A mixed methods assessment of mHealth, nutrition behaviour change communication and unconditional cash transfers in rural Bangladesh: a gender-based approach

Abstract

Gender equality is a prerequisite for health and wellbeing of women. There is data linking women's empowerment and nutrition program outcomes, however, there is a lack of evidence as to how evaluate the impact of programs on women's empowerment. Cash transfers can be used as a gender-sensitive development tool, though more thorough evidence is needed to understand the pathways to empowerment. mHealth interventions rarely consider gender in design. Many agricultural and home gardening interventions aim to improve the nutritional status of women and children by focusing on women as the recipients of the intervention and assume women will be empowered as a result.

This research aims to assess the impact of nutrition BCC and unconditional cash transfers delivered on a mobile platform on women's empowerment in rural Bangladesh using a mixed methods approach.

A systematic review provided evidence on how mHealth interventions can affect gender relations revealed the need for gender sensitive design. Qualitative methods were used to investigate potential changes in women’s empowerment in a pilot study in rural Bangladesh and to explore women’s experience of decision-making at the start of the SCC Trial. Quantitative analysis of Bangladesh Demographic and Health Survey (BDHS) provided the characteristics of women who do not participate in decision-making.

The overall purpose of this thesis is to generate evidence for best practices for programmers and policy makers when assessing women's empowerment in nutrition interventions that aim to empower women in low and middle-income countries.

This thesis has highlighted the importance of assessing the impact of nutrition-specific and -sensitive interventions on women's empowerment. My PhD research provides evidence of the significance of evaluating impact of the SCC Trial and adds to the methodology of assessing the relationship between mHealth, nutrition BCC and transfers and women’s empowerment.