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TYPE Original Research

PUBLISHED 31 October 2024
DOI 10.3389/fgwh.2024.1463157

What factors influence women’s

empowerment in Ethiopia?
EDITED BY
Jay S. Mishra,
University of Wisconsin-Madison,
A multilevel analysis of Ethiopia’s
United States

REVIEWED BY
demographic and health
Nosakhare Orobaton,
Bill and Melinda Gates Foundation, survey data
United States
Pankaj Yadav,
University of Wisconsin-Madison,
Endalkachew Dellie1*†, Misganaw Guadie Tiruneh1,
United States Melak Jejaw1, Kaleb Assegid Demissie1, Mihret Getnet2,
*CORRESPONDENCE Tadele Biresaw Belachew1, Getachew Teshale1, Banchlay Addis1,
Endalkachew Dellie
endalkd.07@gmail.com
Demiss Mulatu Geberu1, Lake Yazachew1,
†
These authors have contributed equally to Tesfahun Zemene Tafere1 and Nigusu Worku1†
this work 1
Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health
RECEIVED 11 July 2024 Sciences, University of Gondar, Gondar, Ethiopia, 2Department of Epidemiology and Biostatics, Institute
ACCEPTED 14 October 2024 of Public Health, University of Gondar, Gondar, Ethiopia
PUBLISHED 31 October 2024

CITATION
Dellie E, Tiruneh MG, Jejaw M, Demissie KA,
Background: Women’s empowerment has been a global priority, as countries
Getnet M, Belachew TB, Teshale G, Addis B, can achieve significant growth and economic development by empowering
Geberu DM, Yazachew L, Tafere TZ and women. Understanding the individual and community-level factors that
Worku N (2024) What factors influence influence women’s empowerment is crucial for policymakers to develop
women’s empowerment in Ethiopia? A
effective policies and to improve women’s empowerment.
multilevel analysis of Ethiopia’s demographic
and health survey data.
Method: A community-based cross-sectional survey was conducted in 11
Front. Glob. Womens Health 5:1463157. administrative regions of Ethiopia. The analysis included a weighted sample of
doi: 10.3389/fgwh.2024.1463157 7,108 married women of reproductive age (15–49 years) from the 2,016
COPYRIGHT Ethiopian Demographic and Health Survey (EDHS). A multilevel mixed-effect
© 2024 Dellie, Tiruneh, Jejaw, Demissie, binary logistic regression analysis was used to examine the individual and
Getnet, Belachew, Teshale, Addis, Geberu,
community-level factors associated with women’s empowerment. In the final
Yazachew, Tafere and Worku. This is an open-
access article distributed under the terms of model, significant variables were identified using a p-value of <0.05 and an
the Creative Commons Attribution License adjusted odds ratio (AOR) with a 95% confidence interval (CI).
(CC BY). The use, distribution or reproduction
Results: The overall magnitude of women’s empowerment was 23.7% (95% CI:
in other forums is permitted, provided the
original author(s) and the copyright owner(s) 22.7–24.7). Only 30.9% of women reported participating in household
are credited and that the original publication in decision-making, and 32.5% disagreed with all the reasons justifying wife-
this journal is cited, in accordance with
beating. At individual-level, factors positively associated with women’s
accepted academic practice. No use,
distribution or reproduction is permitted empowerment included secondary (AOR: 2.72 (1.77–4.23), and higher (AOR:
which does not comply with these terms. 3.65 (1.81–7.34) education. However, belonging to the Muslim religion was
negatively associated with women’s empowerment (AOR: 0.63 (0.47–0.85). At
the community level, wealthy communities were positively associated with
women’s empowerment (AOR: 1.60 (1.05–2.44). Conversely, residing in rural
areas (AOR: 0.49 (0.29–0.83), and living in the Afar (AOR: 0.35 (0.17–0.70),
Amhara (AOR: 0.45 (0.26–0.79), Oromia (AOR: 0.43 (0.26–0.73), South Nation
Nationalities, and Peoples (SNNP) (AOR: 0.42 (0.24–0.75), and Gambella
(AOR: 0.36 (0.20–0.66) regional states were negatively associated with
women’s empowerment.

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Conclusion: The overall magnitude of women’s empowerment in this study was

low. Factors that positively influenced empowerment included attending
secondary and higher education, as well as residing in communities with higher
wealth status. On the other hand, being Muslim, residing in rural areas, and
living in the Afar, Amhara, Oromia, SNNPR, Gambella, and Tigray regions were
negatively associated with women’s empowerment. As a result, the government
of Ethiopia needs to design community-based women’s empowerment
strategies and involve women in income-generation activities that improve their
participation in household decision-making to empower them.

