.39% 27.88% 46.73%
Richer 33.22% 35.27% 31.50% 31.70% 39.23% 29.07% 32.41% 35.97% 31.62% 23.48% 28.61% 47.92%
Richest 22.34% 33.46% 44.20% 22.05% 38.12% 39.83% 22.88% 35.27% 41.85% 17.28% 25.33% 57.39%
p-value <0.001 <0.001 <0.001 <0.001
Working status
No 36.12% 32.35% 31.53% 34.76% 36.43% 28.81% 35.69% 33.86% 30.45% 25.38% 28.91% 45.71%
Yes 27.51% 35.93% 36.56% 22.75% 35.12% 42.14% 29.66% 35.70% 34.64% 22.77% 23.55% 53.68%
p-value <0.001 <0.001 <0.001 <0.001
Husband’s occupation
Farmer 37.93% 34.99% 27.09% 37.56% 35.13% 27.32% 38.24% 33.43% 28.32% 26.07% 26.42% 47.51%
Labor 34.16% 32.33% 33.51% 33.42% 37.19% 29.39% 33.76% 34.47% 31.77% 24.59% 26.44% 48.97%
Service 13.80% 29.49% 56.71% 19.35% 37.30% 43.35% 19.11% 35.97% 44.92% 13.66% 24.56% 61.78%
Large business 26.59% 37.19% 36.22% 27.46% 36.90% 35.64% 26.95% 32.93% 40.12% 17.75% 29.65% 52.61%
Small business 35.20% 34.19% 30.60% 33.26% 35.71% 31.02% 33.53% 35.71% 30.76% 24.96% 26.42% 48.62%
Unemployed 35.17% 28.28% 36.55% 38.01% 35.59% 26.39% 45.28% 33.02% 21.70% 25.00% 0.0% 75.00%
Others 30.61% 27.55% 41.84% 42.19% 29.69% 28.13% 38.36% 31.48% 30.16% 24.43% 25.80% 49.77%
p-value <0.001 <0.001 <0.001 <0.001
Relationship with household head
Head 21.85% 28.15% 50.00% 20.21% 30.05% 49.73% 23.00% 29.07% 47.93% 16.76% 19.72% 63.53%
Wife 32.77% 34.05% 33.18% 30.93% 35.92% 33.14% 31.93% 34.06% 34.01% 21.73% 24.91% 53.36%
Daughter 33.68% 31.95% 34.37% 36.64% 39.31% 24.05% 35.97% 38.52% 25.51% 22.85% 31.25% 45.90%
Daughter-in-law 45.21% 33.33% 21.45% 48.95% 37.35% 13.70% 47.81% 35.63% 16.56% 41.76% 33.08% 25.16%
Grand-daughter 25.00% 50.00% 25.00% 71.43% 23.81% 4.76% 29.17% 54.17% 16.67% 18.42% 42.11% 39.47%
Mother 50.00% 15.00% 35.00% 38.94% 36.28% 24.78% 35.00% 37.00% 28.00% 29.52% 29.52% 40.95%
Mother-in-law 27.27% 36.36% 36.36% 11.54% 65.38% 23.08% 34.78% 21.74% 43.48% 28.57% 7.14% 64.29%
Sister 39.68% 28.57% 31.75% 38.12% 39.01% 22.87% 31.58% 39.47% 28.95% 17.86% 31.25% 50.89%
Other relative 36.08% 34.12% 29.80% 39.22% 39.75% 21.02% 41.04% 36.85% 22.11% 29.33% 31.73% 38.94%
Adopted child 75.00% 25.00% 0.0% 25.00% 25.00% 50.00% 40.00% 20.00% 40.00% 14.29% 71.43% 14.29%
Not related 25.0% 50.00% 25.00% 40.00% 30.00% 30.00% 30.77% 46.15% 23.08% 14.29% 28.57% 57.14%
p-value <0.001 <0.001 <0.001 <0.001
Sex of household head
Male 34.20% 33.84% 31.96% 33.79% 36.55% 29.66% 34.44% 34.78% 30.78% 24.55% 26.67% 48.79%
Female 28.14% 28.27% 43.59% 27.74% 32.71% 39.55% 27.87% 30.74% 41.39% 21.08% 24.16% 54.75%
p-value <0.001 <0.001 <0.001 <0.001

p-valueA: p-value of ANOVA F-test.

(48.05%), followed by 2007 BDHS (33.32%), 2014 BDHS (31.53%), and 2011 BDHS (30.29%). In addition, higher-educated women reported having ‘high’ empowerment were 3.5 times as having ‘low’ empowerment (15.81% against 56.05%) in BDHS 2017–18. Moreover, the level of empowerment among women with 1–2 children is higher than that of women with no children. In 2017–18 BDHS, 50.76% of women having 1–2 children experienced high empowerment, which was 34.07% according to BDHS 2007. Similarly, compared to other study years, a greater percentage of women who are exposed to mass media (51.26%) reported having high empowerment in 2017–18 BDHS. However, from the Pearson Chi-square and ANOVA F-test p-values, the study finds significant bivariate association for all the selected covariates with women’s empowerment.

A summary of the multivariable analysis results that were obtained by fitting the proportional odds model is compiled in Table 3. The overall goodness of fit of the model for each study survey has been checked through the likelihood ratio test (LRT) based on chi-square distribution. As the p-value for the corresponding LRT was less than 0.001 for each survey model, the LRT ensured that model was well fitted. Multivariable analysis results demonstrate the adjusted odds ratios (OR) for women’s empowerment from BDHS 2007 to 2017–18. All the covariates except the sex of the household head were found to have a significant effect on women’s empowerment in at least any one study year. The odds of experiencing empowerment

Table 3. Association between different background characteristics with women’s empowerment obtained from adjusted proportional odds model (POM).

