Gender norms, contraceptive use, and intimate partner violence: A six-country analysis
Outcomes: Gender‑Based Violence, Sexual and Reproductive Health
View SourceKey Social Norms Take-aways This cross-country study demonstrates that gender-related attitudes, used as proxies for gender norms, and couple power dynamics are important correlates of contraceptive use and intimate partner violence (IPV). Joint decision-making within couples—particularly regarding major household purchases—was consistently associated with greater modern contraceptive use and, in some settings, lower IPV, suggesting that shared decision-making reflects more equitable power relationships that can improve sexual and reproductive health outcomes. Conversely, couples in which one or both partners justified wife-beating had substantially higher odds of women experiencing IPV, underscoring the importance of challenging norms that legitimize violence. The authors conclude that future research should directly measure descriptive and injunctive social norms, rather than relying solely on attitudes, to better understand how norms influence health behaviors and outcomes.
Objectives To examine whether couple concordance on gender-related attitudes—specifically attitudes toward wife-beating and household decision-making—is associated with both modern contraceptive use and women’s experience of IPV across six low- and middle-income countries (Mali, Nigeria, Nepal, Pakistan, Tanzania, and Zambia), and to identify implications for gender-transformative social and behavior change programming.
Methods The study conducted secondary analyses of nationally representative Demographic and Health Survey (DHS) couples’ datasets collected in or after 2015 from six countries. Using bivariate and multivariate logistic regression models, the authors assessed associations between women’s modern contraceptive use and IPV experience and two proxy measures of gender norms: (1) couple concordance in attitudes justifying wife-beating across five scenarios and (2) joint decision-making regarding major household purchases as a proxy for shared household power. The analysis was guided by Connell’s Theory of Gender and Power and adjusted for relevant social determinants of health and demographic covariates.
Results Joint decision-making was positively associated with modern contraceptive use across all six countries and remained significant in adjusted models for four countries. It was also associated with reduced IPV in Pakistan and Zambia. In contrast, couples in which both partners justified wife-beating consistently had significantly higher odds of women reporting IPV across all settings, while women’s justification of violence was negatively associated with contraceptive use in Nigeria. Husband’s alcohol consumption emerged as a strong and consistent predictor of IPV across countries.
Conclusions The findings suggest that family planning and IPV prevention programs should promote joint household decision-making as a means of strengthening shared power and women’s autonomy, while also encouraging critical reflection on attitudes that justify violence against women. The authors emphasize that existing survey measures capture gender attitudes rather than true social norms and call for the development and validation of more robust measures of descriptive and injunctive norms, alongside measures of agency and power, to better inform policy and intervention design.
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