KEYWORDS

justified wife-beating, multilevel analysis, Ethiopia, decision making, women’s

empowerment

Introduction Constitution (18), the Ethiopian National Policy on Women (19),

and the Growth and Transformation Plan (GTP) I and II (20, 21).
Women’s empowerment is a fundamental driver of sustainable Despite these measures, gaps in women’s empowerment persist.
development and is a global priority agenda, especially in For instance, a significant proportion of women still lack decision-
developing countries where gender disparities are often pronounced making power in key areas; such as household purchases (21%),
(1). It was one of the Millennium Development Goals (MDGs) and healthcare decisions (18%), and visits to their family or relatives
remains central to achieving the Sustainable Development Goals (16%). Additionally, a considerable number of women (63%)
(SDGs (2, 3). Despite numerous efforts to promote gender equality, disapprove of wife-beating for any reason (22). These evidences
many women still face significant barriers to accessing education, highlight the persistent challenges in achieving true gender
economic opportunities, and healthcare services (4–7). equality in Ethiopia.
Women’s empowerment is relatively a complex and Furthermore, a study based on data from the Ethiopian
multidimensional concept that centers on enhancing women’s Demographic and Health Survey (EDHS) conducted in 2011
capacity to make strategic life choices, especially in situations found that about half of the women surveyed disagreed with
where such opportunities have been denied to them (8, 9). Due wife-beating (23). However, this study only measured women’s
to its multifaceted nature, objectively measuring women’s attitudes towards wife-beating and did not thoroughly analyze
empowerment poses challenges for researchers. This study the individual and community-level factors influencing women’s
assessed women’s empowerment using index-based data from the empowerment. Moreover, the previous studies used binary
nationally representative 2016 Ethiopian Demographic and logistic regression, which did not comprehensively analyze both
Health Survey (EDHS), in terms of decision-making power and community-level and individual-level factors, potentially
attitudes toward the justification of wife-beating. overlooking the issue of non-independence.
Women’s empowerment is a significant component of the Understanding individual and community-level factors that
development process. Economically independent and educated are likely to influence women’s empowerment may be a
women are more likely to seek and utilize healthcare services, commencement in exploring strategies to empower women and
leading to better health outcomes for themselves and their cut back on gender inequality. Therefore, this study tried to
families (5). Research conducted in 67 developing countries has examine the magnitude of women’s empowerment and identify
shown a positive association between women’s empowerment its determinants using a multilevel model, from the 2016
and the use of health services (10). For example, women with EDHS data.
higher levels of empowerment are more likely to use
reproductive health services, such as family planning, antenatal
care, and skilled attended delivery (11, 12). Therefore, it is clear Methods
that women’s empowerment is essential for promoting the well-
being of households and children. Additionally, various studies Study settings and period
worldwide have identified several factors contributing to women’s
empowerment, including women’s education, age, media access, Ethiopia is located in the Horn of Africa and shares borders
employment, place of residence, and income level (13–17). with Eritrea, Djibouti, Somalia, Sudan, South Sudan, and Kenya.
The Ethiopian government has implemented various It is the second most populous nation on the African continent
institutional and policy measures to promote gender equality and after Nigeria, with a population of 109,224,559 (24). Ethiopia is
empower women. These efforts include the 1993 Ethiopian divided into nine geographical regions [Afar, Amhara,

Abbreviations
ANC, antenatal care; AOR, adjusted odds ratio; COR, crude odds ratio; EDHS, Ethiopian demographic and health survey; ICC, intra-class correlation coefficient;
PCV, proportional change in variance; PNC, postnatal care.

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Benishangul-Gumuz, Gambela, Harari, Oromia, Somali, Southern Measurements of variables

