Comparison of Social, Economic and Familial Empowerment in Married Women in Three Cities of Iran.

BACKGROUND: Women's empowerment was defined as their ability to achieve awareness and control their personal, social, economic and political forces aiming at taking measures in order to improve their lives. This study aimed to compare the empowerment of the married women in medical sciences university in social, economic and familial domains in three cities, IRAN.
METHODS: This was a descriptive-analytical study conducted in 2016 on 399 married and employed women. Data collection instrument was a four-part questionnaire consisting of demographic, social, economic and familial domains and made by researchers. Collected data were analyzed using SPSS, version 16. Using paired t-test for intra-group and Chi-square and t-test for between groups comparisons. The significance level was set at<0.05.
RESULTS: The total score of empowerment in Rasht (126.34±17.51) was more than the two cities of Shiraz (123.46±15.62) and Bandar Abbas (123.42±12.34). There was a significant relationship between the mean score of the total empowerment and monthly income of the participants in Bandar Abbas (P=0.04), and job of their husbands in Rasht (P=0.004). The mean score of family empowerment of the women was significantly interrelated with the number of their children in Rasht (P=0.001), and with the education of the participants' husbands in Shiraz (P=0.002).
CONCLUSION: The score of social empowerment in Rasht was more than two other cities. In economic domain, the scores of Rasht and Bandar Abbas were more than those of Shiraz. Scores of Rasht and Shiraz were more than Bandar Abbas in the familial domain. It is useful to carry out qualitative studies aiming at determining the effects of various factors on women's empowerment and strategies for improving it.

INTRODUCTION

Woman’s empowerment means having the required ability to perform a number of tasks, individually or collectively.[1] These processes that help women to acquire more resources and control their lives would cause them to feel more independent and self-confident, which, in turn, leads to an increase in their self-esteem and would improve the image they have about themselves.[2]

According to Malhotra’s views, in the empowerment process, women have to gain power and capacity, and the right for action and influence on their decision.[3] The United Nations defines the empowerment as follows: “The process of enabling people to dominate over their lives and control components and decisions which shape their lives, to increase their resources and capabilities and making capacity to acquire access, partners, network and voice in order to acquire power”. According to the United Nations’ definition, women’s empowerment and their full participation based on equality in all economic and social aspects including participation in the process of decision making and accessing the power is considered to be one of the major components of “achieving equality, development and peace”.[4] Also according to the definition of this organization, factors of women’s empowerment are access to better social, economic, legal and political opportunities and facilities. Empowerment of women is one of the most important components in sustainable development. Women’s empowerment would assist the society to reach the goals of sustainable development, and would lead to progress and excellence of the society[5] so that it would be impossible to reach a sustainable development without women’s active participation in all familial, economic and social aspects.[6] Emphasis on the women’s empowerment leads to not only humanitarian and gender justice, but also to the developmental goals and the role it has in efficiency improvement and economic growth in the societies; also, women are considered as the factor of development. According to Cairo conference, good economic conditions and gender equality are of important factors to facilitate the women’s empowerment in the domain of health and reproductive health.[4,7] Women are identified to be one of the significant elements in social and economic development of countries.[8] Social dimension of empowerment is raised as a process in independence, self-confidence, and action to change social relations.[9] Economic dimension of empowerment often refers to the fact that people are allowed to have more control over resources, and have the right of choice for their own lives. Economic empowerment includes various domains such as property promotion and financing. Also, a huge part of economic empowerment is focused on economic empowering of women.[9,10] Familial dimension of empowerment often refers to the women’s ability to make decisions, which would bring significant gains for themselves and their families.[11] Nowadays, attention to women’s role as a specific group in the family and society is considered necessary. Recognizing the fact that women are a dynamic and energetic group with abundant motives could be effective on their participation in society’s decision making and also on their own destiny. Priority to women and their empowerment, their effective activities in familial, economic, and social dimensions are actually an investment for future generations. Results of some studies carried out in Iran reported different rates of women’s empowerment. In a study on the effective factors on women’s empowerment, the level of female staff of Telecommunication Company of Iran was reported moderate.[12] In a study, it was found that women’s empowerment is at low level, and structural changes seems to be necessary in order to eliminate the women’s poverty and gender inequality.[13]

Given that women are half of the human capital in every society,[8] through their empowerment, the society would take a great step towards development, and the sustainable development goals would be fulfilled. Medical science personnel promote the health of society. Their empowerment in the economic, social and familial domains can guarantee their efficacy. To the best of our knowledge, there were no articles in the domains of employed medical sciences women. Hence, researchers decided to conduct the present research aiming at comparing the empowerment of women working at Medical Science University in three cities of Bandar Abbas, Shiraz and Rasht, Iran.

