Contraceptive use allows women to delay or prevent pregnancies, which can aid in health and gender equality. There is considerable research that examine the women’s empowerment and their reproductive health. Women empowerment is defined by the United Nations Population Information Network as having five components that fully describe it which are “women’s sense of self-worth; their right to have and to determine choices; their right to have access to opportunities and resources; their right to have the power to control their own lives, both within and outside the home; and their ability to influence the direction of social change to create a more just social and economic order, nationally and internationally” (UN 2017).  

Research usually finds that
women empowerment is associated with contraceptive use. Some scholars propose
that women empowerment increases with age, literacy or education, number of
children, and socio economic status (Hameed et al, 2014).  However, in India “the contraceptive
prevalence rate appears to have stagnated after 2004. Moreover, contraceptive
practice in India is known to be severely skewed towards terminal methods which
means that contraception in India is practiced primarily for birth limitation
rather than birth planning” (Chaurasia, 2014), as illustrated in Figure 1.

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The reproductive years for women in
India is single most important to their lives. Women’s role in their
reproductive health is influenced by her status, this includes the choice of
livelihood, who to marry, number
of children, and choice of friends are critical decisions. Many studies have
shown that while women may be empowered in some areas of life they may also not
be in others. Reproductive health and
empowerment for Indian women are often misjudged in the context of the Indian
health care system (D’Souza et al, 2013).

 

The aim or research question for this
study will measure the relationship between women empowerment and contraceptive
use among Indian women. The source of data for this study will be from the
2005-2006 India Demographic and Health Surveys (DHS). The study population is Indian women between the ages of 15
and 49, who either use or don’t use contraception and whether the indicators
for empowerment have played a role. For the selection of population for this
paper, the unmet needs were refined to exclude those not at risk for using
contraceptive use, this includes, those who are pregnant, menopausal,
infertile, and not having sexual intercourse.

 

For
method, some literature will be emphasized regarding the connection between
women’s empowerment and contraceptive use. Furthermore, there will be an
examination of the univariate distributions of main variables such as,
education level, residence type, and current contraception use among the study
population. To measure the associations between these univaiate, this paper
will use bivariate analysis and multivariate analysis to analyze the logistical
regression to measure the association between the variables. The data was
analyzed using Stata 15.0.

 

 

Literature Review and Hypothesis

 

There is extensive research that
examines the key factors of contraceptive use. Education and wealth have been
seen to be strongly associated with the use of contraceptives. Worku et al
found that, in sub-Saharan Africa women’s age, educational status,
religion, family size concordance, and fertility preference were significantly
associated to using contraceptive use. Where education came in as the highest
significance (2014).   

 

Hermalin
in his model of contraceptive use recognized the incentives to control
childbearing and the costs of fertility regulation as the two main determinants
of contraceptive use (1983). Additionally, empirical research shows women who
adopt the use of contraceptive methods, contribute to a reduction in fertility
were higher status (Kishor and Subaiya, 2005). Furthermore,
when looking further into the factors that contribute to women empowerment,
Blackstone found that decision making was found to be positively associated
with contraceptive use, she emphasized those who justified wife beating in one
or more instances were less likely to use contraception (Blackstone, 2016).  

 

According
to summary tables in the DHS Final Report for India, contraceptive use is
higher among the wealthiest and highly educated women. The hypothesis tested in
this study is that there is a link between women’s empowerment and their
contraceptive use. In particular, women who are empowered are assumed to be
more likely to be using contraception comparative to those who are not
empowered. The null hypothesis is that there is no association between women’s
empowerment and whether or not they are using contraception.

 

Data and Methods

The data used
was obtained from the 2005-2006 Indian National Family Health Survey (NFHS-3
2005-2006) individual’s questionnaire. The analysis is specific to 63,231 women
of reproductive age 15-49 years, who were currently married or living with a
partner.  

 

The dependent variable, women’s current contraceptive use, is a
dichotomous variable specifying participants use of any method, modern and
traditional, (modern and traditional) of contraception at the time of the
survey. The independent variables included empowerment factors and gender-specific
variables. Women’s empowerment measures were from factors of analysis conducted
from survey questions representative of different scopes of empowerment. These
measures include five questions related to women’s approval of domestic
violence in the data. Women were asked their views about whether a husband is
justified in hitting his wife if she; burns the food, neglects the children, goes
out without telling her husband, , argues with her husband, refuses to have sex.