Nations, Nationalities, and People’s Region (SNNPR), and
Tigray] and two administrative cities (Addis Ababa and Dire This study examines women’s empowerment as the dependent
Dawa). The majority of the Ethiopian population is an agrarian variable measured using index-based data from two key
society, and about 83.6% live in rural areas. Agriculture accounts dimensions of the 2016 EDHS: decision-making power and
for approximately 43% of the country’s Gross Domestic Product attitudes toward the justification of wife-beating. These
(GDP), and over 80% of the total population resides in the dimensions were chosen based on the availability of data from
regional states of Amhara, Oromia, and SNNP (25). the 2016 Ethiopian Demographic and Health Survey (EDHS) and
In Ethiopia, the majority of the population (83.6%) lives in alignment with existing literature. To assess decision-making
rural areas, and the average household size is 4.7 persons. The power, three questions were asked about women’s involvement in
population is predominantly young, with more than one-third decisions regarding their own healthcare, household purchases,
(44%) being under 15 years old, over half (52%) being between and visits to family or relatives. Women’s responses were
15 and 65 years old, and only a few (3%) of all persons being categorized based on whether they made these decisions alone or
over the age of 65 years. Women of reproductive age constitute jointly with their husbands. For the justification of wife-beating,
24% of the population (26, 27). respondents were asked five questions to determine whether they
The study utilized data from the 2016 Ethiopia Demographic believed a man was justified in beating his wife under certain
and Health Survey (EDHS), which is a nationally representative circumstances, such as burning food, arguing with her husband,
survey conducted every five years. Data collection was organized going out without informing him, refusing sexual intercourse,
by the Central Statistical Agency (CSA) of Ethiopia (22) and and neglecting the children.
conducted from January 18, 2016, to June 27, 2016. The study Responses to these empowerment indicators were then
participants were women of reproductive age (15–49) who reside categorized as either empowered (scored as 1) or unempowered
permanently in the selected households or stayed the night (scored as 0). These scores were then summed to create a
before the survey in the household (22). composite women’s empowerment score. A sum score ranging
from 0 to 7 was classified as unempowered, while a score of
8 was classified as empowered. Thus, women were considered
Study design, data source, and sampling empowered if they participated in all decision-making instances
procedures either alone or jointly with their husbands, and never justified
wife-beating (28). The relevant questions regarding women’s
A cross-sectional survey was conducted in eleven administrative participation in household decision-making and their attitudes
regions of Ethiopia using data from the 2016 EDHS datasets, which toward wife-beating can be found in DHS Module 9 within
were led by the Ethiopian Central Statistical Agency (CSA). The questions 922–932 (29).
EDHS aims to provide valuable information on key demographic The independent variables for this study were categorized as
and health indicators such as fertility, family planning, infant and individual, household, and community-level factors. Individual
child mortality, maternal and child health, and nutrition in the and household-level factors included sociodemographic and
national and sub-national areas of Ethiopia. To date, four rounds economic variables. On the other hand, community-level factors
of the EDHS have been collected using similar procedures. consisted of place of residence, region, community poverty level,
The survey utilized a two-stage stratified cluster sampling and community-level media exposure.
design. In this design, enumeration areas (EAs) or clusters To measure community-level media exposure, we used the
(defined geographical units) were used as the primary units of proportion of women exposed to specific media as an aggregate
data collection. These EAs were stratified based region and value. Mothers’ exposure to mass media was then categorized as
urban-rural residency. Each region was divided into urban and no exposure, less than once a week, and greater than once a week.
rural areas to ensure proper stratification. A total of twenty-one
(21) sampling strata were created, representing the urban and
rural areas in each of the nine regions and two city Data processing and statistical analysis
administrations. In the first stage of sampling, 645 EAs were
randomly chosen from these strata: 202 from urban areas and The outcome variables with important predictors were
443 from rural areas. Independent selection was utilized in each extracted from the 2016 EDHS women’s dataset and editing,
sampling stratum, based on probability proportion. In the second recoding, and analysis were done using STATA 14. Descriptive
stage, a systematic random sampling technique was used to select statistics such as frequencies and proportions of variables were
28 households per EAs/cluster, ensuring equal probability (22). presented using tables and narrations.
For this study, the women’s dataset was used. This dataset Bivariable logistic and multilevel regression models were used
included a total of 15,683 women aged 15–49 years old from to analyze factors associated with women’s empowerment at two
16,650 households within 645 clusters. After weighting the sample, levels: individual and community. To capture the impact of
7,108 currently married women were included in the final analysis. cluster and individual-level factors on women’s empowerment, a
Furthermore, potential independent variables at both the multilevel regression model that accounts for variation at these
individual and community levels were extracted for further analysis. levels was used (30). Likelihood ratio, Intra-Class Correlation

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TABLE 1 Individual and community-level sociodemographic and TABLE 1 Continued

