Husbands' dominance in decision-making about women's health: a spatial diffusion perspective in sub-Saharan Africa

This article maps spatial and temporal variation in husbands' dominance in decision-making about their wives' health using pooled Demographic and Health Surveys from 28 countries in sub-Saharan Africa in an earlier (i.e., 2001–2005) and later (i.e., 2010–2014) period. First, we use adaptive bandwidth kernel density estimation to show how aggregate country-level estimates of husbands' decision-making dominance mask enormous spatial heterogeneity within countries. Our maps also reveal a geographic clustering of cells with similar levels of husband's decision-making dominance both within and between countries. Next, we use panel fixed-effects spatial regression methods to show that decreases in husbands' decision-making dominance in neighboring cells are associated with decreases in husbands' decision-making dominance in the reference cell. These findings support a diffusion explanation for declines in husbands' decision-making dominance over time. Our analyses also indicate that schooling and urbanization may be important channels through which diffusion occurs, which we speculate is because these are places where people are exposed to new ideas and gender norms.

10.1215/00703370-9429489

0070-3370

1955-1975

Andriano, Liliana

d960ab52-0b87-4a01-940d-d1383a44257d

Behrman, Julia

86b8716b-d739-4c35-a238-c8b918ffce9e

Monden, Christiaan

719e45fe-004f-4ab4-88ee-045e768b856e

1 October 2021

Andriano, Liliana

d960ab52-0b87-4a01-940d-d1383a44257d

Behrman, Julia

86b8716b-d739-4c35-a238-c8b918ffce9e

Monden, Christiaan

719e45fe-004f-4ab4-88ee-045e768b856e

Andriano, Liliana, Behrman, Julia and Monden, Christiaan (2021) Husbands' dominance in decision-making about women's health: a spatial diffusion perspective in sub-Saharan Africa. Demography, 58 (5), 1955-1975. (doi:10.1215/00703370-9429489).

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e-pub ahead of print date: 9 September 2021

Published date: 1 October 2021

Additional Information: Funding information: We are grateful to Ridhi Kashyap, Mónica Caudillo, Abigail Weitzman, Doron Shiffer-Sebba, and the Global Family Change (GFC) Team for helpful feedback on an earlier version of this manuscript. This work was supported by the John Fell Fund at the University of Oxford; the Economic and Social Research Council (Grant ES/J500112/1); Nuffield College at the University of Oxford; a Leverhulme Trust Grant for the Leverhulme Centre for Demographic Science; and the GFC Project (http://web.sas.upenn.edu/gfc), which is a collaboration among the University of Pennsylvania, University of Oxford (Nuffield College), Bocconi University, and the Centro de Estudios Demograficos (CED) at the Universitat Autonoma de Barcelona. Funding for the GFC Project is provided through NSF Grant 1729185 (PIs Kohler and Furstenberg), ERC Grant 694262 (PI Billari), ERC Grant 681546 (PI Monden), the Population Studies Center and the University Foundation at the University of Pennsylvania, and the John Fell Fund and Nuffield College at the University of Oxford. All R code used for these analyses is available upon request from the authors. All outputs of these analyses at the country and 0.50 × 0.50-degree levels are available online at https://osf.io/k3x8y/.