Background characteristics BDHS 2007 BDHS 2011 BDHS 2014 BDHS 2017–18
OR p-value OR p-value OR p-value OR p-value
Division
Dhaka 1 1 1 1
Chittagong 0.658 <0.001 0.730 <0.001 0.772 <0.001 0.937 0.224
Barisal 0.597 <0.001 1.014 0.797 0.593 <0.001 0.770 <0.001
Khulna 0.999 0.994 1.053 0.319 0.658 <0.001 0.908 0.077
Mymensingh - - - - - - 1.475 <0.001
Rajshahi 0.998 0.973 0.605 <0.001 0.693 <0.001 0.949 0.349
Rangpur - - 1.336 <0.001 0.900 0.051 0.967 0.554
Sylhet 0.641 <0.001 0.670 <0.001 0.643 <0.001 0.765 <0.001
Place of residence
Urban 1 1 1 1
Rural 0.874 0.006 0.838 <0.001 0.921 0.022 0.758 <0.001
Age at first marriage
Age<18 1 1 1 1
Age≥18 1.165 0.008 1.059 0.147 1.126 0.002 1.090 0.017
Spousal age gap 0.997 0.300 1.005 0.049 0.992 0.003 1.001 0.771
Education level
No education 1 1 1 1
Primary 1.033 0.557 1.055 0.225 1.033 0.474 1.166 0.001
Secondary 1.144 0.040 1.318 <0.001 1.246 <0.001 1.396 <0.001
Higher 2.083 <0.001 2.201 <0.001 1.794 <0.001 1.935 <0.001
Education gap
No difference 1 1 1 1
Higher than partner 0.915 0.110 0.954 0.244 0.995 0.896 0.883 <0.001
Lower than partner 1.009 0.864 1.065 0.097 1.044 0.274 1.020 0.609
Number of living children
No child 1 1 1 1
1–2 1.817 <0.001 2.853 <0.001 2.503 <0.001 1.809 <0.001
3–4 1.978 <0.001 3.191 <0.001 3.119 <0.001 2.095 <0.001
4+ 1.815 0.001 3.154 <0.001 2.950 <0.001 2.100 <0.001
Difference between sons and daughter
No difference 1 1 1 1
More sons 0.970 0.583 0.869 0.001 0.967 0.423 0.892 0.004
More daughters 0.962 0.518 0.902 0.018 0.968 0.442 0.890 0.005
Number of household members
1–4 1 1 1 1
5–7 0.876 0.014 0.838 <0.001 0.848 <0.001 0.884 0.001
7+ 0.805 0.003 0.746 <0.001 0.700 <0.001 0.813 <0.001
Wealth index
Middle 1 1 1 1
Poorest 1.056 0.460 0.931 0.215 0.799 <0.001 1.013 0.937
Poorer 0.952 0.436 0.940 0.179 0.918 0.079 0.996 0.796
Richer 1.110 0.111 1.122 0.016 1.026 0.581 0.980 0.653
Richest 1.446 <0.001 1.512 <0.001 1.377 <0.001 1.26 <0.001
Religion
Non-Muslim 1 1 1 1
Muslim 0.936 0.323 0.845 <0.001 0.770 <0.001 0.759 <0.001
Media exposure
No 1 1 1 1
Yes 1.137 0.010 1.104 0.009 1.103 0.011 1.115 0.001
NGO membership
No 1 1 1 - -
Yes 0.961 0.359 1.073 0.037 1.082 0.018 - -
Working status
No 1 1 1 1
Yes 1.271 <0.001 1.529 <0.001 1.161 <0.001 1.283 <0.001
Husband’s occupation
Farmer 1 1 1 1
Labor 1.060 0.273 0.948 0.189 1.025 0.546 1.013 0.739
Service 1.543 <0.001 1.088 0.254 1.258 0.002 1.184 0.026
Large business 1.037 0.710 0.973 0.704 1.115 0.243 1.001 0.990
Small business 0.972 0.654 0.928 0.122 0.937 0.157 0.926 0.090
Unemployed 1.224 0.219 0.890 0.246 0.791 0.210 2.972 0.364
Others 1.428 0.078 0.928 0.764 0.905 0.336 1.043 0.666
Relationship with household head
Head 1 1 1 1
Wife 0.501 <0.001 0.490 <0.001 0.642 <0.001 0.681 0.001
Daughter 0.524 <0.001 0.443 <0.001 0.631 <0.001 0.634 <0.001
Daughter-in-law 0.301 <0.001 0.249 <0.001 0.370 <0.001 0.265 <0.001
Grand-daughter 0.505 0.443 0.125 <0.001 0.689 0.315 0.591 0.080
Mother 0.306 0.001 0.383 <0.001 0.604 0.020 0.517 0.001
Mother-in-law 0.644 0.298 0.589 0.136 0.727 0.448 0.861 0.718
Sister 0.438 <0.001 0.411 <0.001 0.773 0.142 0.764 0.088
Other relative 0.418 <0.001 0.340 <0.001 0.491 <0.001 0.456 <0.001
Adopted child 0.086 0.034 0.893 0.910 1.140 0.877 0.284 0.041
Not related 0.380 0.273 0.384 0.117 0.457 0.132 0.627 0.528
Sex of household head
Male 1 1 1 1
Female 0.966 0.795 0.953 0.632 1.032 0.749 1.032 0.683