For this paper, respondents are divided into those who said that the reason is
not justified by code 0, indicating a higher level of empowerment and those who
said yes wife beating is justified as code 1.

In the data there are four variables measuring women’s role in household
decision making: The wife’s final say on her own health care, has bank or
savings account, visits to family and relatives, and currently working. Each respondent
is grouped into two classifications, that is, those who reported having any
say, alone and joint, in household decisions coded as 0 demonstrating a higher
level of empowerment and those who reported that their husband or someone else
made the decisions as code 1. As well as, women were asked the highest level of
education they had completed.

Table 1 illustrates the coding and distribution of variables used to measure
women empowerment indicators. Elements were analyzed and conducted using each
of these measures, and the related factors for each dimensions will be used in
the multivariate. Additional gender specific indicator probable to impact women’s
contraceptive use includes ideal number of children, frequency of reading
newspaper or magazine, listening to the radio, and watching television.

In the model,
number of socio-demographic characteristics were controlled which the
literature reviews specify as likely to influence women’s empowerment status
and their reproductive behavior, employment status, respondents level of
education, spousal education, and wealth index. To analyze the factors, factors
were inserted to recognize the structure of hidden factors in the model.

To understand
the effects of women’s empowerment on contraceptive use, a series of logistical
regressions were used. Firstly, gender specific and socio-demographic
characteristics were included to be examined. Secondly, the empowerment
indicators were also fitted onto the contraceptive use with other independent
variables to assess the importance of empowerment indicators in examining
contraceptive use. For the final model, odds ratio (OD) were calculated.

Results

The basic
characteristics of the respondents are reflected in Table 2. where more than
half (86.69%) of women reported ever using a method of contraceptive, 45.84%
were urban, and 36.24% of women were currently working. The average age of women
in the study was 32.9 years. The mean ideal number children were 4.2 (SD=12.9).

About two-thirds (37.36%) of women had no education and only 9.08% had higher
level of education. Fifty-three per cent of women had the same level of
education as their partners and there is no percentage where women have more
education than their partners.

Table 2. Socio-demographic characteristics of women, India
2005-6

Variable

Percentage

Number of
Cases*

Dependent
Variable

 

 

Contraceptive
use

86.69%

57,894

Independent
Variable

 

 

Place of
residence

 

63,231

Urban

45.84%

 

Rural

54.16%

 

Respondent’s
education

 

63,227

No
education

37.36%

 

Primary

16.01%

 

Secondary

37.55%

 

Partner’s
education

 

63,078

No
education

20.67%

 

Primary

15.63%

 

Secondary

48.0%

 

Respondents
currently working – Yes

63.76

63,111

Current age
(Mean ± SD)

32.9 ± 7.86

63,231

Ideal
number of children (Mean ± SD)

4.19 ±
12.96

63,223

*Number of cases
unweighted

Bivariate Results

Current Contraceptive Use and
Measures of Empowerment

To measure contraceptive
use and empowerment, Table 3 presents the distribution. With regard to
acceptance of domestic violence, the amount of contraceptive users among those
who said that wife beating is not justified is greater compared to
contraceptive users who said wife beating is justified. For example, 87.5% of the
women who said wife beating is not justified if she goes out without telling
her husband used contraceptive methods compared to 84.9% contraceptive users who
said wife beating is justified if she goes out without telling husband.

Similarly, contraceptive use between women who reported that they were involved
in decision making alone/jointly were higher than those who were not involved
in decision making. For example, 87.8% of those who were involved in decision
making about their own health care used a contraceptive method compared to 82.8%
of those who were not involved in decision making regarding their own health
care. Contraceptive use was
higher for women with more education, frequent readers of newspapers, listening
to the radio, and watching TV, and women from wealthier households.

