Gendered vulnerabilities to a neglected disease: A comparative investigation of the effect of women’s legal economic rights and social status on malaria rates

Abstract

Although seldom noted in scholarly accounts, malaria represents a leading cause of death and underdevelopment in poor nations. Enormous cross-national variation in malaria rates across its endemic zones suggests the importance of large-scale factors in explaining comparative disease trends. While the biological vulnerability of women and children to malaria is often acknowledged, the literature has yet to investigate how gender inequalities contribute to patterns of malaria prevalence. Utilizing structural equation modeling on a sample of 90 less-developed nations and engaging insights from gender stratification perspectives, we consider the influence of both legal economic status and social dimensions of women’s status on malaria rates. We find that women’s legal economic status has an indirect relationship on malaria rates by enhancing women’s social standing and strengthening general health provisions. The results suggest that addressing issues of gender inequality in poor nations is central to tackling this persistent pandemic.

Keywords

Development gender health malaria Sub-Saharan Africa

Get full access to this article

View all access options for this article.

References

Agarwal

(1994) Gender and command over property: A critical gap in economic analysis and policy in South Asia. World Development 22(10): 1455–1478.

Agarwal

(1997) Bargaining and gender relations: Within and beyond the household. Feminist Economics 3(1): 1–51.

Ali

Stefan

Madhur

(2007) Property rights in a very poor country: Tenure insecurity and investment in Ethiopia. The World Bank Africa Region Sustainable Development Department and Development Research Group, pp. 1–29.

Arbuckle

(1996) Full information estimation in the presence of incomplete data. In: Marcoulides

Schumacker

(eds) Advanced Structure Equation Modeling Issues and Techniques. Mahwah, NJ: Lawrence Erlbaum Associates, pp. 243–277.

Austin

(2013) Export agriculture is feeding malaria: A cross-national examination of the environmental and social causes of malaria prevalence. Population and Environment 35(2): 133–158.

Austin

McKinney

(2012) Disease, war, hunger, and deprivation: A cross-national investigation of the determinants of life expectancy in less-developed and sub-Saharan African nations. Sociological Perspectives 55(3): 394–416.

Austin

Noble

(2014) Measuring gender disparity in the HIV pandemic: A cross-national investigation of female empowerment, inequality, and disease in less-developed nations. Sociological Inquiry 84(1): 102–130.

Bates

Fenton

Gruber

. (2004) Vulnerability to malaria, tuberculosis, and HIV/AIDS infection and disease part II: The determinants operating at environmental and institutional level. Lancet Infectious Diseases 4: 368–375.

Bollen

(1989) Structural Equations with Latent Variables. New York: John Wiley & Sons, Inc.

10.

Brady

Kaya

Beckfield

(2007) Reassessing the effect of economic growth on well-being in less-developed countries, 1980-2003. Studies in Comparative International Development 42: 1–35.

11.

Breman

Alilio

Mills

(2004) Conquering the intolerable burden of malaria: What’s new, what’s needed: A summary. The American Society of Tropical Medicine and Hygiene 71(Suppl. 2): 1–15.

12.

Breman

Alilio

White

(2007) Defining and defeating the intolerable burden of malaria III. Progress and perspectives summary. The American Society of Tropical Medicine and Hygiene 77(6): vi–xi.

13.

Burroway

(2010) Schools against AIDS: Secondary school enrollment and cross-national disparities in AIDS death rates. Social Problems 57(3): 398–420.

14.

Burroway

(2012) A cross-national analysis of sex-specific HIV prevalence rates and women’s access to property land, and loans in developing countries. International Journal of Sociology 42(2): 47–67.

15.

Byrne

(2009) Structural Equation Modeling with AMOS. New York: Psychology Press/Routledge Academic.

16.

CIA World Factbook (2010) Central intelligence agency. Available at: https://www.cia.gov/library/publications/the-world-factbook/ (accessed 5 May 2013).

17.

Enders

Bandalos

(2001) The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling 8(3): 430–457.

18.