differed significantly in all the survey years by division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head. In brief, women living in Sylhet division had lower odds of gaining empowerment as compared to Dhaka dwellers women (OR2007: 0.641, OR2011: 0.670, OR2011: 0.643, OR2017-18: 0.765). Women from rural areas had significantly lesser influence (12.6%, 16.2%, 7.9%, and 24.2% lower odds, respectively) in receiving empowerment than those who were from urban areas. There were significant differences in the level of women’s empowerment among secondary and higher educated women than uneducated. Women who completed secondary education in 2007, 2011, 2014, and 2017–18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, higher educated women in the four BDHS waves, respectively were 2.083, 2.201, 1.794 and 1.935 times as likely to have empowerment compared to those who had no education. Number of living children has been seen as one of the most important covariates in this study with p-value <0.001. The likelihood of having 3–4 children than those couples who had no children from 2007 to 2017–18 BDHS, respectively was 1.978, 3.191, 3.119, and 2.095 times as likely to have empowerment. Similarly, couples with 1–2 children and 4+ children, respectively were more likely to have empowerment than couples with no children. In the present study, women who belong to small size families have a better chance to establish empowerment. Similarly, women from richest families, and are exposed to media have higher odds of being empowered. As expected, the employment status of women in Bangladesh was strongly associated with their empowerment. More precisely, the likelihood of being empowered was 1.271, 1.529, 1.161, and 1.283 times as likely for employed women for the study years, respectively, compared to homemakers. Comparing women who themselves are head of the household with those who have other relationship (i.e., wife, daughter, daughter-in-law, sister etc.) with household head were less likely to have empowerment in household decision-making as well as attitudes toward wife beating.

Discussion

Women’s empowerment is a pivotal determinant of sustainable development, attracting global attention due to its impact on societal power dynamics [28,35,36]. Numerous studies have explored empowerment through decision-making power or attitudes toward wife beating, and our study contributes by focusing on influential determinants in Bangladesh over a decade [17,18,23,24,2630,3644]. Our analysis, rooted in previous research, identified key factors associated with women’s empowerment. Bivariate analysis highlighted strong associations between several covariates and empowerment, emphasizing the role of marriage age, education, media exposure, employment, and socioeconomic status [14,27,28]. Adjusted odds ratios further elucidated these associations, emphasizing their significance in shaping women’s empowerment.

Urban-rural disparities emerged as a crucial factor, with urban women experiencing greater empowerment, particularly in Dhaka. Education played a pivotal role, corroborating findings from prior studies, showcasing the link between education, decision-making ability, and resistance against intimate partner violence [28,36,4547]. However, the unexpected negative association observed for highly educated wives warrants further investigation. Family dynamics, including the number of children and their gender distribution, revealed nuanced insights. Larger families were associated with reduced empowerment, while the impact of sons versus daughters on empowerment exhibited variations across study years. These findings challenge conventional expectations, suggesting the need for a nuanced understanding of family dynamics in the context of women’s empowerment.

Wealth quintiles highlighted socioeconomic disparities, with richer women consistently exhibiting higher odds of empowerment. Religious affiliation, specifically Muslim identity, emerged as a significant factor impacting women’s empowerment, echoing the influence of religious beliefs on societal norms and behaviors [38,48,49]. Media exposure and employment status corroborated past research, showing positive associations with empowerment [46], while NGO membership emerged as a contributing factor in specific survey years.

Spousal occupation also played a role, emphasizing the financial stability’s impact on women’s empowerment [50]. The role of women as household heads showcased a positive association with empowerment, but the low prevalence of female household heads underscored the patriarchal nature of Bangladeshi society. Additionally, regional disparities and variations over the study period highlight the need for targeted interventions based on geographical contexts.

Conclusion

The findings of the study demonstrate that the situation of women’s empowerment in Bangladesh has improved over the survey years, as evidenced by the indicators: household decision-making and attitudes toward violence. Our study confirmed that women’s empowerment is significantly associated with factors such as division, place of residence, education level, number of living children, wealth index, media exposure, working status, and relationship with household head. Additionally, this study also provides evidence that urban dwellers women, secondary educated women, women with 1–2 children, exposed to mass media, employed women reported having more empowerment than the others over the ten-year span of time. Ensuring further steps to open door to women’s education, raising awareness among women, and providing more facilities can accelerate women’s empowerment rapidly and in a better way.

Limitations

Our study is not beyond limitations. Firstly, this study used data extracted from BDHS having in responses only from women which introduced biases to some extent. Secondly, women’s empowerment was defined in our analysis using only two indicators (household decision-making and attitudes toward wife beating) but this could be more strongly defined using more indicators like economic decision-making, access to healthcare, physical mobility, the decision on family planning, assets ownership, etc. Due to lack of data, some important covariates were not considered in this study.

Acknowledgments

The Demographic and Health Survey (DHS), which carried out a nationwide survey and made its data openly accessible, is appreciated by the authors. We would like to express our gratitude and homage to honorable Professor the late Dr. Md. Taslim Sazzad Mallick, Department of Statistics, University of Dhaka. Additionally, we would like to express our gratitude to the academic editor and the anonymous reviewers for their contributions that enhanced the manuscript’s quality and coherence.

Data Availability

The datasets utilized in this study are available for access through the DHS repository. Individuals interested in obtaining the data can do so by submitting a formal request via the DHS website at the following link: https://dhsprogram.com/data/available-datasets.cfm.

Funding Statement

The author(s) received no specific funding for this work.

