Do Participatory Learning and Action Women’s Groups Alone or Combined with Cash or Food Transfers Expand Women’s Agency in Rural Nepal?

Figures & data

Table 1. Descriptive statistics (n = 1309)

	PLA only	PLA and cash	PLA and food	Control	Overall	p-value
Religion, caste and ethnicity
Hindu	0.82 (0.04)	0.83 (0.03)	0.84 (0.05)	0.80 (0.04)	0.83 (0.02)	0.94
Muslim	0.18 (0.04)	0.17 (0.03)	0.16 (0.05)	0.20 (0.04)	0.17 (0.02)	0.30
Dalit	0.17 (0.03)	0.13 (0.02)	0.13 (0.03)	0.19 (0.03)	0.15 (0.01)	0.94
Janajati	0.09 (0.02)	0.04 (0.02)	0.09 (0.03)	0.10 (0.03)	0.07 (0.01)	0.26
Family structure
Head of household herself	0.11 (0.02)	0.10 (0.01)	0.09 (0.01)	0.10 (0.02)	0.10 (0.01)	0.85
Living separately from in-laws	0.10 (0.01)	0.09 (0.02)	0.10 (0.01)	0.08 (0.02)	0.09 (0.01)	0.86
No. of children alive	1.34 (0.07)	1.36 (0.08)	1.43 (0.07)	1.48 (0.12)	1.40 (0.04)	0.51
No. of sons currently alive	0.51 (0.04)	0.52 (0.03)	0.55 (0.04)	0.59 (0.04)	0.54 (0.02)	0.33
Husband migrated abroad	0.40 (0.03)	0.32 (0.03)	0.34 (0.03)	0.38 (0.03)	0.36 (0.01)	0.23
Woman residing in her husband’s home	0.98 (0.01)	0.96 (0.01)	0.96 (0.01)	0.99 (0.01)	0.97 (0.01)	0.13
Age and education (years)
Woman’s current age (years)	23.2 (0.4)	23.3 (0.2)	23.6 (0.2)	23.9 (0.4)	23.5 (0.1)	0.40
Woman’s age at marriage	15.9 (0.2)	16.0 (0.1)	16.2 (0.2)	16.1 (0.2)	16.1 (0.1)	0.33
Husband age minus wife’s age	5.51 (0.29)	5.32 (0.22)	5.41 (0.26)	4.47 (0.22)	5.24 (0.13)	<0.01
Woman’s education (years)	2.35 (0.31)	2.84 (0.25)	2.23 (0.20)	2.42 (0.22)	2.50 (0.13)	0.12
Husband’s education minus wife’s education	2.33 (0.33)	1.70 (0.12)	2.59 (0.20)	1.35 (0.29)	2.02 (0.12)	<0.01
Work, finances and wealth
Working outside the home	0.24 (0.04)	0.23 (0.02)	0.25 (0.02)	0.27 (0.02)	0.25 (0.01)	0.71
No. ‘domestic’ tasks^a	3.45 (0.07)	3.21 (0.08)	3.47 (0.04)	3.39 (0.11)	3.36 (0.04)	0.11
No. ‘social’ tasks^a	1.47 (0.13)	1.52 (0.08)	1.47 (0.09)	1.74 (0.12)	1.54 (0.05)	0.31
No. ‘outdoor’ tasks^a	0.38 (0.04)	0.35 (0.03)	0.31 (0.04)	0.31 (0.04)	0.34 (0.02)	0.69
Having private savings	0.28 (0.02)	0.30 (0.03)	0.27 (0.03)	0.20 (0.04)	0.27 (0.01)	0.20
Wealth index (SD)	0.08 (0.11)	0.06 (0.06)	−0.07 (0.06)	−0.09 (0.09)	0.00 (0.04)	0.28
Health and nutrition
Would seek care in a health facility for a health problem	0.51 (0.05)	0.49 (0.06)	0.61 (0.05)	0.47 (0.05)	0.53 (0.03)	0.24
Experienced food insecurity in the past year	0.13 (0.04)	0.13 (0.03)	0.10 (0.02)	0.12 (0.03)	0.12 (0.02)	0.91
Community interaction
Any friend outside the home	0.58 (0.06)	0.64 (0.05)	0.59 (0.03)	0.63 (0.05)	0.61 (0.02)	0.78
Attending any groups	0.43 (0.03)	0.97 (0.01)	0.91 (0.02)	0.12 (0.03)	0.70 (0.04)	<0.01
Attending a non-trial group	0.15 (0.03)	0.07 (0.01)	0.10 (0.02)	0.12 (0.03)	0.10 (0.01)	0.08
Engagement with the trial intervention
Heard of PLA women’s groups	0.52 (0.04)	0.97 (0.01)	0.98 (0.01)	0.05 (0.01)	0.72 (0.04)	<0.01
Participated in PLA women’s groups (1–3 times)	0.22 (0.03)	0.11 (0.02)	0.20 (0.02)	0.00 (0.00)	0.14 (0.01)	<0.01
Participated in PLA women’s groups (4+ times)	0.12 (0.02)	0.85 (0.03)	0.70 (0.03)	0.00 (0.00)	0.51 (0.04)	<0.01

