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Women's Empowerment in Agriculture Index - Health and Nutrition Module (pro‐WEAI+HN)

The pro-WEAI+HN is a 6-item scale that measures health- and nutrition-related agency. It is an additional, optional module of the pro-WEAI scale. It presents 17 women's health and 13 child health decisions, and asks female respondents about the normal decision-makers for the activity (up to 3 individuals) and the extent to which they participated in the decision.

Categories

Geographies Tested: Bangladesh,Burkina Faso,Mali

Populations Included: Female

Age Range: Adolescents, Adults

Items:

Decisions about women’s health and nutrition

1. When decisions are made about [ACTIVITY], who normally takes the decision?
2. To what extent do you participate in decisions regarding [ACTIVITY]?

Activities:
-Whether or not you consult a doctor or go to a clinic when you are ill
-How much you can rest when you are ill
-Whether or not you have a/another child †
-Whether or not you use a contraceptive method (such as birth control pills, condoms, hormonal shot, or sterilization)? †
-What foods to prepare every day
-What foods (available in the house) you can eat
-Whether you consulted a doctor or went to a clinic during your current or most recent pregnancy*
-How much you worked during your current or most recent pregnancy*
-How much you could rest during your current or most recent pregnancy*
-Whether you could eat eggs during your current or most recent pregnancy*
-Whether you could consume milk or milk products during your current or most recent pregnancy*
-Whether you could eat meat, poultry, or fish during your current or most recent pregnancy*
-How much you worked when your youngest child was being breastfed* †
-How much you could rest when your youngest child was being breastfed* †
-Whether you could eat eggs when your youngest child was being breastfed* †
-Whether you could consume milk or milk products when your youngest child was being breastfed* †
-Whether you could eat meat, poultry, or fish when your youngest child was being breastfed* †

Response Options:
Not at all - 1
To a small extent - 2
To a medium extent - 3
To a high extent - 4

Decisions about child’s health and nutrition

3. When decisions are made about [ACTIVITY], who normally takes the decision?
4. To what extent do you participate in decisions regarding [ACTIVITY]?

Activities:
-Whether your child is taken to a clinic or a doctor is consulted when he/she is sick
-Whether your child gets vaccinations †
-Whether your child visits the health clinic to see if he/she is growing well
-How to feed your child when he/she is sick †
-Who will care for your child when you need to go outside the home for an extended period of time †
-Sending your child to school †
-Whether your child is offered eggs to eat**
-Whether your child is offered milk or milk products, other than breastmilk**
-Whether your child is offered meat, poultry, or fish**
-Whether to breastfeed your child***
-When to stop breastfeeding your child***
-When to start introducing foods and liquids (other than breastmilk) to your child
-Whether or not your child is fed foods prepared or bought especially for children that adult household members do not eat or drink, such as fortified cereals or baby foods? ** *** †

Response Options:
Not at all - 1
To a small extent - 2
To a medium extent - 3
To a high extent - 4

Health and Nutrition Products

5. When decisions are made whether or not to purchase [PRODUCT], who generally makes the decision?
6. You may acquire an item that you need in a variety of ways, such as purchasing or cultivating it or having someone purchase or cultivate it for you. When you need [PRODUCT], can you usually acquire it?

Products:
-Small quantities of food, for example smaller than 5 kg
-Large quantities of food, for example larger than 5 kg
-Eggs
-Milk or milk products
-Meat, poultry, or fish (including organ meats)
-Special foods for children (i.e., foods prepared or bought especially for children that adult household members do not eat or drink, such as fortified cereals or baby foods that programs or health workers tell you should be consumed †
-Any nutritious foods that a program or health worker told you to consume †
-Medication, vitamins, or supplements for children
-Medication, vitamins, or supplements for yourself
-Clothing for children †
-Clothing for yourself †
-Toiletries, such as soap and toothpaste

Response Options:
Yes
No
Not applicable

* Only asked to women who have been pregnant or given birth in the last 2 years
** Only asked to women who have a child aged 6 months or older
*** Only asked to women who have a child aged 2 years or younger
† Item not used in indicator construction

Scoring Procedures

Adequacy cutoff values were based on the proportion of women who would be identified as adequate at different cutoffs - Those reporting any input (sole or joint to a small extent), medium input (sole or joint to a medium extent) or high input (sole or joint to a high extent), into the decisions for each factor; and decides to purchase or has access to 25%, 50%, 75% or 100% of products. To assess the prevalence of empowerment, the mean adequacy value of each indicator was calculated, pooled by region. More scoring details can be found in the original citation.

Original Citation

Heckert, J., Martinez, E. M., Seymour, G., Pereira, A., Roy, S., Kim, S. S., Malapit, H., Gender, A., Agriculture Project Phase, H., & Nutrition Study, T. (2023). Development and validation of a health and nutrition module for the project-level Women's Empowerment in Agriculture Index (pro-WEAI+HN). Maternal & Child Nutrition, 19(2), 1-14. https://doi.org/10.1111/mcn.13464


Psychometric Score

Ease of Use Score

Scoring breakdown

Formative Research

Qualitative Research

Existing Literature/Theoretical Framework

Field Expert Input

Cognitive Interviews / Pilot Testing

Reliability

Internal

Test-retest

Interrater

Validity

Content

Face

Criterion (gold-standard)

Construct

KEY

Ease of Use

Readability

Scoring Clarity

Length

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