References

  • 1.Pakeeza S, Mehmood F. Women Empowerment in Pakistani Law: An Analysis from the Islamic Perspective. Al-Az̤vā. 2021. Jul 5; 36(55):1–8. [Google Scholar]
  • 2.Whitmore E, Kerans P. Participation, empowerment and welfare. Canadian review of social policy. 1988. Jan 1(22):51–60. [Google Scholar]
  • 3.Manuere F, Phiri N. A literature review of women empowerment and development in Zimbabwe: a look at new insights and perspectives. Journal of Public Administration and Governance. 2018;8(4):57–65. [Google Scholar]
  • 4.Bayeh E. The role of empowering women and achieving gender equality to the sustainable development of Ethiopia. Pacific Science Review B: Humanities and Social Sciences. 2016. Jan 1;2(1):37–42. [Google Scholar]
  • 5.Global Gender Gap Report 2021. Geneva, Switzerland: World Economic Forum (WEF); 2021. Mar. [Google Scholar]
  • 6.Global Gender Gap Report 2020. Geneva, Switzerland: World Economic Forum (WEF); 2020. [Google Scholar]
  • 7.List of 11th Parliament Members English [Internet]. Parliament.gov.bd. 2019. Available from: http://www.parliament.gov.bd/index.php/en/mps/members-of-parliament/current-mp-s/list-of-11th-parliament-members-english [Google Scholar]
  • 8.World Health Organization. Millennium Development Goals (MDGs) [Internet]. World Health Organization: WHO; 2018. Available from: https://www.who.int/news-room/fact-sheets/detail/millennium-development-goals-(mdgs) [Google Scholar]
  • 9.Hossain N. The sdgs and the empowerment of Bangladeshi women. The palgrave handbook of development cooperation for achieving the 2030 agenda: Contested collaboration. 2021:453–74. [Google Scholar]
  • 10.World Survey on the Role of Women in Development: Gender Equality and Sustainable Development [Internet]. United States: United Nations publication; 2014. Available from: https://www.unwomen.org/sites/default/files/Headquarters/Attachments/Sections/Library/Publications/2014/World-survey-on-the-role-of-women-in-development-2014-en.pdf [Google Scholar]
  • 11.Gender Statistics of Bangladesh 2018 [Internet]. bbs.portal.gov.bd. Reproduction, Documentation & Publication (RDP) Section, Bangladesh Bureau of Statistics; 2019. Available from: https://bbs.portal.gov.bd/sites/default/files/files/bbs.portal.gov.bd/page/b343a8b4_956b_45ca_872f_4cf9b2f1a6e0/Gender%20Statistrics%20of%20Bangladesh%202018.pdf [Google Scholar]
  • 12.Population & Housing Census 2022 Preliminary Report [Internet]. Dhaka: Bangladesh Bureau of Statistics (BBS); 2022. Aug. Available from: www.bbs.gov.bd [Google Scholar]
  • 13.Musonera A, Heshmati A. Measuring Women’s empowerment in Rwanda. InStudies on economic development and growth in selected African countries 2017. May 3 (pp. 11–39). Singapore: Springer Singapore. [Google Scholar]
  • 14.Sen KK, Nilima S. Women’s Empowerment and Its Determinants in Bangladesh: Evidence from a National Survey. Dhaka University Journal of Science. 2018. Jul 26;66(2):129–34. [Google Scholar]
  • 15.Soharwardi MA, Ahmad TI. Dimensions and determinants of women empowerment in developing countries. International Journal of Sustainable Development and Planning. 2020. Sep;15(6):957–64. [Google Scholar]
  • 16.Chaudhry IS, Nosheen F. The determinants of women empowerment in Southern Punjab (Pakistan): An empirical analysis. European Journal of Social Sciences. 2009;10(2):216–29. [Google Scholar]
  • 17.Hasan MN, Uddin MS. Women empowerment through health seeking behavior in Bangladesh: Evidence from a national survey. South East Asia Journal of Public Health. 2016. Dec 10;6(1):40–5. [Google Scholar]
  • 18.Kabir A., Rashid M.M., Hossain K., Khan A., Sikder S.S. and Gidding H.F., 2020. Women’s empowerment is associated with maternal nutrition and low birth weight: evidence from Bangladesh Demographic Health Survey. BMC women’s health, 20, pp.1–12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 19.National Institute of Population Research and Training—NIPORT/Bangladesh, Mitra and Associates/Bangladesh, and Macro International. 2009. Bangladesh Demographic and Health Survey 2007. Dhaka, Bangladesh: NIPORT, Mitra and Associates, and Macro International. Available at http://dhsprogram.com/pubs/pdf/FR207/FR207.pdf. [Google Scholar]
  • 20.National Institute of Population Research and Training—NIPORT/Bangladesh, Mitra and Associates/Bangladesh, and ICF International. 2013. Bangladesh Demographic and Health Survey 2011. Dhaka, Bangladesh: NIPORT, Mitra and Associates, and ICF International. Available at http://dhsprogram.com/pubs/pdf/FR265/FR265.pdf. [Google Scholar]
  • 21.National Institute of Population Research and Training—NIPORT/Bangladesh, Mitra and Associates, and ICF International. 2016. Bangladesh Demographic and Health Survey 2014. Dhaka, Bangladesh: NIPORT, Mitra and Associates, and ICF International. Available at http://dhsprogram.com/pubs/pdf/FR311/FR311.pdf. [Google Scholar]
  • 22.National Institute of Population Research and Training—NIPORT, Ministry of Health and Family Welfare, and ICF. 2020. Bangladesh Demographic and Health Survey 2017–18. Dhaka, Bangladesh: NIPORT/ICF. Available at https://www.dhsprogram.com/pubs/pdf/FR344/FR344.pdf. [Google Scholar]
  • 23.Dey R, Md MK. Assessment of key dimensions and determinants of women’s empowerment in Bangladesh. Russian Journal of Agricultural and Socio-Economic Sciences. 2015;37(1):38–47. [Google Scholar]
  • 24.Hameed W., Azmat S.K., Ali M., Sheikh M.I., Abbas G., Temmerman M. and Avan B.I., 2014. Women’s empowerment and contraceptive use: the role of independent versus couples’ decision-making, from a lower middle income country perspective. PloS one, 9(8), p.e104633. doi: 10.1371/journal.pone.0104633 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 25.Johnson RA and Wichern DW. Applied Multivariate Statistical Data Analysis. New Jersey: Prentice Hall, 2002. [Google Scholar]