Notes: ^aMean number of tasks are presented for the number of household tasks. For all other variables, mean proportions are shown. Robust standard errors are shown in brackets. ‘Domestic’ tasks comprised cooking, cleaning the house, performing small repairs, washing the dishes and doing laundry. ‘Social’ tasks comprised caring for elderly people, ill children and teaching children manners. ‘Outdoor’ tasks comprised shopping and managing the household money.

Table 2. Descriptive statistics of primary and secondary outcome measures (n = 1309)

	PLA only	PLA and cash	PLA and food	Control	Overall
Work outside the home
Agency freedom	−0.51 (0.18)	−0.50 (0.13)	−0.85 (0.13)	−0.73 (0.14)	−0.64 (0.07)
External motivation	2.63 (0.10)	2.84 (0.08)	3.01 (0.07)	2.83 (0.11)	2.85 (0.05)
Internal motivation	2.13 (0.14)	2.34 (0.11)	2.16 (0.11)	2.11 (0.10)	2.21 (0.06)
Household chores
Agency freedom	0.92 (0.11)	1.02 (0.09)	0.68 (0.08)	0.89 (0.10)	0.88 (0.05)
External motivation	2.65 (0.12)	2.76 (0.09)	3.00 (0.10)	2.71 (0.12)	2.80 (0.05)
Internal motivation	3.57 (0.08)	3.77 (0.06)	3.68 (0.07)	3.60 (0.09)	3.68 (0.04)
Health-seeking
Agency freedom	0.45 (0.11)	0.60 (0.12)	0.33 (0.10)	0.68 (0.19)	0.51 (0.07)
External motivation	2.98 (0.12)	3.08 (0.13)	3.40 (0.12)	2.87 (0.17)	3.11 (0.07)
Internal motivation	3.43 (0.08)	3.68 (0.06)	3.72 (0.05)	3.55 (0.07)	3.62 (0.03)
Group participation
Agency freedom	0.02 (0.18)	0.86 (0.15)	0.42 (0.10)	−0.36 (0.17)	0.35 (0.09)
External motivation	2.24 (0.14)	2.75 (0.14)	3.11 (0.11)	2.31 (0.15)	2.67 (0.08)
Internal motivation	2.25 (0.09)	3.61 (0.09)	3.53 (0.08)	1.94 (0.08)	3.02 (0.09)
Large purchases
Sole decision-maker	0.08 (0.01)	0.05 (0.02)	0.05 (0.01)	0.07 (0.02)	0.06 (0.01)
Joint decision-maker	0.26 (0.04)	0.25 (0.03)	0.23 (0.04)	0.25 (0.02)	0.25 (0.02)
Not involved, but able to	0.26 (0.03)	0.41 (0.04)	0.33 (0.03)	0.28 (0.04)	0.34 (0.02)
Not involved and unable to	0.40 (0.04)	0.28 (0.04)	0.38 (0.04)	0.40 (0.04)	0.36 (0.02)
Food preparation and serving
Sole decision-maker	0.56 (0.04)	0.52 (0.02)	0.56 (0.03)	0.56 (0.04)	0.55 (0.02)
Joint decision-maker	0.07 (0.02)	0.07 (0.02)	0.05 (0.01)	0.09 (0.02)	0.07 (0.01)
Not involved, but able to	0.23 (0.04)	0.33 (0.03)	0.25 (0.03)	0.23 (0.04)	0.27 (0.02)
Not involved and unable to	0.14 (0.03)	0.07 (0.02)	0.14 (0.02)	0.12 (0.03)	0.11 (0.01)
Own pregnancy
Sole decision-maker	0.17 (0.03)	0.16 (0.03)	0.14 (0.02)	0.19 (0.04)	0.16 (0.01)
Joint decision-maker	0.27 (0.04)	0.29 (0.04)	0.25 (0.04)	0.29 (0.04)	0.28 (0.02)
Not involved, but able to	0.27 (0.03)	0.42 (0.03)	0.41 (0.03)	0.33 (0.04)	0.37 (0.02)
Not involved and unable to	0.29 (0.05)	0.14 (0.03)	0.20 (0.02)	0.19 (0.05)	0.19 (0.02)
Step on the Power Ladder	4.55 (0.31)	5.27 (0.17)	4.68 (0.18)	4.72 (0.17)	4.86 (0.11)
Main agent of change in own life
No change desired	0.30 (0.05)	0.19 (0.04)	0.19 (0.05)	0.17 (0.05)	0.21 (0.02)
Woman herself	0.29 (0.05)	0.28 (0.05)	0.26 (0.06)	0.33 (0.08)	0.29 (0.03)
Not the woman herself	0.42 (0.05)	0.52 (0.05)	0.55 (0.08)	0.50 (0.07)	0.51 (0.03)