economic characteristics of study participants in Ethiopia, EDHS 2016
(n = 7,108).
Variables Category Frequency Percent
(n) (%)
Variables Category Frequency Percent
Number of living children Zero 38 0.5
(n) (%)
One 1,337 18.8
Maternal age in years 15–24 1,633 23.0
Two 1,242 17.5
25–34 3,627 51.0
Three 1,079 15.2
≥35 1,848 26.0
Four and above 3,412 48.0
Age at first marriage <18 4,471 62.9
in years 18–24 2,332 32.8 a
Catholic, traditional and other.
>25 305 4.3
b
Subsistence farmers, fishers, hunters, building and related trades workers, construction,
main street, and related sales and service.
Residence Urban 882 12.4
Rural 6,226 87.6
Region Tigray 470 6.6
Afar 67 0.9 (ICC), and Proportional Change in Variance (PCV) were
Amhara 1,525 21.4 computed to measure the variation between clusters, and model
Oromia 2,921 41.1 comparison was conducted using deviances. The ICC coefficient
Somali 254 3.6
quantifies the degree of heterogeneity of women’s empowerment
Benishangul- 78 1.1
Gumuz
between clusters, ICC = ϭ2/(ϭ2 + π2/3) (31), with ϭ2 indicating
SNNP 1,556 21.9 cluster variance. PCV measures the total variation attributed to
Gambella 19 0.3 individual and community-level factors in the multilevel model
Harari 16 0.2 compared to the null model; PCV ¼ var (null var
model)var (full model)
(null model) .
Addis Ababa 173 2.4 A two-level (individual and community), multilevel
Dire Dawa 29 0.4 multivariable logistic regression analysis was used to explore
Religion Orthodox 2,652 37.3
factors related to women’s empowerment. Furthermore, four
Muslim 2,661 37.4
models were created for the analysis. The first model had no
Protestant 1,577 22.2
Othersa 218 3.1
variables and was used to determine the extent of cluster
Sex of household head Male 6,313 88.8 variation in women’s empowerment. The second model included
Female 795 11.2 individual-level variables, the third model included community-
Women’s educational No education 4,508 63.4 level variables, and the fourth model included both individual
status Primary 1,995 28.1 and community-level variables. The model with the lowest
education
deviance was chosen. Variables with a p-value of <0.2 in the
Secondary 391 5.5
education bivariate analysis for both individual and community-level
Higher 214 3.0 factors were included in the multivariable model. An adjusted
Husband’s/partner’s No education 3,388 47.6 odds ratio (AOR) with a 95% confidence interval (CI) and a
educational status Primary 2,731 38.4 p-value of <0.05 in the multivariable model indicated a
education
significant association between the independent variables and
Secondary 613 8.6
education
women’s empowerment.
Higher 376 5.3
Women’s occupation No work 3,985 56.1
Professional 992 13.9 Results
Agricultural 1,636 23.0
Othersb 495 6.9
Individual and community-level
Husband’s/partner’s No work 804 11.31
occupation Professional 845 11.8
sociodemographic and economic
Agricultural 4,605 64.7
characteristics
Othersb 854 12.0
Community-level Poor 3,000 42.2 A total of 7,108 women were included in the final analysis.
poverty Middle 1,488 20.9 The mean ages of the respondents were 29.3 (SD ± 6.8) years.
Rich 2,620 36.8 The majority (87.6%) were rural dwellers, 41.1% were from the
Household wealth Poorest 1,512 21.3 Oromia region and 37.4% of the participants were Muslim.
quintile Poorer 1,582 22.2
Moreover, 63.4% and 56.1% of the women had no education and
Middle 1,493 21.0
were not employed, respectively. Similarly, 47.7% and 64.8% of
Richer 1,347 18.9
Richest 1,174 16.52 their husbands had no education and worked in agriculture,
Community media No 4,643 65.3 respectively. Additionally, 88.8% of the household heads were
exposure <Once a week 2,409 33.9 male, 42.2% of the participants were in poor wealth status, had
≥Once a week 56 0.8 no access to media (65.31%), and had four or more living
(Continued) children (48%) (Table 1).

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TABLE 2 Magnitude of women’s empowerment with their respective domain in Ethiopia, EDHS 2016 (n = 7,108).

Variables Yes n (%) No n (%)

Women’s participation in household decision-making 2,194 (30.9) 4,914 (69.1)
Usually makes decisions about own health care 1,404 (19.7) 5,704 (80.2)
Usually makes decisions about large household purchases 1,634 (23.0) 5,474 (77.0)
Usually makes decisions about visits to family or relatives 1,224 (17.2) 5,884 (82.8)
Attitude towards wife-beating 2,311 (32.5) 4,797 (67.5)
A husband is justified in hitting/beating their wife when she burns the food 3,934 (55.3) 3,174 (44.7)
A husband is justified in hitting/beating their wife when she argues with him 3,718 (52.3) 3,390 (47.7)
A husband is justified in hitting/beating their wife when she goes out without telling him 3,659 (51.5) 3,449 (48.5)
A husband is justified in hitting/beating their wife when she refuses to have sexual intercourse 4,260 (59.9) 2,848 (40.1)
A husband is justified in hitting/beating their wife when she neglects the children. 3,424 (48.2) 3,684 (51.8)
Overall women empowerment 1,685 (23.7) 5,423 (76.3)

Bold values indicate the overall magnitude of women’s empowerment and the two domains.

The magnitude of women’s empowerment TABLE 3 The magnitude of women’s empowerment across regions in
Ethiopia, EDHS, 2016.

In this study, the overall magnitude of women’s Name of regions Women empowerment
empowerment was 23.7% (95% CI: 22.7–24.7). Specifically, Yes No Total Percentage
only 30.9% of women were involved in household decision- Tigray 159 533 692 23.0
making, either alone or jointly with their husbands. The Afar 104 523 627 16.6
lowest level of women’s decision-making power was seen in Amhara 204 612 816 25.0

decisions regarding visits to family or relatives, with only Oromia 189 764 953 19.8
Somali 278 430 708 39.3
17.2% of women participating. Another aspect of women’s
Benishangul-Gumuz 180 403 583 30.9
empowerment was their attitude toward wife-beating, with
SNNP 192 688 880 21.8
32.5% of women disagreeing with all justifications for it. Gambella 144 371 515 28.0
Among these women, the highest level of empowerment was Harari 208 209 417 49.9
observed in cases where husbands beat their wives for refusing Addis Ababa 339 151 490 69.3
sexual intercourse (59.9%) (Table 2). Dire Dawa 147 280 427 34.4
The overall magnitude of women’s empowerment varied
significantly across different regions of the country. The lowest
TABLE 4 A random intercept model (variations) for women empowerment
level of women’s empowerment was observed in the Afar at cluster level by multilevel logistic regression analysis, EDHS 2016.
region (16.6%), while the highest was seen in Addis Ababa
Measure of Model 0 Model 1 Model 2 Model 3
(69.3%) (Table 3).
vibrations (null (full
model) model)
Variance 1.0 0.6 0.5 0.5
Individual and community-level Explained variation Ref. 42.2 47.1 53.0
determinants for women empowerment (PCV) (%)
ICC (%) 24.4 16.5 34.1 48.2

