Article section
The Economics of Health and Agency: Analysing the Impact of Women's Economic Empowerment on Reproductive Health Outcomes in Oyo State, Nigeria
Abstract
This study used a cross-sectional quantitative survey design. Two randomly selected Local Government Areas (LGA) are Egbeda and Ibadan North East. The study population was women of reproductive age. Amartya Kumar Sen’s Capability Approach provided the framework. A five stage sampling technique was adopted for the selection of these women. Utilising a structured questionnaire administered to 233 women across Oyo State, the research explores the types of reproductive health services accessed, perceived barriers, and the relationship between economic autonomy and health outcomes. Findings reveal that maternal care (88.8%), delivery services (82.0%), postnatal care (81.5%), and family planning (79.8%) are the most commonly accessed services, indicating strong engagement with maternal and preventive health care. Despite positive perceptions of access, particularly regarding confidentiality (mean = 3.55) and affordability (mean = 3.37) some gaps persist, especially in service availability during convenient hours (mean = 3.07) and regular health information dissemination (mean = 2.93). Women reported high levels of economic empowerment, with strong agreement on their ability to work or run businesses (mean = 3.55) and access to financial resources (mean = 3.60). A significant positive relationship was found between women’s economic empowerment and access to reproductive health services (r = .708, p < .001), especially in areas such as family planning and reproductive health education, which enhance productivity and business opportunities. Barriers to empowerment and health access were linked to cultural, social, policy, and financial factors. Respondents strongly supported strategies such as increased government funding (mean = 3.90), policy integration (mean = 3.88), and community engagement, particularly involving men and traditional leaders. The study concludes that strengthening the link between reproductive health and economic empowerment through policy reform, education, and inclusive community strategies is essential for advancing women’s well-being and economic growth in Oyo State. The government should prioritise the integration of reproductive health and women’s economic empowerment into national and state-level development policies.
Keywords:
Empowering Women Economic Empowerment Reproductive Health Women of Reproductive Age
Article information
Journal
Journal of Economics, Business, and Commerce
Volume (Issue)
2(2), (2025)
Pages
74-91
Published
Copyright
Copyright (c) 2025 Helen Ajibike Fatoye, Abimbola Afolabi, Suliat Moyosore Arowolo, Ajibola Mary Adejuwon (Author)
Open access

This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
Afolabi, A., Afolabi, K. A., & Badayi, M. S. (2022). Impact of the level of maternal education on maternal and newborn health in Nigeria. SSRN.
Afolabi, A., & Hendricks, E. (2025). Impact of sociocultural factors on reproductive health among teenagers in Nigeria. African Journal for the psychological studies of social issues, 28(1), 337-348
Afolabi, A. (2019). Knowledge and attitude as determinants of practice of family planning among married men in Aleshinloye market, Ibadan. Ibadan Journal of educational studies, 16(2), 58-63.
Agbor, I. M. (2020). Access to reproductive health-care services and its impact on the health of women in Guma Local Government Area, Benue State, Nigeria. Journal of Social and Political Sciences, 3(2), 419-438. https://doi.org/10.31014/aior.1991.03.02.180
Agrawal, S. (2012). The sociocultural context of family size preference, ideal sex composition, and induced abortion in India: findings from India's National Family Health surveys. Health Care for Women International, 33(11), 986-1019. https://doi.org/10.1080/07399332.2012.692413.
Ahinkorah, B. O., Seidu, A. A., Armah-Ansah, E. K., Ameyaw, E. K., Budu, E., & Yaya, S. (2021). Socio-economic and demographic factors associated with fertility preferences among women of reproductive age in Ghana: evidence from the 2014 Demographic and Health Survey. Reproductive Health, 18(1), 2. https://doi.org/10.1186/s12978-020-01057-9.
Ahmed Shallo, S. (2020). Roles of proximate determinants of fertility in recent fertility decline in Ethiopia: Application of the Revised Bongaarts Model. Open Access Journal of Contraception, 3(11), 33-41. https://doi.org/10.2147/OAJC.S251693.