  • 26.Tuz-Zahura F, Sen KK, Nilima S, Bari W. Can women’s 3E index impede short birth interval? evidence from Bangladesh Demographic and Health Survey, 2017–18. Plos one. 2022. Jan 26;17(1):e0263003. doi: 10.1371/journal.pone.0263003 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 27.Sen K.K., Islam M. and Hasan M.M., 2018. Socio-economic and demographic determinants of women’s household decision making autonomy in Bangladesh: A cross-sectional Study. Dhaka University Journal of Science, 66(2), pp.115–120. [Google Scholar]
  • 28.Kabir R, Rahman S, Monte-Serrat DM, Arafat SY. Exploring the decision-making power of Bangladeshi women of reproductive age: Results from a national survey. South East Asia Journal of Medical Sciences. 2017. Sep 15:4–8. [Google Scholar]
  • 29.Sutopa TS. Maternal Health Care Seeking Behavior in Urban Area of Bangladesh: Does Migration Create Inequity?. Dhaka University Journal of Science. 2019. Jul 30;67(2):131–8. [Google Scholar]
  • 30.Rahman A, Hossain Z, Rahman ML, Kabir E. Determinants of children ever born among ever-married women in Bangladesh: evidence from the Demographic and Health Survey 2017–2018. BMJ open. 2022. Jun 1;12(6):e055223. doi: 10.1136/bmjopen-2021-055223 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 31.Kleinbaum DG, Klein M. Logistic Regression: a Self-Learning Text. New York, Ny: Springer New York; 2010. [Google Scholar]
  • 32.Dobson AJ, Barnett A. An Introduction to Generalized Linear Models. CRC Press; 2008. [Google Scholar]
  • 33.Ananth CV, Kleinbaum DG. Regression models for ordinal responses: a review of methods and applications. International journal of epidemiology. 1997. Dec 1;26(6):1323–33. doi: 10.1093/ije/26.6.1323 [DOI] [PubMed] [Google Scholar]
  • 34.Harrell FE. Regression modeling strategies: with applications to linear models, logistic regression, and survival analysis. New York: springer; 2001. Jan 10. [Google Scholar]
  • 35.Zaman UR, Rahman MM, Hussain SM, Zaki M. Women empowerment in different household issues of Bangladesh. Bangladesh Medical Journal. 2008;37(2):41–5. [Google Scholar]
  • 36.Mainuddin AK, Begum HA, Rawal LB, Islam A, Islam SS. Women empowerment and its relation with health seeking behavior in Bangladesh. Journal of family & reproductive health. 2015. Jun;9(2):65. [PMC free article] [PubMed] [Google Scholar]
  • 37.Kabir R, Khan HT. A cross-sectional study to explore intimate partner violence and barriers to empowerment of women in Armenia. BioMed research international. 2019 Jul 16;2019. doi: 10.1155/2019/6939684 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 38.Koenig MA, Ahmed S, Hossain MB, Mozumder AK. Women’s status and domestic violence in rural Bangladesh: individual-and community-level effects. Demography. 2003. May;40(2):269–88. doi: 10.1353/dem.2003.0014 [DOI] [PubMed] [Google Scholar]
  • 39.Khatun MT, Rahman KF. Domestic violence against women in Bangladesh: Analysis from a socio-legal perspective. Bangladesh e-journal of Sociology. 2012;9(2):19–29. [Google Scholar]
  • 40.Acha CK. Trend and levels of women empowerment in Nigeria. Am J Appl Math Stat. 2014;2(6):402–8. [Google Scholar]
  • 41.Rapp D, Zoch B, Khan MM, Pollmann T, Krämer A. Association between gap in spousal education and domestic violence in India and Bangladesh. BMC public health. 2012. Dec;12(1):1–9. doi: 10.1186/1471-2458-12-467 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 42.Islam M, Ahmed MS, Mistry SK. Factors associated with women’s approval on intimate partner violence in Bangladesh: A cross-sectional analysis of latest demographic and health survey 2017–18. Heliyon. 2021. Dec 1;7(12):e08582. doi: 10.1016/j.heliyon.2021.e08582 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 43.Ahmmed F. Women’s empowerment and practice of maternal healthcare facilities in Bangladesh: a trend analysis. Journal of Health Research. 2022. Sep 27;36(6):1104–17. [Google Scholar]
  • 44.Biswas RK, Rahman N, Kabir E, Raihan F. Women’s opinion on the justification of physical spousal violence: A quantitative approach to model the most vulnerable households in Bangladesh. PloS one. 2017. Nov 21;12(11):e0187884. doi: 10.1371/journal.pone.0187884 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 45.Kawaguchi L, Fouad NA, Chiang C, Elshair IH, Abdou NM, El Banna SR, Aoyama A. Dimensions of women’s empowerment and their influence on the utilization of maternal health services in an Egyptian village: a multivariate analysis. Nagoya journal of medical science. 2014. Feb;76(1–2):161. [PMC free article] [PubMed] [Google Scholar]
  • 46.Lailulo YA, Sathiya Susuman A, Blignaut R. Correlates of gender characteristics, health and empowerment of women in Ethiopia. BMC women’s health. 2015. Dec;15:1–9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 47.Kabir R, Khan H. Utilization of Antenatal care among pregnant women of Urban Slums of Dhaka City, Bangladesh. IOSR Journal of Nursing and Health Science. 2013. May 8;2(2). [Google Scholar]
  • 48.Sanawar SB, Islam MA, Majumder S, Misu F. Women’s empowerment and intimate partner violence in Bangladesh: investigating the complex relationship. Journal of biosocial science. 2019. Mar;51(2):188–202. doi: 10.1017/S0021932018000068 [DOI] [PubMed] [Google Scholar]
  • 49.Sayem AM, Begum HA, Moneesha SS. Attitudes towards justifying intimate partner violence among married women in Bangladesh. Journal of biosocial science. 2012. Nov;44(6):641–60. doi: 10.1017/S0021932012000223 [DOI] [PubMed] [Google Scholar]
  • 50.Rani M, Bonu S. Attitudes toward wife beating: a cross-country study in Asia. Journal of interpersonal violence. 2009. Aug;24(8):1371–97. doi: 10.1177/0886260508322182 [DOI] [PubMed] [Google Scholar]