Random effect analysis Model fitness

The ICC in the empty model indicated that 24.4% of the total Log-likelihood −3,705.6 −3,580.8 −3,599.6 −3,547.2
Deviance 7,411.2 7,161.6 7,199.3 7,094.5
variability of women empowerment was due to cluster differences,
while the remaining unexplained 75.6% was attributable to Model 0: without independent variables (null model), Model 1: only individual-level
variables, Model 2: only community-level variables, Model 3: individual and community-
individual differences. Fifty-three percent of the variability in level variables (full model).
women’s empowerment was explained by the full model and
deviance was used for model comparison. As a result, the final
model was the best-fitted model since it had the lowest place of residence, region, and community wealth status, were
deviance (Table 4). found to be significantly associated with women’s empowerment.
Accordingly, Women who attended secondary and higher
education were 2.7 times (AOR: 2.7, 95% CI: 1.8–4.2) and 3.6 times
Fixed effects analysis (AOR: 3.6, 95% CI: 1.8–7.3) more likely to be empowered compared
A multilevel mixed-effects binary logistic regression analysis was to those who were not educated, respectively. Additionally, Muslim
conducted to identify potential individual and community-level women were 37% less likely to be empowered compared to
determinants of women’s empowerment. In the final model Orthodox Christian women (AOR: 0.6, 95% CI: 0.5–0.8).
(model 3), individual-level factors such as women’s educational Women living in rural areas were 51% less likely to be
status and religion, as well as community-level variables including empowered compared to their urban counterparts (AOR: 0.49,

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95% CI: 0.3–0.8). The odds of women’s empowerment in the Afar, primary education or higher being more empowered than those
Amhara, Oromia, SNNPR, and Gambella regions were lower by with no formal education. This result aligns with studies
65% (AOR: 0.35, 95% CI: 0.2–0.7), 55% (AOR: 0.45, 95% CI: conducted in southern Ethiopia (39) and other African countries,
0.3–0.8), 57% (AOR: 0.43, 95% CI: 0.3–0.7), 58% (AOR: 0.42, where higher educational attainment is linked to increased
95% CI: 0.2–0.7), 64% (AOR: 0.36, 95% CI: 0.2–0.6), and 68% empowerment for women (40–44). Similarly, studies from
(AOR: 0.32, 95% CI: 0.2–0.5), respectively, compared to women different Asian countries highlight education as a significant
living in Addis Ababa. Moreover, women who live in wealthy factor in positively influencing women’s empowerment (33, 34,
communities had a 1.6 times higher chance of empowerment 41, 45–51). This might be due to the fact that education
compared to women from poor communities (AOR: 1.6, 95% CI: increases individuals’ awareness and enhances self-esteem. When
1.1–2.4) (Table 5). women become more educated, they become more informed
about their rights and are more likely to advocate for and uphold
these rights (52). This finding is also supported by the Human
Discussion Capabilities Theory by Martha Nussbaum and Amartya Sen,
which emphasizes the role of education in expanding individual
The overall magnitude of women’s empowerment in Ethiopia was capabilities, fostering autonomy, and promoting overall
found to be 23.7% (95% CI: 22.7–24.7), with 30.9% of women empowerment and well-being (53, 54).
participating in household decision-making. Specifically, only 19.75% Besides, the findings of this study revealed a significant
of women were involved in decisions regarding their healthcare. This association between residency and women’s empowerment.
finding was unexpectedly lower than a previous study using EDHS Respondents from rural areas were less empowered compared to
2005 data, which showed that 29.3% of women had a say in their those from urban settings. This finding is consistent with studies
healthcare needs (32). The possible reason for the discrepancy might from various African and Asian countries, indicating that women
be due to the donor-driven nature of maternal and child healthcare in urban areas experience higher levels of empowerment than
programs, which may lack sustainability after the termination of their rural counterparts (17, 44, 55, 56). This disparity may be
funding, the reduced functionality of women’s associations, and the attributed to limited access to information on women’s rights
poor involvement of husbands in maternal and child health and autonomy among women living in rural settings.
decisions. Furthermore, it is possible that in 2016, women were Additionally, awareness levels within rural communities
more willing to express the limitations they faced in decision-making regarding women’s rights and autonomy tend to be lower
due to increased awareness of gender issues. This awareness could compared to urban areas.
have led to more honest reporting compared to 2005, when they Participants who identify as Muslim exhibit lower levels of
might not have openly acknowledged these constraints. empowerment compared to their Christian counterparts.
However, our results were significantly lower than a study in Research conducted in Africa on the impact of religion on the
Bangladesh, where nearly 45% of women participated in Millennium Development Goals has similarly shown that being
healthcare decisions, large household purchases, and family visits Muslim is associated with lower female school participation rates,
(33). Similarly, our findings were lower than those in Pakistan and less non-agricultural employment among women, and lower
India. In Pakistan, 36.6% of women were involved in household representation of women in government (57). Other studies also
decision-making (34), while in North India, 53% participated in highlighted that gender inequality tends to be more pronounced
major household decisions (35). In Nepal, 72% of women were among Muslims and Hindus compared to Christians and
involved in decisions regarding household purchases (36). Buddhists (58, 59). This disparity may stem from cultural
Moreover, our finding is also slightly lower compared to other challenges in reconciling religious values with traditional beliefs
African countries. For instance, approximately 37% of women and practices. Gender inequality often persists due to cultural
participated in at least one household decision in Mali (37) and norms and interpretations of religious teachings, which are
35.9% in the Democratic Republic of the Congo (DRC) (38). The prevalent in Muslim societies.
possible reason for the discrepancy might be measurement and The level of community poverty significantly influences women’s
study setting differences, in this study women’s participation in empowerment. Women residing in the wealthy communities exhibit
decision-making was measured by considering the composite higher levels of empowerment compared to those in poorer
value of decision-making indicators like decision-making on communities. It is well known that poverty constrains women’s
health care, household purchases, and a family visit whereas self-determination and limits their participation in economic, social,
empowerment in India was measured in terms of women’s and political spheres. It is widely recognized that poverty is a
autonomy, which is slightly different. Additionally, the study fundamental driver of gender inequality, which hinders women’s
settings might contribute to discrepancies. Gender equality and economic and social empowerment (60, 61). Moreover, women and
women’s participation in many aspects are higher in developing girls living in poverty are more vulnerable to sexual exploitation
countries like Bangladesh, Nepal, and Pakistan compared to due to their lack of income and resources (62–64).
Ethiopia. However, in Ethiopia, women’s participation remains a In this study, the geographical region where women reside was
significant public health policy concern. found to significantly impact their empowerment. Women living in
This study showed that educational status significantly impacts Afar, Amhara, Oromia, SNNPR, Gambella, and Tigray regions
women’s empowerment, with respondents who had completed exhibited lower levels of empowerment compared to those

