How stressful Is women's work?: understanding rural Nigerian women's domestic work experience, characterizing the physical demands, and estimating associations with musculoskeletal pain

Despite the improvements in female workforce participation rates over the past three decades globally, the fact remains the same- women are still disproportionately responsible for domestic work. Engaging in strenuous domestic tasks increases the risk of musculoskeletal pain. This health risk increases among millions of women in developing countries because of limited access to time-saving technologies and the high prevalence of water insecurity in rural communities. However, research on the burden and health consequences of domestic work demands is limited in the literature. To address these gaps: we assessed and characterized domestic work using self-report, observation, and sensor-type (Fit-bit-like) tools; developed and utilized survey applicable to the context of domestic work in developing countries to estimate demands; and quantified how the developed measures increase the risks of MSP among women. Published studies were reviewed and quantitative data were aggregated to assess the evidence on the relationship between physically demanding domestic labor (PDDL) and back pain- the most common type of MSP. Next, the domestic work experience (DWE) survey was developed using items that best capture the physical, psychosocial, and social conditions in rural women’s environments and lives. The most representative DWE measures were then derived and the relationship between the measures and self-reported risk of MSP (gotten from survey) was estimated. Finally, PDDL were characterized using observations data in conjunction with data from the fit-bit-like sensors among rural Nigerian women.

PDDL significantly increased women’s risk of BP. This risk was higher among studies of women from LIC countries. High DWE scores were associated with an increased risk of experiencing pain. Characterizing PDDL using observation and instrument-based measures revealed that women spent a reasonable proportion of their worktime bending and engaging in PDDL characterized as vigorous physical activity. Women that frequently fetch and carry water had higher exposures compared to those that have on-plot water services. This research contributes to knowledge by presenting data on how the domestic work burden contributes to women’s health globally and particularly in LMIC. Recognizing the burden of domestic work will be important in designing future interventions (behavioral, infrastructural, and ergonomic) that can reduce burdens from domestic labor. Domestic labor is the occupational reality of many women and the result from this study indicates that the work contains health risks like those experienced by women in paid domestic and other service-related professions.