Men's Migration, Women's Autonomy, and Union Dissolution in Rural Mozambique

Migration, Gender, and Families: The Effects of Spousal Migration on Women's Empowerment

Labor migration has a profound effect on families, but evidence documenting the impact of migration on women left behind is still lacking. Utilizing the Matlab Health and Socioeconomic Surveys, we examined the roles of migration and families in four domains of empowerment for women in Bangladesh. We found that women with international migrant spouses saw significant improvements in economic empowerment, mobility, and decision-making relative to women with coresident spouses (p < .0001). However, women who lived in multigenerational households with their parents or in-laws experienced significant reductions in empowerment across these three domains. Both having a migrant spouse and living in a multigenerational household had negative effects on beliefs about gender equivalence and reduced joint decision-making for women. Results, which were robust to migration selection controls (including propensity approaches), indicate that the benefits of migration for women left behind might be diluted by family structures that perpetuate unequal gender dynamics.

Drought and migration: a case study of rural Mozambique

Migration is commonly seen as a last resort for households impacted by climate shocks, given the costs and risks that migration typically entails. However, pre-existing labor migration channels may facilitate immediate migration decisions in response to climate shocks. This study explores the relationship between migration and droughts in a rural Sub-Saharan setting from which men commonly migrate in search of non-agricultural employment. We use data from the Men's Migrations and Women's Lives project, which includes a longitudinal household panel conducted in rural Mozambique between 2006 and 2017, and combine it with the Standardized Precipitation Evapotranspiration Index, a high-resolution climate measure. The fixed-effect models assess the lagged impact of droughts on the labor migration status of male household heads. We find an immediate increase in migration following a drought, peaking in the first year, then diminishing in the second year, with a slight resurgence in the third year. However, by the sixth-year post-drought, the likelihood of being a migrant turns negative. These findings demonstrate the complex associations of climate shocks with labor migration in low-income rural settings.

HIV and viremia prevalence in non-migrating members of migrant households in Rakai region, Uganda: A cross-sectional population-based study

Introduction

In sub-Saharan Africa, migrants are more likely to be HIV seropositive and viremic than non-migrants. However, little is known about HIV prevalence and viremia in non-migrants living in households with in- or out-migration events. We compared HIV outcomes in non-migrating persons in households with and without migration events using data from the Rakai Community Cohort Study (RCCS), an open population-based cohort in Uganda.

Methods

We analyzed RCCS survey data from one survey round collected between August 2016 and May 2018 from non-migrating participants aged 15-49. Migrant households were classified as those reporting ≥1 member moving into or out of the household since the prior survey. A validated rapid test algorithm determined HIV serostatus. HIV viremia was defined as >1,000 copies/mL. Modified Poisson regression was used to estimate associations between household migration and HIV outcomes, with results reported as adjusted prevalence ratios (adjPR) with 95% confidence intervals (95%CI). Analyses were stratified by gender, direction of migration (into/out of the household), and relationship between non-migrants and migrants (e.g., spouse).

Results

There were 14,599 non-migrants (7,654, 52% women) identified in 9,299 households. 4,415 (30%) lived in a household with ≥1 recent migrant; of these, 972(22%) had migrant spouses, 1,102(25%) migrant children, and 875(20%) migrant siblings. Overall, HIV prevalence and viremia did not differ between non-migrants in migrant and non-migrant households. However, in stratified analyses, non-migrant women with migrant spouses were significantly more likely to be HIV seropositive compared to non-migrant women with non-migrant spouses (adjPR:1.44, 95%CI:1.21-1.71). Conversely, non-migrant mothers living with HIV who had migrant children were less likely to be viremic (adjPR:0.34, 95%CI:0.13-0.86). Among non-migrant men living with HIV, spousal migration was associated with a non-significant increased risk of viremia (adjPR:1.37, 95%CI:0.94-1.99). Associations did not typically differ for migration into or out of the household.

Conclusions

Household migration was associated with HIV outcomes for certain non-migrants, suggesting that the context of household migration influences the observed association with HIV outcomes. In particular, non-migrating women with migrating spouses were more likely to have substantially higher HIV burden. Non-migrants with migrant spouses may benefit from additional support when accessing HIV services.