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TABLE 5 Multilevel logistic regression analysis of individual and community-level factors associated with women’s empowerment in Ethiopia, EDHS
2016 (n = 7,108).

Variables Women’s COR (95%CI) Model 0 Model 1 Model 2 Model 3

empowered (ICC: 24.4%) AOR (95% CI) AOR (95%CI) AOR (95%CI)
Yes n (%) No n (%)
Individual-level characteristics
Mothers educational status
No education 846 (18.8) 3,662 (81.2) 1 1 1
Primary 506 (25.4) 1,488 (74.6) 1.4 (1.2–1.8) 1.3 (1.0–1.7) 1.3 (1.0–1.7)
Secondary 197 (50.1) 196 (49.9) 3.9 (2.7–5.7) 2.9 (1.9–4.4) 2.7 (1.8–4.2)a
Higher 136 (64.0) 77 (36.0) 7.3 (4.5–11.7) 4.6 (2.4–8.7) 3.7 (1.8–7.3)a

Husband educational status

No education 635 (18.8) 2,753 (81.2) 1 1 1
Primary 639 (23.4) 2,092 (76.6) 1.3 (1.0–1.6) 1.2 (0.9–1.5) 1.2 (0.9–1.5)
Secondary 221(36.0) 393 (64.0) 1.9 (1.4–2.6) 1.0 (0.7–1.5) 0.9 (0.7–1.4)
Higher 191 (50.9) 184 (49.0) 3.8 (2.6–5.5) 1.2 (0.7–1.9) 1.10 (0.7–1.8)

Sex of household head

Male 1,445 (22.9) 4,868 (77.1) 1 1 1
Female 240 (30.3) 555 (69.7) 1.4 (1.1–1.8) 1.3 (1.0–1.7) 1.2 (0.9–1.6)

Women’s occupation
No work 908 (23.4) 2,972 (76.6) 1 1 1
Professional 239 (28.3) 605 (17.7) 1.1 (0.8–1.5) 0.9 (0.6–1.5) 0.9 (0.6–1.5)
Agricultural 297 (32.2) 1,338 (81.8) 0.7 (0.6–0.9) 0.8 (0.6–1.1) 0.5 (0.6–1.2)
Othersa 241 (23.7) 508 (67.8) 1.4 (1.1–1.9) 0.9 (0.6–1.4) 0.9 (0.6–1.4)

