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Gender and Reproductive Health Empowerment  

Shannon N. Wood, Robel Yirgu, and Celia Karp

Gender and reproductive health empowerment are central concepts for understanding and improving population health and well-being. Beginning in the 1990s, global platforms, including the United Nations, began recognizing gender-based inequities, including violence against women and lack of women’s participation in education and the economy, as social determinants of health. Since the 1990s there has been growing international interest in the concept of empowerment as a means for understanding the mechanisms that drive outcomes related to health and development. Although several definitions of empowerment have evolved over the past 30 years, the pivotal work of Dr. Naila Kabeer has grounded many interpretations of women’s empowerment as a process by which a woman has the individual capacity and freedom to act on her own choices in life. To date, the lack of comparable empowerment definitions remains a major hindrance to conducting comprehensive research that links empowerment to health outcomes. Additionally, while most recognize empowerment as a multidimensional process, the majority of measures used for examining this concept have been unidimensional (focused on agency, self-efficacy, household decision-making, etc.), thereby limiting the understanding of empowerment across populations, geographies, and contexts. Subsequent framing of women’s empowerment has focused specifically on sexual and reproductive empowerment, recognizing that women may be empowered in certain realms (e.g., economic), but not in others (e.g., autonomy in contraceptive decisions). Developments in the conceptualization of reproductive empowerment since 2015 have paved the way for improved measurement and exploration of this concept, yet gaps in research remain.

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Maternal Health and Well-Being  

Samuel Akombeng Ojong, Bridgette Wamakima, Cheryl A. Moyer, and Marleen Temmerman

Maternal health and well-being refers to the physical, psychological, and emotional well-being of women during pregnancy, childbirth, and the postnatal period, as well as the absence of any morbidities or death either due to pregnancy or its management. Despite making a comparatively late appearance on the international global policy agenda, maternal health and well-being has progressively become a global health policy priority following Deborah Maine’s revolutionary article on maternal mortality. Consequently, key international policy events from Alma Ata to the International Conference on Population and Development events, through the Millennium Development Goals to the Sustainable Development Goals (SDGs) in the last decade have consecrated women’s inalienable right to safe and respectful health services. Also, the growing focus on rights-based care against the backdrop of the need to ensure equity in all communities worldwide has led to an evolution in policy focus, calling on health systems to not only protect women and girls from preventable deaths but to also empower them to thrive, all while recognizing their unique role is ensuring the positive transformation of the communities in which they live. This increasing policy attention has contributed to a disproportionate yet marked reduction in global maternal mortality and morbidity statistics over the last 30 years. However, if the world is to achieve its 2030 SDGs women’s health and gender equality agendas, it is important to recognize that the broad concept of women’s health cannot be limited to the rather narrow window of pregnancy, childbirth, and the postpartum period. While there are huge gaps in all resource-type settings in promoting and protecting women’s agency and autonomy, the fact remains that in addition to ensuring the availability of and access to high-quality maternal health services, women’s health outcomes are inextricably linked to their decision-making power on key issues such as when to become sexually active, the use of contraception, whether or not they want to achieve pregnancy and childbirth, and access to safe abortion care services. Additionally, the growing burden of noncommunicable diseases and the increasing occurrence of worldwide pandemics are providing novel challenges to the health and well-being of the world’s most vulnerable women and girls, thus creating the need to ensure resilient health systems that are considerate of the rights and wishes of the world’s women and girls.