Long-term Consequences of Men's Migration for Women's Well-being in a Rural African Setting

Labor migration is a massive global reality, and its effects on the well-being of nonmigrating household members vary considerably. However, much existing research is limited to cross-sectional or short-term assessments of these effects. This study uses unique longitudinal panel data collected over 12 years in rural Mozambique to examine long-term connections of women's exposure to husband's labor migration with women's material security, their perception of their households' relative economic standing in the community, their overall life satisfaction, and their expectations of future improvements in household conditions. To capture the cumulative quality of such exposure, we use two approaches: one based on migrant remittances ("objective") and the other based on woman's own assessment of migration's impact on the household ("subjective"). The multivariable analyses detect a significant positive association between "objective" migration quality and household assets, regardless of women's current marital status and other characteristics. However, net of household assets, "objective" quality shows a positive association with life satisfaction, but not with perceived relative standing of the household or future expectations. In comparison, "subjective" quality is positively associated with all the outcomes even after controlling for other characteristics. These findings illustrate the gendered complexities of long-term migration impact on nonmigrants' well-being.

HIV incidence among non-migrating persons following a household migration event: a population-based, longitudinal study in Uganda

Background

The impact of migration on HIV risk among non-migrating household members is poorly understood. We measured HIV incidence among non-migrants living in households with and without migrants in Uganda.

Methods

We used four survey rounds of data collected from July 2011-May 2018 from non-migrant participants aged 15-49 years in the Rakai Community Cohort Study, an open, population-based cohort. Non-migrants were individuals with no evidence of migration between surveys or at the prior survey. The primary exposure, household migration, was assessed using census data and defined as ≥1 household member migrating in or out of the house from another community between surveys (∼18 months). Incident HIV cases tested positive following a negative result at the preceding visit. Incidence rate ratios (IRR) with 95% confidence intervals were estimated using Poisson regression with generalized estimating equations and robust standard errors. Analyses were stratified by gender, migration into or out of the household, and the relationship between non-migrants and migrants (i.e., any household migration, spouse, child).

Findings

Overall, 11,318 non-migrants (5,674 women) were followed for 37,320 person-years. 28% (6,059/21,370) of non-migrant person-visits had recent migration into or out of the household, and 240 HIV incident cases were identified in non-migrating household members. Overall, non-migrants in migrant households were not at greater risk of acquiring HIV. However, HIV incidence among men was significantly higher when the spouse had recently migrated in (adjIRR:2·12;95%CI:1·05-4·27) or out (adjIRR:4·01;95%CI:2·16-7·44) compared to men with no spousal migration. Women with in- and out-migrant spouses also had higher HIV incidence, but results were not statistically significant.

Interpretation

HIV incidence is higher among non-migrating persons with migrant spouses, especially men. Targeted HIV testing and prevention interventions such as pre-exposure prophylaxis could be considered for those with migrant spouses.

Funding

National Institutes of Health, US Centers for Disease Control and Prevention.

Research in context

We searched PubMed for studies focused on HIV acquisition, prevalence or sexual behaviors among non-migrants who lived with migrants in sub-Saharan Africa (SSA) using search terms such as "HIV", "Emigration and Immigration", "family", "spouses", "household", "parents", and "children". Despite high levels of migration and an established association with HIV risk in SSA, there is limited data on the broader societal impacts of migration on HIV acquisition risk among non-migrant populations directly impacted by it.There has been only one published study that has previously evaluated impact of migration on HIV incidence among non-migrating persons in sub-Saharan Africa. This study, which exclusively assessed spousal migration, was conducted in Tanzania more than two decades earlier prior to HIV treatment availability and found that non-migrant men with long-term mobile partners were more than four times as likely to acquire HIV compared to men who had partners that were residents. To the best of our knowledge, this is the first study to examine the effect of non-spousal migration, including any household migration and child migration, on HIV incidence among non-migrants.

