Association between measures of women's empowerment and use of modern contraceptives: An analysis of Nigeria's demographic and health surveys

Ibitola O. Asaolu, Chioma T. Okafor, Jennifer C. Ehiri, Heather M. Dreifuss, John E. Ehiri

Research output: Research - peer-reviewArticle

Abstract

Background: Women's empowerment is hypothesized as a predictor of reproductive health outcomes. It is believed that empowered girls and women are more likely to delay marriage, plan their pregnancies, receive prenatal care, and have their childbirth attended by a skilled health provider. The objective of this study was to assess the association between women's empowerment and use of modern contraception among a representative sample of Nigerian women. Methods: This study used the 2003, 2008, and 2013 Nigeria Demographic and Health Survey data. The analytic sample was restricted to 35,633 women who expressed no desire to have children within 2 years following each survey, were undecided about timing for children, and who reported no desire for more children. Measures of women's empowerment included their ability to partake in decisions pertaining to their healthcare, large household purchases, and visit to their family or relatives. Multivariable regression models adjusting for respondent's age at first birth, religion, education, wealth status, number of children, and geopolitical region were used to measure the association between empowerment and use of modern contraceptives. Results: The proportion of women who participated in decisions to visit their relatives increased from 42.5% in 2003 to 50.6% in 2013. The prevalence of women involved in decision-making related to large household purchases increased from 24.3% in 2003 to 41.1% in 2013, while the proportion of those who partook in decision related to their health care increased from 28.4% in 2003 to 41.9% in 2013. Use of modern contraception was positively associated with women's participation in decisions related to large household purchases [2008: adjusted OR (aOR) = 1.15; 95% CI = 1.01-1.31] and (2013; aOR = 1.60; 1.40-1.83), health care [2008: (aOR = 1.20; 1.04-1.39) and (2013; aOR = 1.39; 1.22-1.59)], and visiting family or relatives [2013; aOR = 1.58; 1.36-1.83]. The prevalence of modern contraceptive use among women with need for contraception increased marginally from 11.1% in 2003 to 12.8% in 2013. Conclusion: Although there were marked improvements in all measures of women's empowerment between 2003 and 2013 in Nigeria, the use of modern contraceptives increased only marginally during this period. Beyond women's participation in household decision-making, further research is needed to elucidate how measures of women's empowerment interact with cultural values and health system factors to influence women's uptake of contraceptives.

LanguageEnglish (US)
Article number293
JournalFrontiers in Public Health
Volume4
Issue numberJAN
DOIs
StatePublished - Jan 9 2017

Fingerprint

Nigeria
Contraceptive Agents
Demography
Power (Psychology)
Contraception
Delivery of Health Care
Decision Making
Health
Surveys and Questionnaires
Birth Order
Aptitude
Prenatal Care
Reproductive Health
Religion
Marriage
Parturition
Education
Pregnancy
Research

Keywords

  • Contraceptives
  • Family planning
  • Gender equality
  • Nigeria
  • Population and development
  • Sub-Saharan Africa
  • Women's empowerment

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Association between measures of women's empowerment and use of modern contraceptives : An analysis of Nigeria's demographic and health surveys. / Asaolu, Ibitola O.; Okafor, Chioma T.; Ehiri, Jennifer C.; Dreifuss, Heather M.; Ehiri, John E.

In: Frontiers in Public Health, Vol. 4, No. JAN, 293, 09.01.2017.

Research output: Research - peer-reviewArticle

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abstract = "Background: Women's empowerment is hypothesized as a predictor of reproductive health outcomes. It is believed that empowered girls and women are more likely to delay marriage, plan their pregnancies, receive prenatal care, and have their childbirth attended by a skilled health provider. The objective of this study was to assess the association between women's empowerment and use of modern contraception among a representative sample of Nigerian women. Methods: This study used the 2003, 2008, and 2013 Nigeria Demographic and Health Survey data. The analytic sample was restricted to 35,633 women who expressed no desire to have children within 2 years following each survey, were undecided about timing for children, and who reported no desire for more children. Measures of women's empowerment included their ability to partake in decisions pertaining to their healthcare, large household purchases, and visit to their family or relatives. Multivariable regression models adjusting for respondent's age at first birth, religion, education, wealth status, number of children, and geopolitical region were used to measure the association between empowerment and use of modern contraceptives. Results: The proportion of women who participated in decisions to visit their relatives increased from 42.5% in 2003 to 50.6% in 2013. The prevalence of women involved in decision-making related to large household purchases increased from 24.3% in 2003 to 41.1% in 2013, while the proportion of those who partook in decision related to their health care increased from 28.4% in 2003 to 41.9% in 2013. Use of modern contraception was positively associated with women's participation in decisions related to large household purchases [2008: adjusted OR (aOR) = 1.15; 95% CI = 1.01-1.31] and (2013; aOR = 1.60; 1.40-1.83), health care [2008: (aOR = 1.20; 1.04-1.39) and (2013; aOR = 1.39; 1.22-1.59)], and visiting family or relatives [2013; aOR = 1.58; 1.36-1.83]. The prevalence of modern contraceptive use among women with need for contraception increased marginally from 11.1% in 2003 to 12.8% in 2013. Conclusion: Although there were marked improvements in all measures of women's empowerment between 2003 and 2013 in Nigeria, the use of modern contraceptives increased only marginally during this period. Beyond women's participation in household decision-making, further research is needed to elucidate how measures of women's empowerment interact with cultural values and health system factors to influence women's uptake of contraceptives.",
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KW - Nigeria

KW - Population and development

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