COVID-19 made Mental Wellbeing a Focus Area

September 2021

By Divya Bhardwaj

The lived experiences of COVID-19 over the past 18-months have exhibited its many socio-economic implications. With governments oscillating between instituting travel bans and lockdowns while fighting recurring waves of COVID-19 cases–lives and livelihoods across the world continue to be gravely impacted.

Months into this pandemic, we observed an increased articulation of constant stress and anxiety due to a sudden loss of control over sustenance, life and future. Vihara conducted longitudinal, design-led qualitative research studies, with remote and in-person data collection in India, specifically in Bihar, Uttar Pradesh, Delhi, and Maharashtra. These studies were conducted with women, men, adolescent girls and frontline workers. The research unpacked COVID-19’s impact on lived experiences, mental stressors, coping mechanisms, as well as potential interventions to address these concerns.

The Second Wave Amplifying the Severity of our Challenge
Our research reveals that what may have been a ubiquitous problem of stress and anxiety, has now led to a pervasive sense of loss, severe grief and trauma, especially since India’s second wave in April-June 2021. In this wave, many experienced the trauma of witnessing near-death experiences themselves or of a loved one, in a time of acute scarcity and an unequivocal breakdown of the health system. Much worse is the guilt, grief and trauma of families who have experienced the loss of one/both parents, a partner, provider or a loved one, with the inability to offer last rites respectfully. Coping with such severe mental health conditions is foremost about acknowledging them, finding support or an appropriate release, and learning to live through it without suppressing the emotions. This could not be further from the reality for women like Radha*, in rural Darbhanga, Bihar, who lost her partner, the provider to her family to COVID-19. With the sudden loss of her husband to an unknown fever with no local doctors willing to touch, let alone cure him – her grief and despair are unparalleled. There is a strong sense of abandonment from both her deceased husband and the system, but what takes precedence is the fear and uncertainty about life and sustenance of her three children. Radha finds odd jobs to put food on the table, with little time to mourn or focus on coping with everything she is feeling. Much like Radha, women in rural India don’t have the privilege to take time off to acknowledge or process their mental health as household and child care responsibilities are solely theirs.

With the added burden of providing for their families due to the dire economic stress that many women face today – there is little opportunity to heal. Vihara’s research also brought to fore the discomfort women feel when pushed into a provider role as it conflicts with their gender role of a caregiver and hinders their capability to perform it.

Correspondingly, our research identified that men experience a constant internal conflict as they are unable to fulfill their gender roles of provider and protector of their families, due to the loss of subsistence or loved ones during this economic and health crisis. Men’s discomfort around acknowledgement and expression of their emotions more often manifests in anger leading to violence and increased dependence on substance abuse. We find that women and girls are at the receiving end of such maladaptive coping. Women and girls are more likely to turn to passivity, self-imposed isolation, and non-communicative behaviours3 thereby impacting their efficacy and capacity to fulfill their responsibilities. This further results in stigmatisation from the unit and the community creating a vicious cycle that disproportionately impacts their mental health and reinforces gender inequalities.

Reassessing Psychosocial Interventions Design
Diverse experiences of grief and trauma exist across gender, age, economic strata, or occupations. Traditional clinical approaches to mental health are proving to be inadequate to these widespread needs, not just due to systemic and digital access challenges, but also due to deficient colloquial vocabulary and stigma around mental wellbeing, especially in low-income resource constraint communities.

Mental health interventions need to be community-led and sensitive to contextualities that may often be triggers or exacerbate stressors. Vihara is keen to build such interventions that focus on enabling individual coping strategies through cognitive behavioural reflections, techniques to navigate triggers, especially for men, where we also need to de-stigmatise expressions of distress and vulnerability.

Given the challenges of articulation of mental health, gamified and narrative tools can greatly encourage sharing and become a way to build emotional support and collaborative familial or couple dynamics. There is a lack of direct channels to adolescents, especially with schools shut and curtailed peer networks. We, therefore, need to leverage available entry points and influencers to provide support and develop escalation pathways where necessary. Interventions that focus on adolescents need to also focus on skill-building, both commercial and life skills, to navigate the social stressors impacting their mental wellbeing.