Decision Letter 0

Mohammad Nayeem Hasan

2 Jan 2024

PONE-D-23-17327Assessing the pattern of key factors on women’s empowerment in Bangladesh: evidence from Bangladesh Demographic and Health Survey, 2007 to 2017-18PLOS ONE

Dear Dr. Akter,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Feb 16 2024 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

  • A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.

  • A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.

  • An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: https://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols.

We look forward to receiving your revised manuscript.

Kind regards,

Mohammad Nayeem Hasan

Academic Editor

PLOS ONE

Journal Requirements:

When submitting your revision, we need you to address these additional requirements.

1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at

https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and

https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf.

2. Did you know that depositing data in a repository is associated with up to a 25% citation advantage (https://doi.org/10.1371/journal.pone.0230416)? If you’ve not already done so, consider depositing your raw data in a repository to ensure your work is read, appreciated and cited by the largest possible audience. You’ll also earn an Accessible Data icon on your published paper if you deposit your data in any participating repository (https://plos.org/open-science/open-data/#accessible-data).

Additional Editor Comments:

Manuscript ID PONE-D-23-17327 entitled "Assessing the pattern of key factors on women’s empowerment in Bangladesh: evidence from Bangladesh Demographic and Health Survey, 2007 to 2017-18" which you submitted to the PLOS ONE, has been reviewed and will be reconsidered for publication after the completion of the major revisions as noted. The comments of two reviewers are included at the bottom of this letter. My attempts at obtaining some other reviewers to improve your paper were not successful. Rather than postpone the review process further, I have decided to serve as the 3rd reviewer to increase the quality of this paper.

The paper investigated significant factors of women’s empowerment and at the same time, assessed the pattern of potential factors affecting women’s empowerment in Bangladesh using four cross-sectional waves of Bangladesh Demographic and Health Surveys (2007, 2011, 32 2014, and 2017-18) data. Despite being a significant concern for Bangladesh, this topic has already received considerable attention from numerous earlier and recently published studies.

https://www.tandfonline.com/doi/abs/10.1080/00036846.2015.1051657

https://bmjopen.bmj.com/content/11/8/e049167.abstract

https://link.springer.com/article/10.1186/s12905-020-00952-4

https://www.emerald.com/insight/content/doi/10.1108/JHR-11-2020-0559/full/html

The purpose of the study has also been used in the past to explore comparable issues utilizing earlier data on Bangladesh. As a result, the paper's main original addition appears to be its comparison between different survey data, and its conclusions largely—and not surprisingly—reflect those of previous research. The paper needs to be thoroughly proofread by a professional or expert. It is not written to a high degree for academic writing, and there are several grammatical/spelling errors, which frequently make claims and arguments less clear. Additionally, the authors ought to eliminate any similarities from this work. Numerous times, the way that statistical results are interpreted is also wrong. The introduction fails to effectively justify the need for studying the issue, tables and results are not focused on the title, many unusual tables and results are included in the main manuscript, and the paper's findings by themselves are insufficient to support the conclusions.

Below are some comments with more information:

Abstract

The methods, results, and conclusion need to be re-written. Please check previously published papers from PLOS ONE.

Introduction

Overall, the introduction is so long. Please reduce some text or concise it. In many places of the introduction, citation is needed. Please check and provide the appropriate citation.

Lines 117-118: “At the same time, an evaluation of women's empowerment in Bangladesh over the past 10 years, from 2007 to 2017-18 has also been observed here.” As you compared 4 surveys and it is not time series data, so, 10 years explanation in the title and objective is not acceptable.

Please specify the research gap. Why this study is necessary and so on. I didn’t find it in your introduction.

