Women’s Sexual Empowerment and Its Relationship to Contraceptive Use in Bangladesh: Findings From a Recent National Survey
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PROVIDER: S-EPMC10620289 | biostudies-literature | 2023 Jan
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Project description:BackgroundA fundamental element of gender equity are women's rights to reproductive choice. Women's empowerment is often linked to enabling decisions around contraceptive use and reduced fertility worldwide, although limited evidence is currently available around contraceptive use and decision making in ASEAN countries.ObjectiveTo examine the association between women's empowerment and contraceptive use in five selected ASEAN member states.MethodsData from the latest Demographic and Health Survey of Cambodia, Indonesia, Myanmar, The Philippines, and Timor-Leste were used. The main outcome was contraceptive use among married women (15-49 years) from these five countries. We considered four indicators of empowerment: labor force participation; disagreement with reasons for wife beating; decision-making power over household issues; and knowledge level.ResultsLabor force participation was found to be significantly associated with contraceptive use in all nations. Disagreement with justification of wife beating was not significantly related to contraceptive use in any country. Decision-making power (higher) was only associated with contraceptive use in Cambodia, while higher knowledge levels were associated with contraceptive use in Cambodia, and Myanmar.ConclusionThis study suggests women's labor force participation is an important determinant of contraceptive use. Policies designed to open the labor market and empower women through education should be implemented to enable women's participation. Gender inequality may also be tackled by engaging women in decision-making processes at national, community and family levels.
| S-EPMC10298759 | biostudies-literature
Project description:The relationship between women's empowerment and women's nutrition is understudied. We aimed to elucidate this relationship by quantifying possible pathways between empowerment and dietary diversity among women in rural Bangladesh. In 2015, we conducted a cross-sectional survey of 2,599 married women ages 15-40 (median: 25) living in 96 settlements of Habiganj District, Bangladesh, as a baseline for the Food and Agricultural Approaches to Reducing Malnutrition trial. We collected data on women's empowerment (highest completed grade of schooling and agency), dietary diversity, and demographic factors, including household wealth. We used exploratory factor analysis and confirmatory factor analysis on random split-half samples, followed by structural equation modelling, to test pathways from schooling, through domains of women's agency, to dietary diversity. Factor analysis revealed 3 latent domains of women's agency: social solidarity, decision-making, and voice with husband. In the adjusted mediation model, having any postprimary schooling was positively associated with voice with husband (β41 = .051, p = .010), which was positively associated with dietary diversity (β54 = .39, p = .002). Schooling also had a direct positive association with women's dietary diversity (β51 = .22, p < .001). Neither women's social solidarity nor decision-making mediated the relationship between schooling and dietary diversity. The link between schooling and dietary diversity was direct and indirect, through women's voice with husband but not through women's social solidarity or decision-making. In this population, women with postprimary schooling seem to be better able to negotiate improved diets for themselves.
| S-EPMC6866060 | biostudies-literature
Project description:ObjectiveTo describe actual and preferred contraceptive sources among young people in Britain and whether discordance between these is associated with markers of sexual risk behaviour or poor sexual health.DesignCross-sectional probability sample survey.SettingBritish general population.Participants3869 men and women aged 16-24 years interviewed for the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) between 2010 and 2012.Main outcome measuresReported source of contraceptive method(s) and preferred source if all were available and easily accessible.ResultsOf the 75% of young people (aged 16-24) who were heterosexually active (1619 women, 1233 men), >86% reported obtaining contraceptives in the past year. Most common sources were general practice (women, 63%) and retail (men, 60%): using multiple sources was common (women 40%, men 45%). Healthcare sources were preferred by 81% of women and 57% of men. Overall, 32% of women and 39% of men had not used their preferred source. This discordance was most common among men who preferred general practice (69%) and women who preferred retail (52%). Likelihood of discordance was higher among women who usually used a less effective contraceptive method or had an abortion. It was less likely among men who usually used a less effective method of contraception and men who were not in a steady relationship.ConclusionsMost young people in Britain obtained contraception in the past year but one-third had not used their preferred source. Healthcare sources were preferred. Discordance was associated with using less effective contraception and abortion among young women. Meeting young people's preference for obtaining contraception from healthcare sources could improve uptake of effective contraception to reduce unwanted pregnancies.