Added value of this study

In this study, we used data from the Rakai Community Cohort Study (RCCS), a population-based HIV surveillance cohort to measure the impact of migration on HIV incidence for non-migrant household members. The RCCS captures HIV incident events through regular, repeat HIV testing of participants and migration events through household censuses. Our study adds to the current literature by examining the general effect of migration in the household on HIV incidence in addition to child, and spousal migration. Using data from over 11,000 non-migrant individuals, we found that spousal, but not other types of household migration, substantially increased HIV risk among non-migrants, especially among men. Taken together, our results suggest that spousal migration may be associated with an increased risk of HIV acquisition in the period surrounding and immediately after spousal migration.

Implications of all the available evidence

Our findings suggest that spousal migration in or out of the household is associated with greater HIV incidence. Targeted HIV testing and prevention interventions such as pre-exposure prophylaxis could be considered for men with migrant spouses.

The effects of spousal migration on perinatal healthcare utilization

Over the last three decades, out-migration has become a stable source of income for more than 12 million Bangladeshis. Of those migrants, 90% are men. Due to patriarchal cultural norms in Bangladeshi society, the migration of a male spouse may have significant consequences for the social well-being and health of left-behind women. In this study, we examine the impact of external (out of country) and internal (rural to urban) spousal migration on the perinatal healthcare utilization of left-behind women. We used data from the 2012 Matlab Health and Socioeconomic Survey (MHSS2) to examine use of antenatal care, presence of a medically qualified attendant at birth, and delivery at a healthcare facility for live births that occurred between 2007 and 2014 for currently married women aged 15-45 (N = 1,458 births among 1,180 women). Adjusted regression models indicated that for births occurring to women with a migrant spouse, odds of receiving antenatal care were significantly higher (OR: 4.1 for births to women with a domestic urban migrant spouse and 4.6 for births to women with an international migrant spouse, p < 0.01). Spousal migration was not linked to having a medically qualified attendant at birth or delivery at a clinic or hospital. Results suggest that spousal migration may be beneficial for receiving health care during a pregnancy, but not for the type of attendant or place of delivery at birth.

Effects of spousal migration on access to healthcare for women left behind: A cross-sectional follow-up study

Background

Women left behind by migration represent a unique and growing population yet remain understudied as key players in the context of migration and development. Using a unique longitudinal survey of life in Bangladesh, the Matlab Health and Socioeconomic Surveys, we examined the role of spousal migration in healthcare utilization for women. The objective of this study was to assess realized access to care (do women actually get healthcare when it is needed) and consider specific macrostructural, predisposing, and resource barriers to care that are related to migration.

Methods and findings

In a sample of 3,187 currently married women, we estimated multivariate logistic and multinomial regression models controlling for a wide range of baseline sociodemographic factors measured as far back as 1982. Our analyses also controlled for selection effects and explored two mechanisms through which spousal migration can affect healthcare utilization for women, remittances and frequent contact with spouses. We found that women with migrant spouses were approximately half as likely to lack needed healthcare compared to women whose spouses remained in Bangladesh (predicted probability of not getting needed healthcare 11.7% vs. 21.8%, p<0.001). The improvements in access (logistic regression coefficient for lacking care for left-behind women -0.761 p<0.01) primarily occurred through a reduction in financial barriers to care for women whose spouses were abroad.

Conclusions

Wives of international migrants showed significantly better access to healthcare even when accounting for selection into a migrant family. While the overall story is one of positive migration effects on healthcare access due to reductions in financial barriers to care, results also showed an increase in family-related barriers such as not being permitted to get care by a family member or travel alone to a facility, indicating that some of the benefits of migration for women left behind may be diluted by gendered family structures.

When leaving is normal and staying is novel: Men's labor migration and women's employment in rural Mozambique

Considerable cross-national research has examined the impact of international labor migration on livelihoods in sending households and communities. Although findings vary across contexts, the general underlying assumption of this research is that migration represents a novel income-generating alternative to local employment. While engaging with this assumption, we also argue that in many sending communities where labor migration has been going on for generations, it is the decision not to migrate and instead to pursue local livelihood opportunities that might constitute a true departure from the expected behavior. Importantly, both the decisions to migrate and not to migrate are part of a household strategy shaped by gendered negotiation and bargaining. Building on these propositions, we use rich survey data from rural Mozambique, a typical setting of long-established large-scale international male labor out-migration, to examine married women's gainful employment outside subsistence agriculture as it relates to their husbands' migration or local work. We find a somewhat lower likelihood of employment among migrants' wives, compared with nonmigrants' wives, and this pattern strengthens with increased duration of migration. However, we also find substantial differences among nonmigrants' wives: women married to locally employed men have themselves by far the highest probability of employment, while wives of nonemployed men are no different from migrants' wives, net of other factors. These findings are discussed in light of interconnected gendered complexities of both migration-related and local labor market constraints and choices.