Data and Methodology

Data

Table 1 is not needed here as all procedures are shared on the BDHS report. Those who want to check that they will check in the reports. Rather, it is better to show a flow chart of how you reached your final sample (every step of inclusion-exclusion)

Outcome variable

Lines 163-165: “We proposed a total of nine questions which were classified into two broad dimensions; household decision-making and attitudes toward wife beating”. Is it the authors' proposal or followed some published papers, please re-check it.

Lines 179-183: “For creating the women’s empowerment index (WEI), principal component analysis (PCA) has been used with all nine indicators (4 decisions and 5 reasons), where the first principal component was regarded as the women’s empowerment score (WES). The WES was further broken down into 3 quantiles; labeled low, middle, and high for domains below the first, in between the first and second, and above the second quantile, respectively.”. Please explain more about this procedure. How many variables remained after PCA, how did the authors do that, and what’s the methodology of doing it? How did you categorize that on what basis, etc.?

Lines 183-186: The author should write “Finally, our preferred outcome metric is the score index with three ordered categories (i.e., low, medium, and high), where these categories indicate order-wise how empowered a woman is (i.e., low means women have low empowerment)”. Only citation is not appropriate here. As you did your own PCA, you should have a different score from the others. So, please explain your score to categorize them.

Covariates

Lines 191-195: “Based on some previous works of literature, the covariates included in this study are age at first marriage, spousal age gap, respondent’s education level, education gap, respondent’s current working status, number of living children, religion, number of household members, division, place of residence, media exposure, NGO membership, wealth index, husband’s occupation, relationship with household head, and sex of household head.” Please cite all of the previous works after those lines.

Table 2 is not enough to explain the details about covariates. Please cite the appropriate BDHS methodological reports to explain the categories. Or if you follow other reports to categorize them, you can also make them in citation. To remove any confusion, follow this: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15617-8

Statistical analysis

Please provide some model evaluation techniques (AIC, BIC, AUROC, and others…..) to justify that you used an appropriate model to explain your results. In addition, explain about level of significance in statistical analysis.

Ordinal logistic regression model

No need to explain in detail the ordinal logistic regression model, as it is a common method to us. The authors can explain the application of it.

Please explain why the authors used two statistical software, if you just need two software, please explain which statistical analysis performs with which software.

Results

There are some issues with the representations and interpretations of the results.

Univariate analysis

Table 3 is not appropriate in this paper. Please represent Table 3 with the outcome variable and show the P-value in this same table. We need to see the change in women's empowerment situation overtime over the socio-demographic variables. The explanation of Table 3 is too large. Please reduce it by a significant variable. Explain only significant variables by performing a chi-square test on it.

Bivariate analysis

Lines 280-283: “In the bivariate analysis, an attempt has been made to out find the significant exposure factors to women’s empowerment. To evaluate how much a woman's background characteristics influence her level of domestic empowerment in Bangladesh, Pearson Chi-square test was applied.” Please remove these lines from here, because it is a methodological sentence.

Merge Table 4 in Table 3. No need to show a chi-square test value. Show only the P-value (from the chi-square test) for significant tests.

Multivariate analysis

Instead of “multivariate analysis”, please explain it as multivariable analysis.

The authors said before in lines 207-208; “The covariates that were significantly associated with the outcome variable, have been included in the regression model”. However in regression analysis, the authors include all variables.

The representation of Table 5 needs to be followed in a standard format. Please follow this paper’s Table 3 and Table 4 reporting style: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242864

Use <0.001 when it is less than 0.001/<0.01. Explain the P-value as 3 decimal points.

It also seems that the author didn’t maintain the serial of explanation of Table 5 or vice versa. Please, to catch the reader’s interest please keep the flow similar to the table and interpretation.

No need to explain whether it is a 1% or 5% significant level. You should follow only one level of significance when you explain.

The interpretation of table 5 is also very long. Please explain only key significant variables and key findings.

Discussion

The discussion part should be rewritten and should focus on outcome variables. It will be better to discuss the information of supplementary tables and be more specific on the outcome variable. The authors discuss the reason for each association in the discussion part.

Major findings of this study

All explanations of figures need to be replaced in the results section. The quality and the representation of the figure are not good.

Conclusion

The conclusion needs to be more specific and highlight key findings. This should support the result. They are suggested to provide less discussion in the conclusion part. I will suggest providing no citation in the conclusion part.

You can follow the below publication with BDHS/MICS data, try to represent in these styles:

https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-023-15617-8

https://aidsrestherapy.biomedcentral.com/articles/10.1186/s12981-022-00495-8

https://www.frontiersin.org/articles/10.3389/fpubh.2022.985445/full

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0242864

These suggestions aim to enhance the study's coherence, precision, and informative value, ensuring it provides valuable insights.

Reviewers' comments:

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: N/A

Reviewer #2: Yes

**********

3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thanks for inviting me to review this manuscript. Over all is sounds nicely written, constructed, based on many data, with right methodology, constructive discussion and relevant references.and contribute to the literature. I recommend for publication without any major revisions.

Reviewer #2: Dear authors,

Your manuscript is technically sound, and the data supported the conclusions.

Empowering women in Bangladesh is not only a moral obligation, but also a crucial step towards creating a more just and prosperous society. Your study analyzed data from four cross-sectional waves of the Bangladesh Demographic and Health Surveys to identify the factors that contribute to women's empowerment. And found that education, employment, higher wealth index, media exposure, NGO membership, and urban residency all significantly increased the likelihood of women experiencing empowerment.

The statistical analysis had been performed appropriately.

The principal component analysis (PCA) was employed to create women's empowerment index. The Chi-square test was used to assess the unadjusted association between the selected covariates and women's empowerment. And the proportional odds model (POM) was applied to determine the adjusted association of the selected covariates with women's empowerment.