Table 3. Percent of current use of contraceptive
methods and women empowerment characteristics

 

%                                                       %

Wife
beating justified if wife…

No

Yes

Goes
out without telling husband

87.52

84.88

Neglects
the children

87.57

85.33

Argues
with husband

87.79

84.33

Refuses
to have sex

87.05

85.53

Burns
the food

87.18

84.92

Have
a bank or savings account

84.90

93.72

Respondent
involved in decisions (alone or jointly) about …
 

Alone/Jointly

Husband/Other

Her
healthcare

87.82

82.88

Visits
to family and relatives

88.35

81.67

Frequency
of reading newspaper

 

 

Not
at all

 

84.29

Less
than once a week

 

88.11

At
least once a week

 

88.89

Frequency
of listening to radio

 

 

Not
at all

 

85.66

Less
than once a week

 

86.29

At
least once a week

 

87.51

Frequency
of watching TV

 

 

Not
at all

 

77.52

Less
than once a week

 

83.90

At
least once a week

 

87.68

Respondent’s
education level

 

 

No
education

 

84.03

Primary

 

87.67

Secondary
and higher

 

88.51

Wealth
Index

 

 

Poor/poorest

 

77.28

Middle

 

85.09

Rich/richest

 

91.39

 

Multivariate
Results

Women’s Empowerment Indicators on Current Contraceptive
Use

Based
on the bivariate measures of association presented in Table 3, the analysis
suggests that there is an association between contraceptive use and the
variables of empowerment status, wealth, and education. To understand further the
types of relationships, a series of logistic regressions were performed. Dummy
variables were created for the dependent variable and for the independent
variables.

Four models
were fitted to examine the effects of women’s empowerment on contraceptive use.

Table 4 presents the estimates (coefficient) odds ratios of the four models. In
the first model, women’s empowerment indicators were entered with contraceptive
use, in the second model education (excluding higher education) was measured
with contraceptive use, the third model included education and wealth, and the
fourth model wealth and women empowerment indicators were entered on the effect
on women’s use of contraception.

In the first
model, most of women empowerment controls included in the analysis were
significantly associated with contraceptive use. Each indicator in the
empowerment were all found to have a significant positive association on
contraceptive use. The odds ratio of contraceptive use for women who said
domestic violence is not justified was 18.5% more likely to use contraception. Similarly,
women who owned a bank or savings account were 2.43 more like to use
contraception than those who don’t have a bank or savings account.

In model 2,
when measuring education against contraceptive use women with no education were
57.1% less likely to use contraception comparing to higher education. Those
with primary and secondary were 42% and 42.5% less likely to use contraception
when compared to higher education, respectively. When introducing wealth into
education for contraceptive use, women were 1.87 times more likely to use contraception
if they earned higher. When only factoring in wealth and women empowerment
indicators, women were 1.87 times more likely to use contraception if they
earned higher income.

 

Discussion

 

The study
used India’s data as a representative set to examine the relationship between
women’s empowerment and contraceptive use in India. In this paper, omen’s
empowerment was conceptualized as multidimensional. Still, the analysis investigated
the relationship between these magnitudes and contraceptive use. Each indicators
of women’s empowerment and the independent variables were significantly
associated with use of contraceptives. Indicators of women’s empowerment signifying
attitudes towards domestic violence, household decision making and owning a
bank or savings account had a positive association with contraceptive use.

These findings were consistent with the study done in Uganda looking at factors
of contraceptive use (Wablembo and Doctor 2013) found education level, wealth
status to be strong indicators of contraceptive use (Wablembo and Doctor,
2013). Surprisingly, ownership of assets was 2.43 times more likely to use
contraception than other indicators of women empowerment in this study.

This study
has its limitations with respect to the structure of universally accepted women
empowerment indicators based on the available data from the DHS. Literature on
women’s empowerment focuses on the multidimensional perception and therefore it
may be difficult to get an objective measure of women empowerment. Another
limitation may be that women’s empowerment indicators is dependent on the
cultural context and societal norms under which it operates.

Conclusion

The results
from this analysis confirmed that the indicators of women’s empowerment are
associated with their contraceptive use in India, including household decision
making and owning a bank account, are positively associated with empowerment. The
results indicated that all of the women’s empowerment indicators in this
analysis were significantly associated with contraceptive use. Women’s
empowerment is an important determinant of contraceptive use. Therefore, the null hypothesis is rejected and there is a
relation between empowerment status and the use of contraception.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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