Temporary Labor Migration and Spouses' Marital Quality: Evidence from Nepal

OBJECTIVE

This study investigated the effect of temporary labor migration on spouses' marital quality.

BACKGROUND

How temporary international labor migration affects the marital relationship remains unclear. Research shows migration increases couples' risk of dissolution, whereas studies of spouses' marital quality-much of which is cross-sectional and/or limited to either internal or joint migration-is more mixed. This lack of consensus masks the possibility that, under certain conditions, migration may improve spouses' marital quality.

METHOD

This study uses data from the Chitwan Valley Family Study, a panel study set in Nepal, and primary data collected among a subsample of migrant husbands (in East Asia, Middle East) and their wives and nonmigrant couples (in Nepal).

RESULTS

Findings from linear regression models show that, relative to non-migrant spouses, spouses engaged in temporary international labor migration report significantly higher marital quality-less conflict and more love-net of marital quality assessed 6 years earlier. However, these benefits are not enjoyed equally between spouses: husbands' marital quality improves, whereas changes in their wives' are less conclusive.

CONCLUSION

The fact that these benefits (a) diverge from previous understandings and (b) vary by spouse's gender extends current understandings of the conditions shaping this association: social and structural forces supporting men as breadwinners, a strong husband-wife bond facilitating husbands' migration, and marriage-protective social environments at both ends of migration.

Bridewealth Marriage in the 21st Century: A Case Study from Rural Mozambique

OBJECTIVE

This study examines trends over several decades in bridewealth marriage and analyzes the association of bridewealth with women's experiences in marriage in a rural sub-Saharan setting.

BACKGROUND

Bridewealth - payments from the groom's to the bride's family as part of the marriage process - has long been a central element of kinship and marriage systems in patrilineal sub-Saharan Africa. This payment, which symbolizes the transfer of sexual and reproductive rights from the wife's to the husband's family, is grounded in a collectivist-oriented family system that closely ties women's status and value to their reproductive capacity.

METHOD

The study draws on population-based longitudinal survey data collected in 2006, 2009, and 2011 from 1,552 women in rural Mozambique. We use multivariable regression to investigate whether year of marriage predicts being in a bridewealth marriage and whether bridewealth status predicts marital dissolution, women's decision-making autonomy, women's work outside of subsistence agriculture, or modern contraceptive use.

RESULTS

The proportion of marriages involving bridewealth payment has declined over time. While no difference by bridewealth status exists in women's autonomy levels or modern contraceptive use, women in bridewealth marriages are less likely to divorce over a five-year period and less likely to work outside of subsistence agriculture, net of other factors.

CONCLUSION

These findings reflect the complexity of a modernizing marriage system. With the decline of bridewealth marriage, its meaning has evolved, becoming increasingly indicative of individual wealth and status rather than family control.

Men's migration and women's mortality in rural Mozambique

Labor migration is widespread and growing across the world. As migration grows, the economic outcomes of migration increasingly diversify, and so do its consequences for the well-being and health of both migrants and non-migrating household members. A considerable body of scholarship has examined the effects of migration on the physical and mental health of 'left-behind' household members. The impact of migration on mortality, particularly of non-migrating marital partners, is less well understood. Addressing this gap, we use data from a longitudinal survey of married women conducted over twelve years in rural Mozambique to examine the association between men's labor out-migration and their non-migrating wives' mortality. The analyses detect no significant differences when comparing non-migrants' wives to migrants' wives in the aggregate but point to instructive variation among migrants' wives according to the economic success of migration, as measured by the effects of migration on the household's material well-being. Specifically, women married to less successful migrants had higher mortality risks over the project span than women married to more successful migrants, regardless of other individual and household-level factors. Importantly for this setting with high HIV prevalence, the advantage of wives of more successful migrants is significant for HIV/AIDS-unrelated deaths but not for HIV/AIDS-related deaths. We situate these findings within the cross-national scholarship on migration and health.

