Enhanced women's decision-making power after the Suchana intervention in north-eastern Bangladesh: a cluster randomised pre-post study

Objectives Women's decision-making power is a dimension of empowerment and is crucial for better physical and psychosocial outcomes of mothers. Suchana, a large-scale development programme in Bangladesh, actively provided social interventions on behaviour change communication to empower women belonging to the poorest social segment. This paper aims to assess the impact of the Suchana intervention on various indicators related to women's decision-making power. Design, setting and participants The evaluation design was a cluster randomised pre-post design with two cross-sectional surveys conducted among beneficiary women with at least one child aged <23 months from randomly selected poor or very poor beneficiary households in Sylhet division. Outcome measure Decision-making indicators included food purchases, major household purchases, food preparation, children's healthcare as well as women's own healthcare and visiting family and relatives. Results Our findings suggest that 45% of women were able to make decisions on food purchases, 25% on major household purchases, 78% on food preparation, 59% on children's healthcare, 51% on their own healthcare and 43% on visiting family and relatives at baseline in the intervention group, whereas the results were almost the same in the control group. In contrast, at the endline survey, the respective proportions were 75%, 56%, 87%, 80%, 77% and 67% in the intervention group, which were significantly improved when compared with the control group. The prevalence of those outcome indicators were 64%, 41%, 80%, 71%, 68% and 56%, respectively, in the control group. As per multiple logistic regression analysis and structural equation modelling, the Suchana intervention had a substantial influence on the latent variable of women's decision-making power. Conclusion In terms of food purchases, major household purchases, children's healthcare, their own healthcare and visiting family and relatives, the Suchana intervention favourably influenced the decision-making power of rural women living in a vulnerable region of Bangladesh. Trial registration number RIDIE-STUDY-ID-5d5678361809b.