Empowering women can increase modern contraception use among women with no fertility intentions in South Asia
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Patriarchal gender norms and expectations in South Asia can restrict women’s independence, decision-making power, mobility, and reproductive agency. The discussion emphasizes that male supremacy and control over fertility decisions can constrain contraceptive use, including through husbands’ opposition to family planning and women’s fear of discussing fertility because of potential violence. Women’s empowerment may help transform these gender dynamics and the societal expectations governing women’s behavior, but changes in women’s empowerment should be accompanied by shifts in men’s behavior and more equitable partner negotiation and reproductive decision-making.
Objectives To examine the relationship between women’s empowerment and modern contraceptive use among reproductive-aged women in South Asia who do not desire additional children.
Methods This cross-sectional study analyzed nationally representative Demographic and Health Survey data collected from 2015–2022 in Afghanistan, Bangladesh, India, Nepal, and Pakistan. The pooled sample included 42,573 currently married, fecund, non-sterilized, non-pregnant women aged 15–49 who did not want additional children. Women’s empowerment was assessed using the Survey-based Women’s Empowerment Global Index, derived from 14 survey questions across three domains: attitudes toward violence, measuring the extent to which women reject domestic violence; social independence, including access to information, education, and age at marriage and first birth; and participation in major household decision-making. Each domain was categorized as low, medium, or high empowerment. Weighted descriptive analyses, chi-square tests, and multilevel mixed-effects logistic regression models were used to examine associations with modern contraceptive use.
Results Overall, 45.8% of women used modern contraception, ranging from 31.8% in Pakistan to 67.8% in Bangladesh. In pooled adjusted analyses, women with high empowerment in attitudes toward violence had 17% higher odds of modern contraceptive use than women with low empowerment (adjusted odds ratio 1.17; 95% confidence interval 1.08–1.25). High social independence was associated with 22% higher odds (1.22; 1.13–1.33), and high decision-making empowerment with 11% higher odds (1.11; 1.01–1.23). Associations varied across countries.
Conclusions Greater women’s empowerment is associated with increased modern contraceptive use among South Asian women who do not desire additional children. Family planning efforts should therefore incorporate women’s empowerment while promoting equitable partner negotiation, regular communication about fertility and contraception, gender-sensitive education, and broader efforts to challenge gender stereotypes and patriarchal constraints on women’s reproductive agency.
Disclaimer: These summaries were generated with the assistance of artificial intelligence and are based on the interpretation of source documents. While efforts have been made to ensure accuracy and clarity, there may be errors or omissions. Users are encouraged to consult the original documents for complete and authoritative information.