Women's empowerment and generalized anxiety in Minya, Egypt.

Gender disparities in mental health are global, with women experiencing higher rates than men of anxiety disorders, mood disorders, and attempted suicide. Women's low social status may partly explain these disparities, yet evidence from Arab and Middle Eastern settings is limited. We assessed whether women's empowerment - or acquisition of enabling resources, and in turn, enhanced agency - was associated with their lower generalized anxiety. For 539 ever-married women 22-65 years who participated in the 2005 Egypt Demographic Health Survey (EDHS) and a 2012 follow-up survey in rural Minya, we estimated linear reduced-form and mediation regression models to assess the associations of women's premarital enabling resources with their generalized anxiety in 2012, overall and through measures of their marital agency in 2005. Women's higher schooling attainment, premarital economic activity, later age at first marriage, and greater proximity to natal (or birth) family had significant, adjusted associations with lower generalized anxiety. Measures of women's agency in marriage had mixed associations with generalized anxiety, but their inclusion modestly reduced the coefficients for premarital resources. Parallel qualitative findings confirmed nuanced associations between women's exclusive decision-making and their mental health. Efforts to enhance women's education and premarital economic activity might be combined with efforts to delay first marriage and ensure women's extra-marital social support to maximize their empowerment and its mental-health benefits.

Intimate partner violence and women's economic and non-economic activities in Minya, Egypt.

Intimate partner violence (IPV) against women is widespread, but its implications for their economic and non-economic activities are understudied. Leveraging new data from 564 ever-married women aged 22­65 in rural Minya, Egypt, we estimated logistic regressions and zero-inflated negative binomial regressions to test spillover, compensation, and patriarchal bargaining theories about the influences of women's exposure to IPV on their engagement in and time spent on market, subsistence, domestic, and care work. Supporting compensation theory, exposures to lifetime, recent, and chronic physical or sexual IPV were associated with higher adjusted odds of performing market work in the prior month, and exposures to recent and chronic IPV were associated with higher adjusted odds of performing subsistence work in this period. Supporting compensation and patriarchal bargaining theories, exposures to recent and chronic IPV were associated with more time spent on domestic work in the prior day. Supporting spillover and patriarchal bargaining theories, exposures to lifetime IPV of all forms were associated with lower adjusted odds of performing mostly nonspousal care work in the prior day, and this association was partially mediated by women's generalized anxiety. Women in rural Minya who are exposed to IPV may escalate their housework to fulfill local norms of feminine domesticity while substituting economic activities for nonspousal care work to enhance their economic independence from violent partners.

A New Method for Deriving Global Estimates of Maternal Mortality.

Maternal mortality is widely regarded as a key indicator of population health and of social and economic development. Its levels and trends are monitored closely by the United Nations and others, inspired in part by the UN's Millennium Development Goals (MDGs), which call for a three-fourths reduction in the maternal mortality ratio between 1990 and 2015. Unfortunately, the empirical basis for such monitoring remains quite weak, requiring the use of statistical models to obtain estimates for most countries. In this paper we describe a new method for estimating global levels and trends in maternal mortality. For countries lacking adequate data for direct calculation of estimates, we employed a parametric model that separates maternal deaths related to HIV/AIDS from all others. For maternal deaths unrelated to HIV/AIDS, the model consists of a hierarchical linear regression with three predictors and variable intercepts for both countries and regions. The uncertainty of estimates was assessed by simulating the estimation process, accounting for variability both in the data and in other model inputs. The method was used to obtain the most recent set of UN estimates, published in September 2010. Here, we provide a concise description and explanation of the approach, including a new analysis of the components of variability reflected in the uncertainty intervals. Final estimates provide evidence of a more rapid decline in the global maternal mortality ratio than suggested by previous work, including another study published in April 2010. We compare findings from the two recent studies and discuss topics for further research to help resolve differences.