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 thatwomen empowerment is associated with contraceptive use. Some scholars proposethat women empowerment increases with age, literacy or education, number ofchildren, and socio economic status (Hameed et al, 2014). However, in India “the contraceptiveprevalence rate appears to have stagnated after 2004. Moreover, contraceptivepractice in India is known to be severely skewed towards terminal methods whichmeans that contraception in India is practiced primarily for birth limitationrather than birth planning” (Chaurasia, 2014), as illustrated in Figure 1. The reproductive years for women inIndia is single most important to their lives. Women’s role in theirreproductive health is influenced by her status, this includes the choice oflivelihood, who to marry, numberof children, and choice of friends are critical decisions. Many studies haveshown that while women may be empowered in some areas of life they may also notbe in others. Reproductive health andempowerment for Indian women are often misjudged in the context of the Indianhealth care system (D’Souza et al, 2013).
The aim or research question for thisstudy will measure the relationship between women empowerment and contraceptiveuse among Indian women. The source of data for this study will be from the2005-2006 India Demographic and Health Surveys (DHS). The study population is Indian women between the ages of 15and 49, who either use or don’t use contraception and whether the indicatorsfor empowerment have played a role. For the selection of population for thispaper, the unmet needs were refined to exclude those not at risk for usingcontraceptive use, this includes, those who are pregnant, menopausal,infertile, and not having sexual intercourse. Formethod, some literature will be emphasized regarding the connection betweenwomen’s empowerment and contraceptive use. Furthermore, there will be anexamination of the univariate distributions of main variables such as,education level, residence type, and current contraception use among the studypopulation. To measure the associations between these univaiate, this paperwill use bivariate analysis and multivariate analysis to analyze the logisticalregression to measure the association between the variables.
The data wasanalyzed using Stata 15.0. Literature Review and Hypothesis There is extensive research thatexamines the key factors of contraceptive use. Education and wealth have beenseen to be strongly associated with the use of contraceptives. Worku et alfound that, in sub-Saharan Africa women’s age, educational status,religion, family size concordance, and fertility preference were significantlyassociated to using contraceptive use. Where education came in as the highestsignificance (2014). Hermalinin his model of contraceptive use recognized the incentives to controlchildbearing and the costs of fertility regulation as the two main determinantsof contraceptive use (1983). Additionally, empirical research shows women whoadopt the use of contraceptive methods, contribute to a reduction in fertilitywere 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 associatedwith contraceptive use, she emphasized those who justified wife beating in oneor more instances were less likely to use contraception (Blackstone, 2016). Accordingto summary tables in the DHS Final Report for India, contraceptive use ishigher among the wealthiest and highly educated women. The hypothesis tested inthis study is that there is a link between women’s empowerment and theircontraceptive use. In particular, women who are empowered are assumed to bemore likely to be using contraception comparative to those who are notempowered. The null hypothesis is that there is no association between women’sempowerment and whether or not they are using contraception. Data and Methods The data usedwas obtained from the 2005-2006 Indian National Family Health Survey (NFHS-32005-2006) individual’s questionnaire.
The analysis is specific to 63,231 womenof reproductive age 15-49 years, who were currently married or living with apartner. The dependent variable, women’s current contraceptive use, is adichotomous variable specifying participants use of any method, modern andtraditional, (modern and traditional) of contraception at the time of thesurvey. The independent variables included empowerment factors and gender-specificvariables. Women’s empowerment measures were from factors of analysis conductedfrom survey questions representative of different scopes of empowerment. Thesemeasures include five questions related to women’s approval of domesticviolence in the data. Women were asked their views about whether a husband isjustified in hitting his wife if she; burns the food, neglects the children, goesout 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 isnot justified by code 0, indicating a higher level of empowerment and those whosaid yes wife beating is justified as code 1.
In the data there are four variables measuring women’s role in householddecision making: The wife’s final say on her own health care, has bank orsavings account, visits to family and relatives, and currently working. Each respondentis grouped into two classifications, that is, those who reported having anysay, alone and joint, in household decisions coded as 0 demonstrating a higherlevel of empowerment and those who reported that their husband or someone elsemade the decisions as code 1. As well as, women were asked the highest level ofeducation they had completed. Table 1 illustrates the coding and distribution of variables used to measurewomen empowerment indicators. Elements were analyzed and conducted using eachof these measures, and the related factors for each dimensions will be used inthe multivariate. Additional gender specific indicator probable to impact women’scontraceptive use includes ideal number of children, frequency of readingnewspaper or magazine, listening to the radio, and watching television.In the model,number of socio-demographic characteristics were controlled which theliterature reviews specify as likely to influence women’s empowerment statusand their reproductive behavior, employment status, respondents level ofeducation, spousal education, and wealth index.