In addition, the sharp increase in access to mobile internet for women in India is an opportunity for digital innovations if designed with a focus on contextual and behavioural insights. In urban and peri-urban areas, digital solutions must be envisioned to normalize a dialogue around mental wellbeing, equip communities to recognise the symptoms of poor mental health and ways to build healthy active coping behaviours by providing sustained support without fear of judgement.

The COVID-19 pandemic has amplified the need for mental wellbeing interventions that equip men, women, and adolescents to navigate various stressors within and outside of homes. Vihara is committed to designing interventions that consider regional variance around digital access-literacy to develop in tailored offline-online models that are more culturally embedded, contextually rooted and are built on human-centred design approaches for them to be effective and transformative in a meaningful way.

About the author:
Divya Bhardwaj leads the work in gender, social vulnerability, and psychosocial health at Vihara Innovation Network. She brings expertise on social and environmental factors that perpetuate vulnerability, and their impact on behaviours, mental models and decision-making patterns. She directs human-centred design and research projects in RMNCH+A, Covid-19, and has worked across India and Kenya.

Vihara Innovation Network is an impact and innovation firm that uses anthropological research, human-centred design and systems thinking to unpack barriers and design interventions that are inclusive and equitable. We have been working in the development sector for the past 17 years across Asia and Africa.


Measuring Women’s Political Empowerment: the Women’s Empowerment as Political Citizens Index

September 2021

By Nivedita Narain, Soledad Artiz Prillaman, and Natalya Rahman

Gendered imbalances in political spaces are widespread. While women may have attained universal suffrage, women are less present than men in most political institutions (World Bank 2012). Even when women are present, they often hold less political authority and are less likely to be heard than men (Karpowitz and Mendelberg 2014).

Empowering women in political spaces is not only critical for inclusive governance but also bears the promise of improved and responsive policy-making. Despite the need for and benefits from women’s political empowerment, few frameworks exist to assess and diagnose the extent of prevailing political power imbalances, particularly at the individual level. Further, unlike economic empowerment, political empowerment — the ability to choose when and how one interacts with political institutions — has received less scholarly attention. We propose a theoretical framework to conceptualize the process of political empowerment at an individual level and then introduce a new index of political empowerment measured through surveys conducted with individual women.

Conceptualizing Political Empowerment

Drawing on Kabeer (1999), we define political empowerment as the process by which those who have been denied the ability and agency to express their voice in the political system acquire such an ability. By political we refer to actions and beliefs that pertain to government institutions or are in service of engaging government institutions and policies (Burns et al. 2001).

Kabeer (1999) suggests that the ability to exercise strategic life choices, or the process of empowerment, can be thought of in terms of three domains of social change: resources, agency, and achievements. We apply this framework to the domain of political action and argue that it is the accumulation of political resources, agency, and achievements that yields true political empowerment:

  1. Resources or the various material, human, and social resources that enhance the ability to exercise choice and act in the political domain, including knowledge about political systems, interest in political action, networks to facilitate political action, and norms that determine for whom political action is socially acceptable.
  2. Agency or the process related to an individual’s ability to define one’s goals and act upon them with respect to interactions with political institutions, includes both the autonomy to choose to act on one’s own interest and belief that such actions are socially acceptable and likely to achieve their aims.
  3. Achievements or the meaningful improvements in life outcomes that result from increased political agency, including all of the varied ways that individuals engage state institutions, such as through electoral participation, claims-making, public discourse, and resistance against the state.

Figure 1 below maps this conceptual framework for political empowerment and highlights key components of each domain of political empowerment.

Figure 1: Conceptual framework for political empowerment

The Women’s Empowerment as Political Citizens Index

Drawing on this conceptual framework, we develop a set of survey questions to construct a single measure of an individual woman’s political empowerment, which we call the Women’s Empowerment as Political Citizens Index (WEP Citizens Index). The index comprises 30 questions, [1] designed for the context of rural India, which are aggregated and weighted such that each of the three main domains receives equal weight. The final measure for each individual is an empowerment score that ranges from zero to one.

To test and evaluate the WEP Citizens Index, we conducted two surveys in 2019 in Betul district of Madhya Pradesh, India. Both surveys included all component measures of the index and were conducted with a random sample of adult women from rural villages. The first survey was conducted as per usual academic surveying practices with a team of external surveyors and included 540 women from 12 villages. The second survey was conducted as per a common practice of practitioner organizations and employed community-based data collectors (CDC) to survey 756 women from 16 villages, overlapping the 12 villages from the first survey.

