A Critique of the Concept of Empowerment in Global Health 公开
Grap, Mary Ellen (Spring 2022)
Abstract
Background: Empowerment has become an increasingly popular term in global health literature and programming. The ways in which the concept is discussed, implemented, and measured vastly differ. The question, ‘what does empowerment of women and girls actually mean?’ remains ambiguous. Gaps in the literature exist concerning ethical implications, in addition to gaps of the necessary conditions before empowerment occurs, and the outcomes or consequences after implementation.
Methods: This thesis utilized the philosophical conceptual analysis methodology as an analytic model. The Walker & Avant method, in which model cases, borderline, and contrary cases are constructed was adapted to this analysis process. Cases were drawn from interviews with global health professionals and published literature.
Findings: Discussion from interviews provided a model case for how empowerment is currently being used and implemented by a local nongovernmental organization in India. A borderline line case was constructed from lessons learned from the Women’s Empowerment in Agriculture Index. A contrary case was formed from the concept of ‘control choice’ empowerment, demonstrated through reliance on decision-making as an indicator of empowerment. Additionally, measurement of empowerment was found to be a point of debate. Various potential ethical concerns were identified, such as unintended consequences of burdening women and potentials for disempowerment. Enabling environments were also identified as an antecedent for empowerment.
Discussion: The focus on individual levels versus community groups, and implications of ignoring larger social structures was discussed. The concept of ‘control choice’ empowerment, as seen in Menstrual Hygiene Management programs, could potentially disempower women when working within gender roles and unacceptable options. There were also outcomes of programs identified that were distinctly different from impact on gender dynamics, which is often seen as the intended target. There are several ethical implications for empowerment programming, such as the potential burdening of women.
Conclusions: From the findings and discussion, I concluded that empowerment should be viewed carefully and cautiously as one step in a much larger multi-phase journey to shift gender relations. I caution against viewing empowerment as the solution to gender inequalities without recognition of the wider schema of power dynamics.
Table of Contents
Chapter I. Introduction………………………………………………………….………………1
Introduction………………………………………………………………………………………1
Problem Statement……………………………………………………………….………………1
Introduction………………………………………………………………………………………1
Background…………………………………………………………………….………...………2
History………………………………………………………………………………….…………2
Current Uses………………………………………………………………………………………3
Examples of Empowerment Work in Global Health……………………………………………5
Gaps in Knowledge & Significance….……………………………………………...……………8
Chapter II. Methods……………………………………………………………………………12
Study Design…………………………………………………………………………………..…12
Chapter III. Findings & Discussion………………………………………………………..….14
Results………………………………………………………………………………………..….14
Current Uses of Empowerment………………………………………………………………....14
Current Uses: Model Case………………………………………………………..……………..15
Current Uses: Borderline Case……………………………………………...………………….16
Current Uses: Contrary Case………………………………………………………..………….16
Measurement of Empowerment……………………………………………………………...…18
Ethical Implications/Gaps…………………………………………………………..…………..19
Antecedents and Consequences………………………………………………….……………...20
Discussion……………………………………………………………………………………….23
Current Uses………………………………………………………..……………………………23
Ethical Implications……………………………………………………………………………..27
Antecedents & Consequences………………………………………..………………………….29
Limitations………………………………………………………………………………………31
Conclusion………………………………………………………………………………………31
References…………………………………………………………….…………………………33
About this Master's Thesis
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