MATERIALS AND METHODS

The present research was descriptive-analytical study conducted on 399 married and employed women in health centers or hospitals of medical sciences universities in Bandar Abbas, Shiraz and Rasht, in three regions of north, center and south of Iran which are moderately developed areas,[14] from February to March in 2016. Based on a pilot study, mean and standard deviation for each cities were obtained 128.0±9.5 (Rasht), 124.0±9.5 (Shiraz) and 125.0±9.5 (Bandar Abbas) and also α=0.05, 1-β=0.80; the sample size was obtained 399 cases (133 cases in each cites).

In this research, convenient sampling method was used based on inclusion criteria. This means that 133 participants were selected from each city (Women employed at University of Medical Science) in order to form the required sample. At first, this study was approved by ethics committee of Shahid Beheshti University and obtained the necessary permits and letters. After that, the researchers explained the research purpose and methods for participants who were referred to the centers. In the case of agreement to participate in the study based on inclusion criteria, 399 (133 women from each city) were selected. Informed consent was obtained from all individual participants. Then, the questionnaires were delivered to them. The inclusion criteria were: married working women with a bachelor or higher education, and at least one year of experience in marriage. Exclusion criteria were lack of complete response to the questionnaire by the individual. All the participants filled out the questionnaire completely and none of them was excluded.

For collecting data, a researcher-made multi-part questionnaire including demographic information, questions of social dimensions of woman’s empowerment (12 questions), questions of familial dimensions of woman’s empowerment (10 questions), and questions of economic dimensions of woman’s empowerment (9 questions) was used. Validity of the questionnaire was assessed by content, face and construct validity. Accordingly, the questionnaire was prepared on the basis of scientific resources and then given to ten faculty members with expertise and experience in the relevant field; they were asked to review the instrument qualitatively according to the standards of compliance with grammar, dictation, putting items in the right place, and appropriate scoring, and then provide necessary feedback to correct the mistakes and ambiguities in the questionnaires. In order to assess the content validity in quantitative method, Content Validity Ratio (CVR) and Content Validity Index (CVI) with the help of experts and faculty members were used. According to 10 experts and considering the standard of above 0.62 in Lawshe table, the ratio of content validity and the mean score of 0.93 for social dimensions of woman’s empowerment, 0.86 for familial dimensions of woman’s empowerment, 0.82 for economic dimensions of woman’s empowerment, and total score of 0.877, it was verified. In order to verify Content Validity Index, we used the standard of above 0.79; the mean score of Content Validity Index of questionnaire of social dimensions of woman’s empowerment was 0.94, questionnaire of familial dimensions of woman’s empowerment was 0.091, questionnaire of economic dimensions of woman’s empowerment was 0.94, and total score was 0.93.

The reliability of the questionnaire was assessed using Cronbach’s alpha test. It was obtained after giving it to 30 qualified individuals; the results revealed that for the variable of social dimensions of woman’s empowerment it was 0.819, for the variable of familial dimensions of woman’s empowerment 0.727, and for the variable of economic dimensions of woman’s empowerment it was 0.771.

Scoring the questionnaire in the section of social, familial and economic dimensions based on Likert scale (score 1: strongly disagree, 2: disagree, 3: neither agree nor disagree, 4: agree, 5: strongly agree) was calculated. The scores for the social dimension (12 questions) ranged from 12 to 60, the scores for the familial dimensions (10 questions) ranged from 10 to 50, the scores of the economic dimension (9 questions) ranged from 9 to 45, and the total score (31 questions) ranged from 31 to 155; at last, the scores were calculated and announced in percentage.

The collected data were analyzed using SPSS, version 16. For data analysis, we used descriptive statistics (frequency distribution, mean and standard deviation) and analytical statistics (Using paired t-test for intra-group and Chi-square and t-test for between groups comparisons), in which the reliability coefficient was taken as 95%; level of significance was taken as P<0.05.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Shahid Beheshti University of Medical Sciences committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards this project with No. 174 (2015.11.1) was approved at Shahid Beheshti University of Medical Sciences Ethics Committee.

RESULTS

According to the results, the mean age of the total participants in this study was 36.1±7.39, ranging from 21 to 58. The mean age with standard deviation according to cities included: Rasht 37.41±7.82, Shiraz 35.15±7.29, and Bandar Abbas 35.73±6.88 (P=0.06). Totally, their husbands’ age was 39.72±8.01, ranging from 23 to 63. Mean±SD were 40.88±7.93, 38.95±8.55 and 39.32±7.43 for Rasht, Shiraz and Bandar Abbas, respectively (P=0.12). Also, total mean with standard deviation duration of marriage was 10.96±7.14 that was t 11.22±7.35 for Rash, 10.98±7.35 for Shiraz and 10.68±6.74 for Bandar Abbas (P=0.68). Mean and standard deviation of the number of children was 1.33±0.94 in general. It was 1.26±0.89, 1.27±0.91 and 1.44±0.93 for Rasht, Shiraz and Bandar Abbas, respectively (P=0.21). There was no significant difference for other demographic characteristics among the cities (Table 1).