Farmer

(2001) Infections and Inequalities: The Modern Plagues. Los Angeles, CA: University of California Press.

19.

Firebaugh

Beck

. (1994) Does economic growth benefit the masses? Growth, dependence, and welfare in the third world. American Sociological Review 59(5): 631–653.

20.

Fried

Nosten

Brockman

. (1998) Maternal antibodies block malaria. Nature 395(6705): 851–852.

21.

Gupta

(2004) Globalization, women and HIV/AIDS epidemic. Peace Review 16(1): 79–83.

22.

Heimer

(2007) Old inequalities, new disease: HIV/AIDS in sub-Saharan Africa. Annual Review of Sociology 33: 551–577.

23.

Holvoet

(2005) The impact of microfinance on decision-making agency: Evidence from South India. Development and Change 36(1): 75–102.

24.

Karlsen

Say

Souza

J-P

. (2011) The relationship between maternal education and mortality among women giving birth in health care institutions: Analysis of the cross sectional WHO global survey on maternal and perinatal health. BMC Public Health 11(606): 1–10. Available at: http://www.biomedcentral.com/1471-2458/11/606

25.

Kick

McKinney

Thompson

(2011) Intensity of food deprivation: The integrative impacts of the world system, modernization, conflict, militarization and the environment. International Journal of Comparative Sociology 52(6): 478–502.

26.

Kristof

WuDunn

(2009) Half the Sky: Turning Oppression into Opportunity for Women Worldwide. New York, NY: Vintage Books.

27.

Lowassa

Mazigo

Mahande

. (2012) Social economic factors and malaria transmission in Lower Moshi, Northern Tanzania. Parasites & Vectors 5(129): 1–9.

28.

Mayoux

(2001) Tackling the down side: Social capital, women’s empowerment and micro-finance in Cameroon. Development and Change 32(1): 435–464.

29.

Medalia

Chang

(2011) Gender equality, development, and cross-national sex gaps in life expectancy. International Journal of Comparative Sociology 52(5): 371–389.

30.

Naidoo

London

Burdorf

. (2011) Occupational activities associated with a reported history of malaria among women working in small-scale agriculture in South Africa. The American Society of Tropical Medicine and Hygiene 85(5): 805–810.

31.

Norris

(2004) Mosquito-borne diseases as a consequence of land use change. EcoHealth 21(1): 19–24.

32.

Ogbodo

Nwagha

Okaka

ANC

. (2009) Malaria parasitaemia among pregnant women in a rural community of Eastern Nigeria; Need for combined measures. Nigerian Journal of Physiological Sciences 24(2): 95–100.

33.

Organisation for Economic Co-operation and Development (OECD) (2009) Gender, Institutions and Development Database (GID-DB). Available at: http://stats.oecd.org/Index.aspx?DatasetCode=GID2 (accessed 10 June 2013).

34.

Packard

(2009) Roll back on malaria, roll in development? Reassessing the economic burden of malaria. Population Development and Review 35(1): 53–87.

35.

Parvin

Reazaul Ahsan

Chowdhury

(2005) Women empowerment performance of income generating activities supported by Rural Women Employment Creation Project (RWECP): A case study in Dumuria Thana, Bangladesh. The Journal of Geo-Environment 4: 47–62.

36.

Pattanayak

Dickinson

Corey

. (2006) Deforestation, malaria, and poverty: A call for transdisciplinary research to support the design of cross-sectional policies. Sustainability: Science, Practice, and Policy 2(1): 45–56.

37.

Pérez-Escamilla

Dessalines

Finnigan

. (2009) Household food insecurity is associated with childhood malaria in rural Haiti. The Journal of Nutrition 139(11): 2132–2138.

38.

Ridgeway

Smith-Lovin

(1999) The gender system and interaction. Annual Review of Sociology 25: 191–216.

39.

Rubin

(1985) Significance testing with population data. Social Service Review 59(3): 518–520.

40.