Religion
Orthodox 769 (29.0) 1,885 (71.0) 1 1 1
Muslim 5,319 (20.0) 2,130 (80.0) 0.6 (0.4–0.8) 0.7 (0.5–0.9) 0.6 (0.5–0.8)a
Protestant 1,218 (77.3) 359 (22.7) 0.8 (0.6–1.1) 0.8 (0.6–0.9) 0.8 (0.5–1.1)
Other** 28 (12.8) 190 (87.2) 0.6 (0.2–1.7) 0.7 (0.2–1.7) 0.6 (0.2–1.7)

Women’s employment status

Unemployed 1,152 (22.4) 3,985 (77.6) 1 1 1
Employed 533 (27.0) 1,438 (72.9) 1.1 (0.9–1.4) 0.9 (0.7–1.4) 0.9 (0.7–1.3)

Household wealth status

Poorest 299 (19.8) 1,212 (80.2) 1 1 1
Poorer 265 (16.8) 1,318 (83.3) 0.8 (0.6–1.1) 0.8 (0.6–1.0) 0.8 (0.5–1.1)
Middle 287 (19.2) 1,206 (80.8) 0.9 (0.7–1.3) 0.9 (0.6–1.2) 0.7 (0.4–1.1)
Rich 338 (25.1) 1,009 (74.9) 1.3 (0.9–1.8) 1.1 (0.77–1.5) 0.8 (0.4–1.1)
Richest 497 (42.3) 677 (57.7) 2.7 (1.9–3.7) 1.5 (1.1–2.28) 0.8 (0.4–1.5)

Age at first marriage in years

Less than 18 983 (22.0) 3,487 (78.0) 1 1 1
18–24 601 (25.7) 1,732 (74.3) 1.1 (0.9–1.4) 0.9 (0.7–1.1) 0.9 (0.7–1.1)
25+ 102 (33.5) 203 (66.6) 1.5 (1.1–2.3) 1.1 (0.7–1.7) 1.0 (0.6–1.6)

Community-level characteristics
Residence
Urban 426 (48.3) 456 (51.7) 1 1 1
Rural 1,259 (20.2) 4,967 (79.8) 0.2 (0.16–0.3) 0.3 (0.2–0.4) 0.5 (0.3–0.8)a

Region
Addis Ababa 119 (69.3) 53 (30.7) 1 1 1
Afar 11 (16.6) 56 (83.4) 0.1 (0.03–0.1) 0.3 (0.1–0.5) 0.4 (0.2–0.7)a
Amhara 382 (25.0) 1,143 (74.9) 0.1 (0.07–0.2) 0.4 (0.3–0.7) 0.5 (0.3–0.8)a
Oromia 578 (19.8) 2,343 (80.2) 0.1 (0.05–0.1) 0.3 (0.2–0.5) 0.4 (0.3–0.7)a
Somali 100 (39.3) 154 (60.7) 0.2 (0.16–0.4) 1.1 (0.6–1.9) 1.5 (0.8–2.7)
Benishangul 24 (30.9) 53 (69.1) 0.2 (0.09–0.3) 0.7 (0.4–1.2) 0.8 (0.4–1.5)
SNNP 339 (21.8) 1,216 (78.2) 0.1 (0.06–0.2) 0.4 (0.2–0.6) 0.4 (0.24–0.7)a
Gambella 5 (27.9) 13 (72.1) 0.1 (0.08–0.2) 0.4 (0.2–0.7) 0.4 (0.2–0.7)a
Harari 7 (46.9) 8 (53.0) 0.4 (0.25–0.8) 1.0 (0.6–1.7) 1.4 (0.8–2.3)
Dire Dawa 10 (34.4) 19 (65.6) 0.2 (0.11–0.4) 0.4 (0.2–0.8) 0.6 (0.3–1.1)
Tigray 108 (22.9) 362 (77.0) 0.1 (0.06–0.2) 0.4 (0.2–0.6) 0.3 (0.2–0.6)a
(Continued)

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Dellie et al. 10.3389/fgwh.2024.1463157

TABLE 5 Continued

Variables Women’s COR (95%CI) Model 0 Model 1 Model 2 Model 3

empowered (ICC: 24.4%) AOR (95% CI) AOR (95%CI) AOR (95%CI)
Yes n (%) No n (%)
Community poverty status
Poor 598 (20.0) 2,402 (80.0) 1 1 1
Middle 330 (22.2) 1,158 (77.9) 1.2 (0.9–1.5) 1.2 (0.9–1.5) 1.3 (0.9–1.8)
Rich 758 (29.0) 1,862 (71.0) 1.6 (1.3–2.1) 1.6 (1.3–2.1) 1.6 (1.1–2.4)a

Community media exposure

No exposure 3,698 (79.7) 944 (20.3) 1 1 1
<Once a week 704 (29.2) 1,706 (70.8) 1.1 (1.2–1.8) 1.1 (0.8–1.3) 0.9 (0.7–1.2)
≥Once a week 37 (66.9) 19 (33.0) 5.4 (2.3–2.4) 2.4 (1.1–5.6) 1.6 (0.7–3.4)