Women’s Political Empowerment in Rural India

What can we learn from a measure of women’s political empowerment? Figure 2 shows the distribution of empowerment scores  among women in our external enumerator and CDC survey respectively. Three key facts emerge:

  1. The average political empowerment score was 0.4 in the external enumerator survey and 0.35 in the CDC survey. This implies that, on average, women are not entirely disempowered as many measures of political participation alone would suggest, but that there is still quite a way to go to achieve complete empowerment.
  2. There is a large spread of political empowerment across women; women’s political empowerment varies from 0.03 to 0.90. Roughly 13% of women score below 0.2, where they have only a few components of just one domain of political empowerment but lack empowerment in the other two domains. For example, a woman at this score could have knowledge of and interest in politics, but no agency to make choices about political participationOn the other hand, 14% of women score above 0.5, where they would have several components of multiple domains of political empowerment. For example, a woman at this score could have all of the resources needed to participate, some agency over their participation, and may vote, but may still be unlikely to participate in politics outside of voting. About 70% of our respondents are somewhere in the middle of these two kinds of people.
  3. The distributions for the two surveys are similar in shape and spread, as shown in the third panel of the figure. This implies that the WEP Citizens Index is a reliable measure.

Figure 2: Distribution of political empowerment for women across surveys

What drives political empowerment?

One test of the validity of our measure is how it correlates with previously theorized determinants of political participation. We examine whether higher income, increased labor force participation, higher levels of education, and self-help group membership positively correlate with political empowerment, all of which have been hypothesized to increase women’s political activity (Prillaman Forthcoming, Chibber 2002, Burns et al 2001).

Table 1 below reports the correlation between these indicators and our index of political empowerment using a basic OLS regression. Each of these conventional predictors of political participation is positively and significantly correlated with political empowerment. The effect of these predictors is also substantial; for example, SHG members in the external enumerator survey have a higher empowerment score by 0.04 on average. This might translate to one additional act of political participation. Similarly, women in the labor force in the CDC survey have a higher empowerment score by 0.08, which could translate to having one additional resource, for example, political interest. These strong and sizable predictions suggest that the WEP Citizens Index has construct validity.

Table 1: Predicting political empowerment with conventional correlates

What next?
Despite women’s political inclusion being a key goal of the SDGs, we have not had a framework for conceptualizing the holistic process of women’s political empowerment at an individual-level until now. Such a framework is critical for academics as they develop insights into the root causes and consequences of women’s political empowerment and for practitioners as they evaluate whether programs and policies have increased women’s political empowerment. While much more research is needed into the validity of this framework in different contexts and countries, we believe the WEP Citizens Index takes a step forward in conceptualizing the importance of women’s agency in political decision-making and demonstrating how such a conceptual framework can be deployed in realtime to understand progress at achieving this goal.

About the authors:
Nivedita Narain has worked with PRADAN for over three decades in a variety of leadership roles. She currently leads the research portfolio. 

Soledad is an Assistant Professor of Political Science at Stanford University. Her research focuses on gender, political representation, and development, with a focus in South Asia. She received a Ph.D. in Government at Harvard University.

Natalya is a Ph.D. Candidate in Political Science at Stanford University. She studies political behavior and development in South Asia.


Burns, Nancy, Kay Lehman Schlozman, and Sidney Verba. The Private Roots of Public Action. Harvard University Press, 2001.

Chibber, Pradeep. “Why are some women politically active? The household, public space, and political participation in India.” International Journal of Comparative Sociology 43.3-5 (2002): 409-429.

Kabeer, Naila. “Resources, agency, achievements: Reflections on the measurement of women’s empowerment.” Development and change 30.3 (1999): 435-464.

Karpowitz, Christopher F., and Tali Mendelberg. The silent sex. Princeton University Press, 2014.

Prillaman, Soledad Artiz. “Strength in numbers: How women’s groups close India’s political gender gap.” American Journal of Political Science (Forthcoming).

World Bank. 2012. World Development Report: Gender Equality and Development.

[1] The full list of questions can be provided on request.

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