Additional qualitative research may provide more indepth
understanding of the contexts driving the different
associations between women’s empowerment and male
antenatal accompaniment. Qualitative methods could also
assist in examining whether there is indeed no association
between women’s empowerment and joint antenatal careseeking,
or whether women’s empowerment aspects which
are linked to male involvement were unmeasured in this
analysis. Measuring a latent construct such as empowerment
across a range of contexts is inherently challenging,
and it is possible that different meanings and manifestations
of empowerment were unable to be captured by the
DHS. Some researchers have increasingly questioned
the adequacy of DHS empowerment measures for use
in sub-Saharan Africa, particularly since the items were
developed based on experiences and conceptual models
drawn from Asia [35,49]. It is worth noting that in our
analysis none of the socio-familial empowerment items
were associated with male ANC accompaniment. Do &
Kurimoto [35] also found that DHS sociocultural empowerment
measures did not predict contraceptive use in the
study’s four African countries [35]. This suggests that such
indicators, as measured, may not signify empowerment or
are not related to male partner engagement in African
settings. Rather, supplemental qualitative research could
inform the development of more culturally relevant and
sensitive measures of women’s empowerment and its
dimensions in African settings that often have less restrictive
gender norms.