Exploring the link between women's empowerment, depression, and anxiety in Bangladesh: evidence from a nationally representative cross-sectional study

초록

Background Women's mental health remains critically under-researched in Bangladesh, despite its close links with gender inequality. In this study, we examined how three domains of women's empowerment-attitudes to violence, social independence, and decision-making-are associated with mental health outcomes among currently married women in Bangladesh. Methods Using nationally representative data from the 2022 Bangladesh Demographic and Health Survey, we analysed 18 900 currently married women. We assessed women's empowerment using the survey-based women's empowerment index, which was categorised as low, medium, or high. Depression and anxiety were measured using the Patient Health Questionnaire-9 and the Generalised Anxiety Disorder-7, respectively. We applied multivariable logistic regression models, adjusting for key sociodemographic covariates. Results Overall, 4.6% women reported depression, and 4.0% reported anxiety. Women with low empowerment in attitude to violence domain had higher odds of depression (adjusted odds ratio (aOR) = 1.48; 95% confidence interval (CI) = 1.17-1.86) and anxiety (aOR = 1.41; 95% CI = 1.09-1.82), compared to women with high empowerment. In the social independence domain, low empowerment was significantly associated with anxiety (aOR = 1.28; 95% CI = 1.02-1.60) but not with depression. Low empowerment in the decision-making domain was not associated with depressive or anxiety symptoms; however, itwas associatedwith lower odds of severe depressive (aOR = 0.48; 95% CI = 0.33-0.70) and anxiety symptoms (aOR = 0.44; 95% CI = 0.28-0.71) when the outcome was disaggregated by severity. Conclusions Women's empowerment is associated with mental health in Bangladesh. Structural interventions must integrate gender-transformative approaches that challenge discriminatory norms and promote women's social standing, reinforcing the interconnection between Sustainable Development Goal three (good health and well-being) and five (gender equality).

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