**Catholic and traditional religions followers.

a
(in bold) Statistically significant at p-value <0.05 at model 3; Model 0, a model for the intra-class correlation coefficient (null model), Model 1, Individual-level characteristics, Model 2,
Community-level characteristics, Model 3, Both individual and community-level characteristics (full model).

residing in Addis Ababa city administration. This disparity can be enhance maternal education and increase women’s involvement in
attributed to the greater investment by the government and non- household decision-making, thereby promoting empowerment.
governmental organizations in Addis Ababa in areas such as Additionally, implementing community-based empowerment
education, decision-making and economic empowerment programs, including enhancing women’s access to media and
initiatives for women. Additionally, differences in socio-economic health information, and involving them in income-generating
status between urban and rural settings may also contribute to activities, could serve as effective interventions to empower women.
variations in women’s empowerment levels.
In this study, variables such as occupation and community
media exposure, previously identified as key contributors to Data availability statement
women’s empowerment (65–67), did not show statistically
significant associations with empowerment. This contrast may The original contributions presented in the study are included
stem from contextual differences between study populations, as in the article/Supplementary Material, further inquiries can be
the impact of these factors can be highly context-dependent. directed to the corresponding author.
Additionally, variations in the definition or measurement of
empowerment might account for the discrepancy. Furthermore,
unmeasured variables such as cultural norms or regional policies Ethics statement
may have played a more dominant role, minimizing the
influence of occupation and media exposure. Ethical approval and permission to access the data were
granted by MEASURE DHS (available at https://www.
dhsprogram.com/Data/ and accessed on March 24, 2020)
Strengths and limitations following the submission of a brief study concept. As the data
used is secondary and publicly available, participant consent was
The study utilizes nationally representative datasets, enhancing not required. All procedures were carried out in accordance with
the generalizability of its findings to married women of the Helsinki Declaration.
reproductive age across Ethiopia. Besides, employing a multilevel
modelling technique takes into consideration the hierarchical
structure of the survey data, thereby ensuring more robust and Author contributions
valid results. However, a limitation of the study is the absence of
qualitative methods, which could have been valuable in exploring ED: Conceptualization, Data curation, Formal Analysis,
the attitudes and beliefs of women in greater depth. Funding acquisition, Investigation, Methodology, Project
administration, Resources, Software, Supervision, Validation,
Visualization, Writing – original draft, Writing – review &
Conclusion editing. MT: Conceptualization, Data curation, Methodology,
Visualization, Writing – original draft, Writing – review &
This study reveals a low overall magnitude of women’s editing. MJ: Conceptualization, Data curation, Formal Analysis,
empowerment. Maternal education level and religion appeared as Methodology, Validation, Writing – original draft, Writing –
significant individual-level factors, while community wealth status, review & editing. KD: Conceptualization, Formal Analysis,
place of residence, and region were notable community-level Methodology, Software, Validation, Writing – original draft,
variables associated with women’s empowerment. To address these Writing – review & editing. MG: Formal Analysis, Methodology,
findings, the Ethiopian government needs to prioritize strategies that Software, Supervision, Validation, Writing – original draft,

Frontiers in Global Women’s Health 08 frontiersin.org

Dellie et al. 10.3389/fgwh.2024.1463157

Writing – review & editing. TB: Data curation, Methodology, Acknowledgments

Software, Validation, Visualization, Writing – original draft,
Writing – review & editing. GT: Data curation, Formal Analysis, The authors would like to thank MEASURE DHS for permission
Methodology, Software, Validation, Writing – original draft, to use the EDHS 2016 survey data sets for further analysis.
Writing – review & editing. BA: Writing – review & editing,
Conceptualization, Data curation, Methodology, Software,
Validation, Writing – original draft. DG: Investigation,
Methodology, Supervision, Writing – original draft, Writing –
Conflict of interest
review & editing, Data curation. LY: Investigation, Methodology,
The authors declare that the research was conducted in the
Writing – original draft, Writing – review & editing,
absence of any commercial or financial relationships that could
Conceptualization, Software, Supervision. TT: Data curation,
be construed as a potential conflict of interest.
Investigation, Methodology, Validation, Writing – original draft,
Writing – review & editing. NW: Conceptualization, Data
curation, Formal Analysis, Investigation, Methodology, Project
administration, Software, Supervision, Validation, Visualization, Publisher’s note
Writing – original draft, Writing – review & editing.
All claims expressed in this article are solely those of the
authors and do not necessarily represent those of their affiliated
Funding organizations, or those of the publisher, the editors and the
reviewers. Any product that may be evaluated in this article, or
The author(s) declare that no financial support was received for claim that may be made by its manufacturer, is not guaranteed
the research, authorship, and/or publication of this article. or endorsed by the publisher.

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