Akanbi, F. O., Osu U. C., Omokhabi, A. A., & Omokhabi, U. S. (2024). Factors influencing public health care patronage among women of reproductive age in Akinyele Local Government Area Oyo State. Ibadan Journal of Sociology, 15(2), 14-27. https://www.ibadanjournalofsociology.org.ng/
Akram, N., Hamid, A., & Akram, M. I. (2019). Role of women empowerment in utilization of maternal healthcare services: evidence from Pakistan. Pakistan Economic and Social Review, 57, 93. https://www.researchgate.net/publication/336363953_
Alemayehu, Y. K., Theall, K., Lemma, W., Hajito, K. W., & Tushune, K. (2015). The role of empowerment in the association between a woman's educational status and infant mortality in Ethiopia: Secondary Analysis of Demographic and Health Surveys. Ethiopian Journal of Health Science 25(4), 353-62. https://doi.org/10.4314/ejhs.v25i4.9.
Ali, S. M., Siyal, H. B., & Sultan, M. (1995). Women's empowerment and reproductive choices. Pakistan Development Review, 34(4 Pt. III), 137-50.
Alonge, S. K., & Ajala, A. A. (2013). Fertility behaviour and women's empowerment in Oyo State. Journal of Economics and Sustainable Development, 4(18), 33-41.
Aly, R. (2021). Empowerment as a mediator between education and reproductive health care in Egypt: The Impact of Poverty and Residence. Open Journal of Social Sciences, 9, 58-76. https://doi.org/10.4236/jss.2021.93005.
Anderson, S., & Eswaran, M. (2009). What determines female autonomy? evidence from Bangladesh. Journal of Development Economics, 90(2), 179-191.
Asaolu, I. O., Alaofè, H., Gunn, J. K. L., Adu, A. K., Monroy, A. J., Ehiri, J. E., Hayden, M. H., & Ernst, K. C. (2018). Measuring women's empowerment in Sub-Saharan Africa: exploratory and confirmatory factor analyses of the demographic and health surveys. Frontiers in Psychology, 19(9), 994. https://doi.org/10.3389/fpsyg.2018.00994.
Assembly United Nations General. (2000). United Nations millennium declaration. United Nations Gen Assembly https://www.ohchr.org/en/instruments-mechanisms/instruments/united-nations-millennium-declaration
Bertrand, M., Cortés, P., Olivetti, C., & Pan, J. (2016). Social norms, labor market opportunities, and the marriage gap for skilled women. Working Paper No. 22015, National Bureau of Economic Research, Cambridge, MA.
Bhattacharyya, T. L. (1996). Women's struggle for reproductive rights; green left. https://www.greenleft.org.au/content/womens-struggle-reproductive-rights.
Blanc A. K. (2001). The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Studies in Family Planning, 32(3), 189-213. https://doi.org/10.1111/j.1728-4465.2001.00189.x.
Blau, F., & Kahn, L. (2017). The gender wage gap: extent, trends, and explanations. Journal of Economic Literature, 55(3), 789–865. https://doi.org/10.1257/jel.20160995
Butler, M. G., Walker, M., Pablo, L. A., & Bartels, S. A. (2021). Relationship between women’s decision-making power over their own health care and use of modern contraception in the Democratic Republic of the Congo: a cross-sectional secondary data analysis. BMC Women's Health, 21, 309 https://doi.org/10.1186/s12905-021-01450-x
Chandiok, K., Mondal, P. R., Mahajan, C., & Saraswathy, K. N. (2016). Biological and social determinants of fertility behaviour among the Jat women of Haryana State, India. Journal of Anthropology, 2016(1), 5463168. https://doi.org/10.1155/2016/5463168
Chemhaka, G. B., & Odimegwu, C. (2020). Individual and community factors associated with lifetime fertility in Eswatini: an application of the Easterlin–Crimmins model. Journal of Population Research, Springer, 37(3), 291-322. https://doi.org/10.1007_s12546-020-09244-y
Chowdhury, S., Rahman, M. M., & Haque, M. A. (2023). Role of women's empowerment in determining fertility and reproductive health in Bangladesh: a systematic literature review. AJOG Global Reports, 4(3), 100239. https://doi.org/10.1016/j.xagr.2023.100239.