To analyze the factors, factorswere inserted to recognize the structure of hidden factors in the model. To understandthe effects of women’s empowerment on contraceptive use, a series of logisticalregressions were used. Firstly, gender specific and socio-demographiccharacteristics were included to be examined. Secondly, the empowermentindicators were also fitted onto the contraceptive use with other independentvariables to assess the importance of empowerment indicators in examiningcontraceptive use. For the final model, odds ratio (OD) were calculated. ResultsThe basiccharacteristics of the respondents are reflected in Table 2. where more thanhalf (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 womenin 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 higherlevel of education. Fifty-three per cent of women had the same level ofeducation as their partners and there is no percentage where women have moreeducation than their partners. Table 2.
Socio-demographic characteristics of women, India2005-6 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 casesunweighted Bivariate ResultsCurrent Contraceptive Use andMeasures of Empowerment To measure contraceptiveuse and empowerment, Table 3 presents the distribution. With regard toacceptance of domestic violence, the amount of contraceptive users among thosewho said that wife beating is not justified is greater compared tocontraceptive users who said wife beating is justified. For example, 87.
5% of thewomen who said wife beating is not justified if she goes out without tellingher husband used contraceptive methods compared to 84.9% contraceptive users whosaid wife beating is justified if she goes out without telling husband.Similarly, contraceptive use between women who reported that they were involvedin decision making alone/jointly were higher than those who were not involvedin decision making. For example, 87.8% of those who were involved in decisionmaking 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 healthcare.
Contraceptive use washigher for women with more education, frequent readers of newspapers, listeningto the radio, and watching TV, and women from wealthier households. Table 3. Percent of current use of contraceptivemethods 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 MultivariateResultsWomen’s Empowerment Indicators on Current ContraceptiveUse Basedon the bivariate measures of association presented in Table 3, the analysissuggests that there is an association between contraceptive use and thevariables of empowerment status, wealth, and education.
To understand further thetypes of relationships, a series of logistic regressions were performed. Dummyvariables were created for the dependent variable and for the independentvariables. Four modelswere fitted to examine the effects of women’s empowerment on contraceptive use.
Table 4 presents the estimates (coefficient) odds ratios of the four models. Inthe first model, women’s empowerment indicators were entered with contraceptiveuse, in the second model education (excluding higher education) was measuredwith contraceptive use, the third model included education and wealth, and thefourth model wealth and women empowerment indicators were entered on the effecton women’s use of contraception. In the firstmodel, most of women empowerment controls included in the analysis weresignificantly associated with contraceptive use. Each indicator in theempowerment were all found to have a significant positive association oncontraceptive use. The odds ratio of contraceptive use for women who saiddomestic 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 usecontraception than those who don’t have a bank or savings account. In model 2,when measuring education against contraceptive use women with no education were57.1% less likely to use contraception comparing to higher education. Thosewith primary and secondary were 42% and 42.5% less likely to use contraceptionwhen compared to higher education, respectively. When introducing wealth intoeducation for contraceptive use, women were 1.
87 times more likely to use contraceptionif they earned higher. When only factoring in wealth and women empowermentindicators, women were 1.87 times more likely to use contraception if theyearned higher income. Discussion The studyused India’s data as a representative set to examine the relationship betweenwomen’s empowerment and contraceptive use in India.
In this paper, omen’sempowerment was conceptualized as multidimensional. Still, the analysis investigatedthe relationship between these magnitudes and contraceptive use. Each indicatorsof women’s empowerment and the independent variables were significantlyassociated with use of contraceptives. Indicators of women’s empowerment signifyingattitudes towards domestic violence, household decision making and owning abank or savings account had a positive association with contraceptive use.These findings were consistent with the study done in Uganda looking at factorsof contraceptive use (Wablembo and Doctor 2013) found education level, wealthstatus to be strong indicators of contraceptive use (Wablembo and Doctor,2013).
Surprisingly, ownership of assets was 2.43 times more likely to usecontraception than other indicators of women empowerment in this study. This studyhas its limitations with respect to the structure of universally accepted womenempowerment indicators based on the available data from the DHS. Literature onwomen’s empowerment focuses on the multidimensional perception and therefore itmay be difficult to get an objective measure of women empowerment. Anotherlimitation may be that women’s empowerment indicators is dependent on thecultural context and societal norms under which it operates. Conclusion The resultsfrom this analysis confirmed that the indicators of women’s empowerment areassociated with their contraceptive use in India, including household decisionmaking and owning a bank account, are positively associated with empowerment.
Theresults indicated that all of the women’s empowerment indicators in thisanalysis were significantly associated with contraceptive use. Women’sempowerment is an important determinant of contraceptive use. Therefore, the null hypothesis is rejected and there is arelation between empowerment status and the use of contraception.