Sabin

Rizal

Brooks

. (2010) Attitudes, knowledge, and practices regarding malaria prevention and treatment among pregnant women in Eastern India. The American Society of Tropical Medicine and Hygiene 82(6): 1010–1016.

41.

Sachs

Malaney

(2002) The economic and social burden of malaria. Nature 415: 680–685.

42.

Schuler

Hashemi

(1994) Credit programs, women’s empowerment, and contraceptive use in rural Bangladesh. Studies in Family Planning 25(2): 65–76.

43.

Sen

(1999) Development as Freedom. New York: Knopf.

44.

Shandra

London

(2011) World bank structural adjustment, water, and sanitation: A cross-national analysis of child mortality in Sub-Saharan Africa. Organization & Environment 24(1): 107–129.

45.

Shargie

Ngondi

Graves

. (2010) Rapid increase in ownership and use of long-lasting insecticidal nets and decrease in prevalence of malaria in three regional states of Ethiopia (2006–2007). Journal of Tropical Medicine 2010: 1–12.

46.

Shen

Williamson

(1997) Child mortality, women’s status, economic dependency, and state strength: A cross-national study of less-developed countries. Social Forces 76(2): 667–694.

47.

Sherer

Jr. Bronson

Teter

. (2004) Microeconomic loans and health education to families in impoverished communities: Implications for the HIV pandemic. Journal of the International Association of AIDS Care 3(4): 110–114.

48.

Shircliff

Shandra

(2011) Non-governmental organizations, democracy, and HIV prevalence: A cross-national analysis. Sociological Inquiry 81(2): 143–173.

49.

Soares

(2007) On the determinants of morality reductions in the developing world. Population Development and Review 33(2): 247–287.

50.

Taj

Akmal

Shah

. (2008) Gender involvement in small enterprises through micro-credit in Rainfed Pothwar. Sarhad Journal of Agriculture 24(4): 779–784.

51.

Tsai

Witte

Aira

. (2011) Piloting a savings-led microfinance intervention with women engaging in sex work in Mongolia: Further innovation for HIV risk reduction. The Open Women’s Health Journal 5: 26–32.

52.

Verhoeff

Brabin

Hart

. (1999) Increased prevalence of malaria in HIV-infected pregnant women and its implications for malaria control. Tropical Medicine & International Health 4(1): 5–12.

53.

Villarreal

(2006) Changing customary land rights and gender relations in the context of HIV/AIDS in Africa. In: Colloque international ‘Les frontières de la question foncière – At the frontier of land issues’, Montpellier.

54.

Wickrama

KAS

Lorenz

(2002) Women’s status, fertility decline, and women’s health in developing countries: Direct and indirect influences of social status on health. Rural Sociology 67(2): 255–277.

55.

Williams

PCM

Martina

Cumming

. (2009) Malaria prevention in sub-Saharan Africa: A field study in rural Uganda. Journal of Community Health 34: 288–294.

56.

World Bank (2013) World development indicators online. Available at: http://databank.worldbank.org/data/views/variableSelection/selectvariables.aspx?source=world-development-indicators# (accessed 10 June 2013).

57.

World Health Organization (WHO) (2003) Lives at Risk: Malaria and Pregnancy. WHO. Available at: http://www.who.int/features/2003/04b/en/# (accessed 10 June 2013).

58.

World Health Organization (WHO) (2008) Proportion of Births Attended by a Skilled Health Worker 2008 Updates. Department of Reproductive Health Research, WHO. Available at: http://www.who.int/reproductivehealth/publications/maternal_perinatal_health/2008_skilled_attendant.pdf (accessed 5 May 2013).

59.

World Health Organization (WHO) (2013) Malaria fact sheet. Available at: http://www.who.int/mediacentre/factsheets/fs094/en/ (accessed 10 June 2013).

60.

World Health Organization (WHO) (2014) Health promotion, Track 1: Community empowerment. Available at: http://www.who.int/healthpromotion/conferences/7gchp/track1/en/ (accessed 22 March 2014).

61.

Wright

(1934) The method of path coefficients. The Annuals of Mathematical Statistics 5(3): 161–215.