Cohen, S. A., & Richards, C. L. (1994). The Cairo Consensus: population, development and women. Family Planning Perspectives, 26, 272-277. https://doi.org/10.2307/2135895
Corroon, M., Speizer, I. S., Fotso, J. C., Akiode, A., Saad, A., Calhoun, L., & Irani, L. (2014). The role of gender empowerment on reproductive health outcomes in urban Nigeria. Maternal and Child Health Journal, 18(1), 307-315. https://doi.org/10.1007/s10995-013-1266-1.
Darebo, T. D., Birhanu, Z., Alemayehu, M., Balcha, B., Worku, A., Assele, D. D., & Spigt, M. (2024). Utilization of sexual and reproductive health services among construction worker women in southern Ethiopia. BMC Women's Health 24, 201. https://doi.org/10.1186/s12905-024-03042-x
Darteh, E. K., Doku, D. T., & Esia-Donkoh, K. (2014). Reproductive health decision making among Ghanaian women. Reproductive Health, 11, 23. https://doi.org/10.1186/1742-4755-11-23.
DeJong, J., Bashour, H., Benkirane, M., Ghanem, M., Gherissi, A., & Zurayk, H. (2015). Regional advocacy tool sexual and reproductive health and rights advocacy in Egypt, Lebanon, Morocco, Oman, Syria, Tunisia and Yemen.
Field, E., Rohini, P., Natalia, R., Simone, S., & Charity, T. M. (2021). On her own account: how strengthening women’s financial control impacts labor supply and gender norms. American Economic Review, 111(7), 2342–75.
Gammage, S., Joshi, S., & Rodgers, Y. M. (2019). The intersections of women’s economic and reproductive empowerment Taylor and Francis online (pp. 1-22). https://doi.org/10.1080/13545701.2019.1674451
Hameed, W., Azmat, S. K., Ali, M., Sheikh, M. I., Abbas, G., Temmerman, M., & Avan, B. I. (2014). Women's empowerment and contraceptive use: the role of independent versus couples' decision-making, from a lower middle income country perspective. PLoS ONE, 9(8), e104633. https://doi.org/10.1371/journal.pone.0104633
Heath, R., Bernhardt, A., Borker, G., Fitzpatrick, A., Keats, A., McKelway, M., Menzel, A., Molina, T., & Sharma, G. (2024). Female labour force participation. VoxDevLit, 11(1). https://voxdev.org/sites/default/files/202402/Female_Labour_Force_Participation_Issue_1_0.pdf
Heath, R., & Jayachandran, S. (2017). The causes and consequences of increased female education and labor force participation in developing countries. Working Paper 22766. http://Www.Nber.Org/Papers/W22766
Hossain, B. (2015). Women empowerment and infant mortality in Bangladesh. Applied Economics, 47(51), 5534-5547. https://doi.org/10.1080/00036846.2015.1051657
Humble, M. (1995). Women's perspectives on reproductive health and rights. Overview. Planned Parenthood Challenges, 2, 26-31.
Ibrahim, S., & Alkire, S. (2007). Agency and empowerment: a proposal for internationally comparable indicators. OPHI working paper 04. http://ophi.org.uk/working-paper-number-04/.
Kabeer, N., Mahmud, S., & Tasneem, S. (2017). The contested relationship between paid work and women’s empowerment: empirical analysis from Bangladesh. European Journal of Development Research, 0957-8811. https://doi.org/10.1057/s41287-017-0119-y
Kabeer, N. (2012). Women’s Economic Empowerment and Inclusive Growth: Labour Markets and Enterprise Development. Discussion Paper No. 29. Centre for Development Policy & Research, School of Oriental & African Studies, University of London.
Kc, H., Shrestha, M., Pokharel, N., Niraula, S. R., Pyakurel, P., & Parajuli, S. B. (2021). Women’s empowerment for abortion and family planning decision making among marginalized women in Nepal: a mixed method study. Reproductive Health 18, 28. https://doi.org/10.1186/s12978-021-01087-x
Laelago, T., Habtu, Y., & Yohannes, S. (2019). Proximate determinants of fertility in Ethiopia; an application of revised Bongaarts model. Reproductive Health 16, 13. https://doi.org/10.1186/s12978-019-0677-x
Lal, S., Singh, R., Makun, K., Chand, N., & Khan, M. (2021). Socio-economic and demographic determinants of fertility in six selected Pacific Island Countries: An empirical study. PLoS One, 16(9), e0257570. https://doi.org/10.1371/journal.pone.0257570.
