Methods Logic models developed from our critical review of
theory were used to guide our search strategy and to locate relevant
literature. Studies were identified by searching seven bibliographic databases,
screening reference lists, consulting key informants and searching
organisational websites. Observational studies of any design were included that
addressed our review question. Data extraction and quality appraisal of
included studies were carried out by two reviewers, with disagreements brought
to the wider team for discussion. This was followed by a narrative synthesis.
Results We identified 61 studies, 25 of which reported
findings on the health-related outcomes of low control/discrimination against
women, all but one set in low and middle-income countries. There is some
evidence that women with low control have reduced freedom of movement and
control over important determinants of health such as access to food and
nutrition, household resources, healthcare, education, employment, land and
property ownership and reproductive rights. For women, low control or autonomy
was associated with increased anxiety, stress and depression, increased
childhood malnutrition and mortality, higher fertility, poorer reproductive
health and higher levels of violence against women. Son preference, in
societies characterised by low female control and discrimination, is associated
with poorer health outcomes that include reduced survival of girls and women;
resulting in the phenomenon of “missing women”. The effects of gender
discrimination on survival begin before birth through selective abortion of
female foetuses, leading to distorted population demographics.
Conclusion There is empirical evidence of an adverse impact on the health of women and female children living in societies in which they suffer low control and overt gender discrimination. Purposeful measures to improve the economic, social and political position of women in their societies are advocated to improve the situation.
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