Table 1

Comparison of demographic characteristics of the participants

Characteristics	City	Rasht	Shiraz	Bandar Abbas	P value*
		N (%)	N (%)	N (%)
Women’s education	Bachelor	113 (85)	123 (92.50)	119 (89.50)	P=0.27
	Master Degree	17 (12.80)	9 (6.80)	12 (9)
	PhD	3 (2.30)	1 (0.80)	2 (1.50)
Husband’s education	Diploma or less	19 (14.30)	17 (12.80)	24 (18)	P=0.08
	Associate diploma & bachelor	85 (63.90)	89 (66.90)	85 (63.90)
	Higher than bachelor	29 (21.80)	27 (20.30)	24 (18)
Husband’s job	Employee	66 (49.60)	58 (43.60)	83 (62.40)	P=0.12
	Self Employed	44 (33.10)	59 (44.40)	38 (28.60)
	Other	23 (17.30)	16 (12)	12 (9.10)
Women’s income	250-500 USD	95 (71.50)	120 (90.20)	83 (62.50)	P=0.017
	501-750 USD	32 (24.10)	13 (9.80)	46 (34.60)
	More than 750 USD	6 (4.50)	0 (0)	4 (3)

Chi square test

The results indicated that the total score of empowerment and the scores of economic, social and familial dimensions of women’s empowerment in the three cities were above the mean scores and in a favorable condition. The scores of women’s empowerment in the three economic, familial and social dimensions in total and according to the cities are shown in Table 2.

Table 2

Comparison of women’s empowerment in social, familial and economic domains in Rasht, Shiraz and Bandar Abbas

Scores of empowerment	Cities	Score of mean±SD of empowerment	Minimum score	Maximum score	P value*
Total score of empowerment	Rasht	126.34±17.51	52	155	P=0.20
	Shiraz	123.42±15.62	81	155
	Bandar Abbas	123.42±12.34	70	155
Score of economic empowerment	Rasht	34.12±6.36	13	45	P=0.30
	Shiraz	33.36±5.99	21	45
	Bandar Abbas	34.39±4.51	24	45
Score of Social empowerment	Rasht	49.24±7.45	20	60	P=0.10
	Shiraz	48.00±8.11	28	60
	Bandar Abbas	47.47±5.20	28	60
Score of familial empowerment	Rasht	42.97±5.66	19	50	P=0.09
	Shiraz	42.10±5.18	25	50
	Bandar Abbas	41.54±5.07	23	50

ANOVA test

Chi-square test showed that the women’s empowerment in economic dimension in Rasht was significantly related to their husband’s job (P=0.007). The score of women’s empowerment in economic dimension in Rasht, Bandar Abbas and Shiraz was not significantly related to other demographic factors (P>0.05).

There was a significant difference between the women’s empowerment in social dimension in Rasht and women’s education (P=0.04) and their husband’s job (P=0.004) using Chi-square test. There were no significant differences between the score of women’s empowerment in social dimension in Rasht, Shiraz and Bandar Abbas and other demographic factors using Chi-square and t-test.

Women’s empowerment in familial dimension was significantly related to the number of children of the participants (P=0.001) in Rasht, and to their husband’s education (P=0.002) in Shiraz (Chi-square test). There were no significant differences between the score of women’s empowerment in familial dimension in Rasht, Shiraz and Bandar Abbas with other demographic factors (P>0.05).

Based on Chi-square test, women’s empowerment in total (in three dimensions of economic, social and familial) was significantly associated with the amount of income of the participants in Bandar Abbas (P=0.04), and with the jobs of their husbands in Rasht (P=0.004).There were no significant differences between the total score of women’s empowerment (in the dimensions of economic, social and familial) and other demographic factors in these three cities (P>0.05).

DISCUSSION

The results of the present research revealed that the total score of women’s empowerment in Rasht was more than the two other cities, which could be due to the level of higher education (MSc and PhD) in Rasht (15.1%) in comparison with Shiraz (7.6%) and Bandar Abbas (2.4%). Education can inter-related with the women’s empowerment.

In Ethiopia, a research showed that women’s education has improved from 2005 to 2011.Their education and work status were related to the quality of healthy life and empowerment of women. The authors suggest that policy makers, planners, program managers and government and nongovernment organizations should minimize the number of girls who never attend school or drop out to marry. Also, they should improve the family planning programs to empower the women.[15] Results of a survey showed that women’s knowledge improvement raised more expectation in women’s participation in the national development projects.[16]

CONCLUSION

The results of this study revealed that the score of social empowerment in Rasht was more than those of the two other cities. In economic domain, the scores of Rasht and Bandar Abbas were more than Shiraz. Also, the scores of Rasht and Shiraz were more than those of Bandar Abbas in the familial domain. Also, the total score of empowerment and the scores of economic, social, and familial dimensions of women’s empowerment in the three cities are in favorable condition. It is recommended that some research should be designed with larger sample size and participation of more subjects in different occupational groups. Also, qualitative studies aiming at determining the effects of various factors on women’s empowerment and strategies for improving this important cause are recommended to be conducted. If the questionnaire used in our study is used in other cities of Iran, we can generalize the findings to all cities in Iran. [5]