Narayan, D. (2002). Empowerment and Poverty Reduction: A Sourcebook. Washington DC: World Bank
Nepal, A., Dangol, S. K., Karki, S., & Shrestha, N. (2023). Factors that determine women's autonomy to make decisions about sexual and reproductive health and rights in Nepal: A cross-sectional study. PLOS Global Public Health, 3(1), e0000832. https://doi.org/10.1371/journal.pgph.0000832. .
Olajide, O. E., & Omokhabi, A. A. (2014). Perception, knowledge level and barriers to reproductive health behaviour among community women in selected Local Government Areas (LGAs) of Oyo State, Nigeria. African Journal of Sustainable Development, 4(2), 29-47.
Omokhabi, A. A. (2016). Factors influencing reproductive health behaviour of female non-academic staff in the Nigerian Universities. Ibadan Journal of Education Studies, 13(1), 89-102.
Omokhabi, A. A., & Egunyomi, D. A. (2016). Predictors of female lecturers reproductive health behaviour in Tertiary Institutions in Nigeria. African Journal of Educational Management, 17(1), 21-54.
Omokhabi, A. A., & Fajimi, B. A. (2023). Women in pandemics and sustainability of african rural communities. Shodh Sari-An International Multidisciplinary Journal, 2(3), 67-105.
Omokhabi, A. A. (2014). Determinants of reproductive health behaviour among female workers in tertiary institutions in Southwestern Nigeria. Unpublished Ph.D. Thesis, Department of Adult Education, Faculty of Education, University of Ibadan, Ibadan, Nigeria.
Omokhabi, A. A. (2020). Testing theory of planned behaviour in predicting married women’s use of modern family planning methods at Ibadan North Local Government. In K. O. Kester, P. B. Abu, I. A. Abiona and E. J. Oghenekohwo (Eds.). Human and Social Development Investment (pp. 364-390). Ibadan: Department of Adult Education, University of Ibadan.
Omokhabi, A. A. (2021). Investing in the informal sector in Ibadan: entrepreneurship factors and women participation. Unilorin Journal of Lifelong Education, 5, 79-100.
Omokhabi, A. A. (2024). Reproductive health needs of women with disabilities: a non- pharmaceutical interventions approach. African Journal for the Psychological Study of Social Issues, 27(2), 82-91.
Paul, G., Talukder, M., & Kibria, K. (2014). Impact of women status on fertility Asian Academic Research Journal of Social Science and Humanities, 1, 281–294.
Pourreza, A., Sadeghi, A., Amini-Rarani, M., Khodayari-Zarnaq, R., & Jafari, H. (2021). Contributing factors to the total fertility rate declining trend in the Middle East and North Africa: a systemic review. Journal of Health, Population and Nutrition, 40(1), 11. https://doi.org/10.1186/s41043-021-00239-w.
Pratley, P. (2016). Associations between quantitative measures of women's empowerment and access to care and health status for mothers and their children: A systematic review of evidence from the developing world. Social Science Medicine, 169, 119-131. https://doi.org/10.1016/j.socscimed.2016.08.001.
Rahman, M. M., Farhana, Z., Tani, T. A., & Ullah, M. O. (2017). Integrating overweight-obesity and reproductive factors of married women in Bangladesh. Society and Change, XI(4) 64-75.
Robinson, J. L, Narasimhan, M., Amin, A., Morse, S., Beres L. K., Yeh, P. T., & Kennedy, C. E. (2017). Interventions to address unequal gender and power relations and improve self-efficacy and empowerment for sexual and reproductive health decision-making for women living with HIV: A systematic review. PLoS One, 12(8), e0180699. https://doi.org/10.1371/journal.pone.0180699.
Roy, P., Haque, S., Jannat, A., Ali, M., & Khan, M. (2017). Contribution of women to household income and decision making in some selected areas of Mymensingh in Bangladesh. Agriculture, 28(2), 120–129.
