Women's economic empowerment through chamas: Evidence from a maternal health program in Kenya

The Chamas for Change (Chamas) program in western Kenya combines health education, peer support, and microfinance to address both maternal health and economic barriers. We conducted a secondary analysis of a cluster randomized controlled trial (N=1550) to examine Chamas' effect on women's economic empowerment and its relationship with maternal health outcomes. Using an adapted Women's Empowerment Scale, Chamas participants (n=822) showed higher overall empowerment than controls (n=728) (adjusted risk ratio=1.28, 95% CI=1.03-1.58), with greater cash savings (aRR=1.36) and income-generating activities (aRR=1.56). Participants were also 32% less likely to face restrictions on working outside the home. Although women's empowerment improved, these economic gains did not explain the maternal health benefits previously reported. The health improvements were likely primarily driven by Chamas' health education and peer-support components. The Chamas model illustrates how community-based platforms can simultaneously strengthen women's empowerment and health outcomes, offering practical lessons for integrated interventions in resource-limited African settings.