Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Michael Cappello


The purpose of this qualitative research study was to better understand perceptions of the limitations, motivations and influence of women's political participation on the health of a community in northern India. This study was nested within a larger community-based participatory neonatal health intervention led by the Saksham study group. Eighteen small focus groups were held in the rural villages of Shivgarh, separated based on gender, age category, and parent study intervention status. Scenarios were presented on culturally sensitive, locally relevant topics surrounding the concept of women's health agency, defined generally as a woman's ability to advocate for better health. Qualitative results were analyzed based on four key discussion themes: participation, autonomy, agency/self-efficacy and health systems. Elder women were found to demonstrate the greatest sense of self-efficacy and as a group, cited the largest number of successful health advocacy efforts. Women consistently prioritized issues relating to education, child health and familial well-being. Male concerns included infrastructure repair, village development and need for business opportunities. Caste was a significant factor in that the greatest political party participation, and sense of self-efficacy were seen among the highest and lowest caste members, and the strictest limitations to autonomy were among members of the warrior caste. Participation in the community-based intervention had varying effects, showing some differences in self-efficacy, but rare improvements in participation, autonomy and the functioning of the health system. Conclusions include the need to keenly understand the local infrastructure and health system, cultural norms surrounding autonomy, and male and female perceptions of participation and self-efficacy to appropriately define and ultimately improve women's health agency. In addition, in order for a community-based participatory health intervention to truly improve women's empowerment, explicit strategies in keeping with this aim must be as central as the health-related goals.


This is an Open Access Thesis.

Open Access

This Article is Open Access