Notes: PLA refers here to participatory learning and action with women’s groups. For agency freedom, external motivation, internal motivation and the Power Ladder question, mean scores are presented. For the remaining indicators, mean proportions are presented. Robust standard errors in brackets.

Table 3. Main trial impacts on agency (n = 1309)

	PLA only versus control	PLA and cash versus control	PLA and food versus control
Work outside the home
Agency	−0.02	−0.01	−0.02
	(0.20)	(0.18)	(0.14)
External motivation	−0.16	−0.07	0.01
	(0.13)	(0.14)	(0.12)
Internal motivation	−0.17	−0.08	0.00
	(0.18)	(0.14)	(0.14)
Household chores
Agency	0.09	0.20	−0.04
	(0.11)	(0.13)	(0.12)
External motivation	−0.02	−0.06	0.10
	(0.11)	(0.13)	(0.11)
Internal motivation	0.07	0.15*	0.05
	(0.08)	(0.08)	(0.08)
Health-seeking
Agency	−0.05	0.00	−0.07
	(0.13)	(0.16)	(0.12)
External motivation	0.00	0.04	0.14
	(0.10)	(0.13)	(0.09)
Internal motivation	−0.05	0.03	0.07
	(0.08)	(0.08)	(0.07)
Group participation
Agency	0.53***	1.33***	1.14***
	(0.18)	(0.19)	(0.17)
External motivation	−0.19	0.34**	0.44***
	(0.15)	(0.15)	(0.14)
Internal motivation	0.33**	1.67***	1.58***
	(0.14)	(0.11)	(0.11)

Notes: PLA refers here to participatory learning and action with women’s groups. Mean effects with robust standard errors provided in brackets. Agency scores range from −4 to +4. Internal and external motivation scores range from 0 to 4. Control covariates are listed in Section 4.3. *Significant at 10 per cent; **significant at 5 per cent; ***significant at 1 per cent.

Table 4. Trial impacts on secondary measures of agency (n = 1309)

	PLA only versus control	PLA and cash versus control	PLA and food versus control
Household decision-making
Large household purchases	0.07	0.32	−0.06
	(0.21)	(0.23)	(0.21)
Food preparation and serving	−0.09	0.18	−0.09
	(0.21)	(0.18)	(0.18)
Own pregnancy	−0.08	0.25	−0.13
	(0.19)	(0.21)	(0.21)
Power Ladder	0.08	0.21	−0.06
	(0.20)	(0.15)	(0.14)
Main agent of change in own life	−0.14	−0.14	−0.15
	(0.17)	(0.17)	(0.20)

Notes: Mean log-odds ratios with robust standard errors in brackets are shown. The same controls are applied as in Table 4. *Significant at 10 per cent; **significant at 5 per cent; ***significant at 1 per cent.