Condemned and Condoned: Polygynous Marriage in Christian Africa

OBJECTIVE

This study contributes to a better understanding of the role of Christianity in the persistence of polygyny in sub-Saharan Africa.

BACKGROUND

Marital systems and practices are closely connected to religious norms, but these connections are often complex and contradictory. Polygynous marriage remains widespread in sub-Saharan Africa, including its heavily Christianized parts, where public opposition to it should be strongest.

METHODS

The study analyzes a rich combination of quantitative and qualitative data from a predominantly Christian district in Mozambique. The data include a household-based survey, a census of the district's religious congregations, and focus group discussions and individual interviews with leaders and rank-and-file members of various churches.

RESULTS

The multivariate statistical tests point to instructive denominational differences in the prevalence and acceptance of polygyny, with the starkest contrast being between two types of African Initiated Churches - one that is more lenient on pre-Christian practices and the other that is vehemently opposed to them. These tests also show a contrast between church leaders and rank-and-file members, the latter being generally more accepting of polygyny, and illustrate variations in acceptability of polygyny across different church membership scenarios. The analysis of the qualitative data complements the statistical tests by highlighting ideological and social mechanisms through which polygynous marriage is both rejected and legitimized in Christian communities.

CONCLUSION

Both condemnation and toleration of polygyny by Christian churches reflect the complexities of the transformation of sub-Saharan marital systems and of the role that religion plays in that process.

Polygyny and Intimate Partner Violence in Mozambique

Polygyny has shown a positive association with intimate partner violence (IPV), yet the nature and mechanisms of this association are not well understood. This study uses data from rural Mozambique to distinguish women in polygynous unions by rank and co-residence. Findings show that senior wives report higher rates of violence than their junior-wife and monogamously married counterparts. At the same time, no difference is detected between junior wives and women in monogamous marriages. Additionally, the analysis finds that polygynously married women living away from their co-wives report higher rates of violence than both women co-residing with co-wives and women in monogamous unions, while the difference between the latter two categories is not statistically significant. However, the results also indicate that senior wives living away from their co-wives face particularly high risks of violence. These findings illustrate the social complexity of polygynous marriages and resulting differential vulnerabilities of women in them.

Spacing, Stopping, or Postponing? Fertility Desires in a Sub-Saharan Setting

A growing body of research has argued that the traditional categories of stopping and spacing are insufficient to understand why individuals want to control fertility. In a series of articles, Timæus, Moultrie, and colleagues defined a third type of fertility motivation-postponement-that reflects a desire to avoid childbearing in the short term without clear goals for long-term fertility. Although postponement is fundamentally a description of fertility desires, existing quantitative research has primarily studied fertility behavior in an effort to find evidence for the model. In this study, we use longitudinal survey data to consider whether postponement can be identified in standard measures of fertility desires among reproductive-age women in rural Mozambique. Findings show strong evidence for a postponement mindset in this population, but postponement coexists with stopping and spacing goals. We reflect on the difference between birth spacing and postponement and consider whether and how postponement is a distinctive sub-Saharan phenomenon.

Determined to stop? Longitudinal analysis of the desire to have no more children in rural Mozambique

Classic demographic theories conceptualize desired family size as a fixed goal that guides fertility intentions over the childbearing years. However, a growing body of research shows that fertility plans, even nominally long-term plans for completed childbearing, change in response to short-term conditions. Because of data limitations, much of this research has focused on low-fertility contexts, but short-term conditions are likely to be even more important in high-fertility contexts. This paper uses three waves of survey data collected in rural Mozambique to study predictors of the desire to stop childbearing in a context of relatively high fertility and high individual and social instability. We use fixed effects models to assess how women's desires to stop childbearing are shaped by demographic factors, household economic conditions, and health status, controlling for constant individual characteristics. Results provide evidence that fertility desires both reflect stable underlying goals and evolve in response to individual and social circumstances.