All data underlying the findings in your manuscript are fully available for readers.

Finally, the manuscript is presented in an intelligible fashion and written in standard English.

Sincerely,

Beisan Ali

**********

6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: Yes: Beisan A. Mohammad

**********

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PLoS One. 2024 Mar 29;19(3):e0301501. doi: 10.1371/journal.pone.0301501.r002

Author response to Decision Letter 0


5 Feb 2024

The Academic Editor and the reviewers: We have incorporated all of your suggestions into my revision. They were very helpful. Thank you.

Attachment

Submitted filename: Response to reviewers.docx

pone.0301501.s001.docx (14.6KB, docx)

Decision Letter 1

Mohammad Nayeem Hasan

18 Mar 2024

Assessing the pattern of key factors on women’s empowerment in Bangladesh: evidence from Bangladesh Demographic and Health Survey, 2007 to 2017-18

PONE-D-23-17327R1

Dear Dr. Sahera Akter,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

An invoice will be generated when your article is formally accepted. Please note, if your institution has a publishing partnership with PLOS and your article meets the relevant criteria, all or part of your publication costs will be covered. Please make sure your user information is up-to-date by logging into Editorial Manager at http://www.editorialmanager.com/pone/ and clicking the ‘Update My Information' link at the top of the page. If you have any questions relating to publication charges, please contact our Author Billing department directly at authorbilling@plos.org.

If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

Kind regards,

Mohammad Nayeem Hasan

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #3: All comments have been addressed

Reviewer #4: All comments have been addressed

Reviewer #5: All comments have been addressed

**********

2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: I Don't Know

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #3: Yes

Reviewer #4: Yes

Reviewer #5: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #3: 1. Although the authors have addressed all of the comments, there are certain instances of grammatical and spelling errors in the manuscript. As such, the authors are advised to proofread the manuscript and make relevant corrections.

2. Abstract, results section, lines (51-54): “For instance, women who completed secondary education in 2007, 2011, 2014, and 2017-18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated.” The authors should consider removing the aforementioned lines from the abstract as these are redundant.

3. In the limitations section, the authors mention that due to insufficient data, certain covariates were not considered. Could the authors briefly mention those covariates, highlighting the need for further research in those areas.

Reviewer #4: Dear editor and authors,

The authors addressed the identify factors contributing to women’s empowerment in Bangladesh. They proposed four waves of BDHS data (2007, 2011, 2014, and 2017-18) to assess temporal changes in covariates impacting women’s empowerment. They approach to decision-making and decision-making problems toward wife beating household. Later, they evaluated the comprehensive analysis of evolving factors

Overall, the authors presented detailed information of their motivation and experiment details. The experiment results and discussion support authors' claim. The entire manuscript is well described with scientific soundness on an interval-valued picture fuzzy context. Notations, formulations, tables, materials and methods, and statements of practical results are readable. Discussion, conclusions and limitations are correct.

After checking the revised version of this manuscript. I am satisfied with the efforts the authors made in revising this manuscript. Most concerns raised by reviewers have been addressed, but there are still some errors. The current revised manuscript looks good and could be accepted to publish on “PLOS ONE”. Make the following comments:

• Make the “Abstract” section as one paragraph. Do not use the words “Background”, “Methods”, “Results” and “Conclusion”.

Reviewer #5: If the affiliations are the same for all authors, please remove duplicate entries from the affiliation section.

Rewrite the beginning of the abstract to ensure sentence harmony.

Insert citations at the end of the 1st paragraph, 2nd paragraph, and the last paragraph of the introduction.

As previously suggested, tables have been removed from the manuscript.

The manuscript now includes an explanation about PCA.

Citations have been added to Table 1, improving the referencing within the manuscript.

The results and discussion sections have been updated as per the reviewer's suggestions.

**********

7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #3: No

Reviewer #4: No

Reviewer #5: Yes: Dr. Muhammad Asad

**********

Acceptance letter

Mohammad Nayeem Hasan

21 Mar 2024

PONE-D-23-17327R1

PLOS ONE

Dear Dr. Akter,

I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now being handed over to our production team.

At this stage, our production department will prepare your paper for publication. This includes ensuring the following:

* All references, tables, and figures are properly cited

* All relevant supporting information is included in the manuscript submission,

* There are no issues that prevent the paper from being properly typeset

If revisions are needed, the production department will contact you directly to resolve them. If no revisions are needed, you will receive an email when the publication date has been set. At this time, we do not offer pre-publication proofs to authors during production of the accepted work. Please keep in mind that we are working through a large volume of accepted articles, so please give us a few weeks to review your paper and let you know the next and final steps.

Lastly, if your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org.

If we can help with anything else, please email us at customercare@plos.org.

Thank you for submitting your work to PLOS ONE and supporting open access.

Kind regards,

PLOS ONE Editorial Office Staff

on behalf of

Dr. Mohammad Nayeem Hasan

Academic Editor

PLOS ONE

Associated Data

    This section collects any data citations, data availability statements, or supplementary materials included in this article.

    Supplementary Materials

    Attachment

    Submitted filename: Response to reviewers.docx

    pone.0301501.s001.docx (14.6KB, docx)

    Data Availability Statement

    The datasets utilized in this study are available for access through the DHS repository. Individuals interested in obtaining the data can do so by submitting a formal request via the DHS website at the following link: https://dhsprogram.com/data/available-datasets.cfm.


    Articles from PLOS ONE are provided here courtesy of PLOS

    RESOURCES