Table 5. Impact of age on agency (n = 1309)

	Main agency index				Decision-making
Age of woman	Work outside the home	Household chores	Health-seeking	Group participation	Large purchases	Food serving & preparation	Own pregnancy	Power Ladder	Main agent of change in own life
<20 years	-	-	-	-	-	-	-	-	-
20–24 years	0.25*	0.15	−0.10	0.15	0.51***	0.35**	0.38**	0.37**	0.11
	(0.14)	(0.10)	(0.10)	(0.13)	(0.18)	(0.17)	(0.17)	(0.17)	(0.17)
25–29 years	0.63***	0.36**	0.11	0.55***	0.81***	0.71***	0.81***	0.42**	−0.02
	(0.19)	(0.15)	(0.11)	(0.18)	(0.24)	(0.23)	(0.21)	(0.20)	(0.23)
30–34 years	0.94***	0.37*	0.06	0.48**	1.03***	0.49	1.23***	0.27	0.38
	(0.28)	(0.20)	(0.17)	(0.21)	(0.27)	(0.34)	(0.29)	(0.31)	(0.31)
35+ years	1.44***	1.18***	0.40*	0.81***	1.41***	0.69	1.08***	0.84*	0.54
	(0.34)	(0.29)	(0.22)	(0.30)	(0.49)	(0.64)	(0.40)	(0.43)	(0.42)

Notes: The same covariates are adjusted for in the model as in Table 4. Mean effects are shown for the main agency index. Log-odds ratios are shown for decision-making, Power Ladder, and the question on the main agent of change in respondents’ own life. Robust standard errors provided in brackets. *Significant at 10 per cent; **significant at 5 per cent; ***significant at 1 per cent.

Figure A1. Sampling strategy and trial flow.

Table A1. Respondent characteristics for intervention and control arms, with (n = 365) and without (n = 1309) missing empowerment data

		Included in main analysis (n = 1309)
	PLA only	PLA and cash	PLA and food	Control	Overall	p-value
Education (years)	2.35 (0.31)	2.84 (0.25)	2.23 (0.20)	2.42 (0.22)	2.50 (0.13)	0.12
Age (years)	23.2 (0.4)	23.3 (0.2)	23.6 (0.2)	23.9 (0.4)	23.5 (0.1)	0.40
Hindu	0.82 (0.04)	0.83 (0.03)	0.84 (0.05)	0.80 (0.04)	0.83 (0.02)	0.94
Muslim	0.18 (0.04)	0.17 (0.03)	0.16 (0.05)	0.20 (0.04)	0.17 (0.02)	0.30
Dalit	0.17 (0.03)	0.13 (0.02)	0.13 (0.03)	0.19 (0.03)	0.15 (0.01)	0.94
Janajati	0.09 (0.02)	0.04 (0.02)	0.09 (0.03)	0.10 (0.03)	0.07 (0.01)	0.26
No. of children alive	1.34 (0.07)	1.36 (0.08)	1.43 (0.07)	1.48 (0.12)	1.40 (0.04)	0.51
Wealth index (SD)	0.08 (0.11)	0.06 (0.06)	−0.07 (0.06)	−0.09 (0.09)	0.00 (0.04)	0.28
		Lost to follow-up (n = 365)
	PLA only	PLA and cash	PLA and food	Control	Overall	p-value
Education (years)	3.42 (0.64)	3.87 (0.34)	2.71 (0.33)	3.19 (0.38)	3.30 (0.22)	0.14
Age (years)	21.9 (0.5)	21.4 (0.5)	22.0 (0.4)	22.3 (0.6)	21.8 (0.3)	0.73
Hindu	0.73 (0.08)	0.80 (0.05)	0.72 (0.06)	0.68 (0.07)	0.74 (0.03)	0.48
Muslim	0.27 (0.08)	0.20 (0.05)	0.27 (0.05)	0.32 (0.07)	0.26 (0.03)	0.69
Dalit	0.13 (0.04)	0.17 (0.04)	0.21 (0.05)	0.17 (0.06)	0.17 (0.02)	0.51
Janajati^a	0.04 (0.02)	0.00 (0.00)	0.06 (0.03)	0.05 (0.03)	0.04 (0.01)	0.00
No. of children alive	0.99 (0.17)	0.97 (0.13)	1.16 (0.07)	0.89 (0.11)	1.02 (0.06)	0.10
Wealth index (SD)	−0.06 (0.16)	0.15 (0.10)	0.12 (0.09)	0.00 (0.11)	0.07 (0.06)	0.59

Notes: Means are provided with robust standard errors in brackets and global robust tests for differences across arms. Testing for differences between participants with and without missing data, education (p < 0.01), age (p < 0.01), Hindu religion (p < 0.01), Muslim religion (p < 0.01), Janajati ethnicity (p = 0.03) and number of children alive (p < 0.01) are strongly related to missingness. However, Dalit caste (p = 0.30) and wealth (p = 0.22) are not. ^aOnly 13 women lost to follow-up were Janajatis.