Health Entrepreneurship and Women’s Economic Empowerment in 300 Social Health Entrepreneurs (SHE) Pubblico

Abstract

Background: This study assessed women's economic empowerment through a Skilled Health Entrepreneur (SHE) program implemented in Sunamganj District, Bangladesh. The SHE programs prepared community women as community-based skilled birth attendants (CSBAs) who offered safe home-based delivery, other maternal & child health, family planning, and non-communicable diseases services. The program incorporated activities designed to increase the empowerment of SHE in their social context.

Objectives: This study aimed to identify the relationship between health entrepreneurship and women's economic empowerment in the Sunamganj District of Bangladesh. This study captured the perspectives of individuals and groups of SHEs, community leaders, community support group members, household heads, and government and private service providers to assess power, agency, and economic advancement in thematic areas of economic empowerment. 

Methods: Data were analyzed using MAXQDA22 of nine in-depth interviews and two focus group discussions with SHEs. It captured the data/information of focus group discussions with SHEs, Community Leaders, and group members, and five Key Informant Interviews with SHE’s husbands, government, and private service providers in three sub-districts in Sunamganj, Bangladesh. The qualitative data are related to control over assets, decision making, self-confidence, income, gender norms, gender roles and responsibilities, productivity and skills, and prosperity. This study also used secondary data from project studies and quantitative analyses done by project and another researcher related to SHE service delivery performance and empowerment. In addition, a literature review incorporated findings from references in PubMed using EndNote software.

Results: The SHE program built SHEs’ entrepreneurial skills, professional confidence, and individual decision making. This approach supported women from the community, government, and private health sectors in becoming recognized as health entrepreneurs and contributing to their livelihoods. This study found remarkably increased power, agency, and economic advances in the SHEs. 

Discussion: The SHE program design increased SHEs’ economic advancement by improving individual and family wealth, health, and nutritional status, reinforcing positive gender norms, roles, and responsibilities. Training on government-affiliated certification courses, linking with existing public-private health institutions, and developing supervised training and monitoring by existing public health care systems exist or can be scaled up in other remote communities. In addition, SHEs have become an inspiration for other women in their communities.

Table of Contents

1.     Chapter 1

1.1  Introduction…….............................................. 1

1.2  Background ………...........................                2

1.3  Context 

1.3.1. Sunamganj District ……….....................3

1.3.2. Program Description……………………4

1.3.3. Skill Health Entrepreneurs (SHE)……  9

1.3.4. Financial and Marketing Skill building 11

1.4  Relevance and Importance …………………12

1.5  Conceptual Framework ……………………. 15

1.6  Objectives and Research Questions …………17

2.     Chapter 2 

2.1  Literature Review ……………………………20

2.2  Methods for Literature Review ………………23

2.3  Summary of Literature Review ………………27

3.     Chapter 3

3.1  Methodology

3.1.1      Introduction………………………….29

3.1.2      Population and Sample…………….   29

3.1.3      Research Design………………………30

3.1.4      Study Aims…………………………….30

3.1.5      Procedures……………………………...30

3.1.6      Study Instruments………………………31

3.1.7      Indicators and Operationalization…32

3.2  Data Analysis……………………………...34

3.3  Ethical Consideration……………………..35 

3.4  Limitation and Delimitations………………36

4.     Chapter 4

4.1  Results 

4.1.1      Findings from qualitative analysis……37

4.1.2       Findings from Secondary Data/Information 50

5.     Chapter 5 

5.1  Discussion……………………………………54

5.2  Recommendations and Implications………..58 

5.3  Conclusion…………………………………….59 

6.     Reference ………………………………………….63

7.     Annex A……………………………………………66

8.     Annex B……………………………………………69

9.     Annex C …………………………………………..72

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Education
Parola chiave	Economic Empowerment Empowerment Health Entrepreneurship Women's Economic Empowerment
Committee Chair / Thesis Advisor	Deborah A. McFarland, Emory University

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