How are the domains of women’s inclusion, justice, and security associated with maternal and infant mortality across countries? Insights from the Women, Peace, and Security Index.
Open accessAbstract
Women's autonomy and empowerment in their homes, communities, and societies at large have been shown, through many direct and indirect pathways, to be associated with maternal and infant health. A novel global measure-the Women, Peace, and Security (WPS) Index-that bridges insights from gender and development indices with those from peace and security has recently been developed to capture the constructs of women's inclusion, justice, and security, using indicators and targets in the Sustainable Development Goals. This paper adds to the growing literature about the importance of gender inequality to key mortality outcomes for women and children by investigating the associations between nations' WPS Index scores and maternal mortality ratios and infant mortality rates. We use a range of international databases to obtain country-level data from 144 nations on health, demographic, income, and gender equality indicators. The aim is to highlight the role of women's inclusion, justice, and security in explaining national rates of maternal and infant mortality. Fully adjusted Poisson regression models indicate that a one point (0.01) increase on the WPS Index score is associated with a 2.0% reduction in the number of maternal deaths and a 2.3% reduction in the number of infant deaths. For a country such as Sierra Leone, with a maternal mortality ratio of 1360 maternal deaths per 100,000 live births, a one point improvement in the WPS Index would correspond to a maternal mortality ratio of 1,332, or 28 fewer deaths per 100,000 births. These associations are ecological and apply to the average level of mortality at the country level rather than the likelihood or risk faced at the individual level. Although we cannot claim causality for the observed relations in the cross-country regressions, the findings and recurring patterns are both suggestive and encouraging about the potential contributions of women's inclusion, justice, and security to maternal and infant mortality.
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Two global studies and one focused on sub-Saharan Africa found increased access to improved water and sanitation to be significantly associated with decreased maternal mortality.
“Two global studies (with data from 193 [284] and 144 [286] countries) and one focused on sub-Saharan Africa [287] found increased access to improved water and sanitation to be significantly associated with decreased maternal mortality.”
From Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis (2022) · cites this paper as [286]
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Water, sanitation, and women’s empowerment: A systematic review and qualitative metasynthesis
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- Authors
- Klugman, J., Li, L., Barker, K. M., Parsons, J., & Dale, K.
- Affiliations
- Georgetown University (US)
- Fred Hutch Cancer Center (US)
- University of California San Diego (US)
- Corresponding author
- Klugman, Jeni
- Venue
- SSM - Population Health
- Publisher
- Elsevier BV
- Published
- 2019-12
- Volume
- 9
- Pages
- 100486
- ISSN
- 2352-8273 (ISSN-L)
- PMC
- PMC6978497
- OpenAlex
- W2990217589
- Cited by
- 16
- References
- 36
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 3 · 2023: 1 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 4
- FWCI
- 2.60
- Type
- journal article
- Language
- en
- Update notices
- erratum (2020-12-01)
- Open access
- gold
- doi.org
- Licence
- Locations
- SSM - Population Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Government of Norway's Ministry of Foreign Affairs (QZA-16/0019)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Social Sciences › Education › Gender, Education, and Development Issues
- Health Sciences › Health Professions › General Health Professions › Health and Conflict Studies
- Keywords
- maternal mortality, infant mortality, women's inclusion, gender equality, women's empowerment, peace and security, Sustainable Development Goals, gender inequality, maternal and child health
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