Sado, L., Spaho, A., & Hotchkiss, D. R. (2014). The influence of women's empowerment on maternal health care utilization: evidence from Albania. Social Science & Medicine, 114, 169-77. https://doi.org/10.1016/j.socscimed.05.047.
Saith, R. (2001). Capabilities: the concept and its operationalisationí. QEH Working Paper Series qehwps66, Queen Elizabeth House, University of Oxford.
Sen, A. (1989). Development as capability expansion. Journal of Development Planning, 19, 41-58. https://doi.org/10.1007/978-1-349-21136-4_3
Sen, A. (1993). Capability and Wellbeing. In M. Nussbaum, & A. Sen (Eds.), The Quality of Life (pp. 30-53). Oxford: Clarendon Press. https://doi.org/10.1093/0198287976.003.0003
Sen, A. K. (1985a), Well-being, agency and freedom: the Dewey lectures. Journal of Philosophy, 82(4), 169-221.
Sen, A. K. (1985). Commodities and Capabilities. North-Holland, Amsterdam.
Shain, R. N., Piper, J. M., Newton, E. R., Perdue, S. T., Ramos, R., Champion, J. D., & Guerra, F. A. (1999). A randomized, controlled trial of a behavioral intervention to prevent sexually transmitted disease among minority women. New England Journal of Medicine, 340(2), 93-100. https://doi.org/10.1056/NEJM199901143400203.
Tiruneh, F. N., Chuang, K.-Y., & Chuang, Y.-C. (2017). Women’s autonomy and maternal healthcare service utilization in Ethiopia. BMC Health Services Research, 17, 718. https://doi.org/10.1186/s12913-017-2670-9
Toufique, M. M. K. (2016). The context specific factors affecting women empowerment and empowerment's implications for resource allocation, awareness and fertility: an econometric analysis. International Letters of Social and Humanistic Sciences, 66, 38-44. https://nbn-resolving.org/urn:nbn:de:101:1-2019072015234121772124
Upadhyay, U. D., Gipson, J. D., Withers, M., Lewis S., Ciaraldi, E. J., Fraser, A., Huchko, M. J., & Prata, N. (2014). Women’s empowerment and fertility: a review of the literature. Social Science and Medicine, 115, 111–20. https://doi.org/10.1016/j.socscimed.2014.06.014
Utaka, E. N., Sekoni, A. O., & Badru, F. A. (2023). Knowledge and utilization of sexual and reproductive health services among young males in a slum area in Nigeria: A cross-sectional study. Heliyon, 9(6), e16289. https://doi.org/10.1016/j.heliyon.2023.e16289
Waiswa, P., O'Connell, T., Bagenda, D., Mullachery, P., Mpanga, F., Henriksson, D. K., Katahoire, A. R., Ssegujja, E., Mbonye, A. K., & Peterson, S. S. (2016). Community and district empowerment for scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial. Trials, 17(1), 135. https://doi.org/10.1186/s13063-016-1241-4
World Health Organisation. (2010). Developing sexual health programmes: a framework for action. World Health Organization. https://iris.who.int/handle/10665/70501
Yaya, S., Uthman, O. A., Ekholuenetale, M., & Bishwajit, G. (2018). Women empowerment as an enabling factor of contraceptive use in sub-Saharan Africa: a multilevel analysis of cross-sectional surveys of 32 countries. Reproductive Health, 15, 214. https://doi.org/10.1186/s12978-018-0658-5
Zepro N. B., Ali N. T., Tarr N., Medhanyie A. A., Paris D. H., Probst-Hensch N., & Merten S. (2023). Sexual and reproductive health services use among adolescents in pastoralist settings, northeastern Ethiopia. BMC Health Services Research, 23(1), 677. https://doi.org/10.1186/s12913-023-09616-z
Zhou, Y., Wang, T., Fu, J., Chen, M., Meng, Y., & Luo, Y. (2019). Access to reproductive health services among the female floating population of childbearing age: a cross-sectional study in Changsha, China. BMC Health Services Research, 19(1), 540. https://doi.org/10.1186/s12913-019-4334-4.