| S-EPMC5051385 | biostudies-literature
Project description:BackgroundWomen in rural Bangladesh face multiple, inter-related challenges including food insecurity, malnutrition, and low levels of empowerment. We aimed to investigate the pathway towards empowerment experienced by women participating in a three-year nutrition-sensitive homestead food production (HFP) program, which was evaluated through the Food and Agricultural Approaches to Reducing Malnutrition (FAARM) cluster-randomized controlled trial.MethodsWe conducted 44 in-depth interviews and 12 focus group discussions with men and women in both intervention and control communities of the FAARM study site in rural, north-eastern Bangladesh. Using a modified grounded theory approach to data collection and analysis, we developed a framework to explain the pathway towards empowerment among HFP program participants.ResultsThe analysis and resulting framework identified seven steps towards empowerment: 1) receiving training and materials; 2) establishing home gardens and rearing poultry; 3) experiencing initial success with food production; 4) generating social or financial resources; 5) expanding agency in household decision-making; 6) producing renewable resources (e.g. farm produce) and social resources; and 7) sustaining empowerment. The most meaningful improvements in empowerment occurred among participants who were able to produce food beyond what was needed for household consumption and were able to successfully leverage these surplus resources to gain higher bargaining power in their household. Additionally, women used negotiation skills with their husbands, fostered social support networks with other women, and developed increased self-efficacy and motivation. Meanwhile, the least empowered participants lacked support in critical areas, such as support from their spouses, social support networks, or sufficient space or time to produce enough food to meaningfully increase their contribution and therefore bargaining power within their household.ConclusionsThis study developed a novel framework to describe a pathway to empowerment among female participants in an HFP intervention, as implemented in the FAARM trial. These results have implications for the design of future nutrition-sensitive agriculture interventions, which should prioritize opportunities to increase empowerment and mitigate the barriers identified in our study.Trial registrationFAARM is registered with ClinicalTrials.gov ( NCT02505711 ).
| S-EPMC8772198 | biostudies-literature
Project description:ObjectiveEvaluate the relationship between women's empowerment and the use of modern contraceptive methods.Study designA secondary analysis was conducted using the 2022 Demographic and Health Survey of Peru, selecting women who were married, ever married, or cohabiting with a partner. The survey-based Women's Empowerment Index was employed to assess empowerment, and the dependent variable was the use of modern contraceptives at the time of the interview. Regression analysis was performed using generalized linear models of the Poisson family.ResultsSixty percent of the selected women were using a contraceptive method at the time of the survey. We found an association between low empowerment levels and lower frequency of modern contraceptive use (aPR = 0.87, p = 0.001). Additionally, among the empowerment domains, we observed that lower levels of independence (aPR = 0.89, p = 0.001) and tolerance of intimate partner violence (aPR = 0.75, p = 0.003) were associated with a lower frequency of modern contraceptive use.ConclusionWomen's empowerment is related to the use of modern contraceptive methods, as well as its various domains. Future studies should evaluate different perspectives, such as empowerment and decision-making in the sexual and reproductive aspects.ImplicationsThe level of female empowerment is directly related to the use of modern contraceptive methods, a relevant situation in culturally diverse developing countries. Sexual health promoters need to encourage autonomy in the decision to use appropriate methods for proper family planning.
| S-EPMC11667171 | biostudies-literature
Project description:The COVID-19 pandemic in Bangladesh, associated public health measures, and people's reactions were projected to have caused job losses among women, a decline in women's empowerment and reduced women's diet diversity. Using a November 2020 telephone survey to re-interview adult female respondents of a November 2019 in-person survey, contrary to expectations we find that more women found than lost jobs, and women's diet diversity increased over the year partly marked by the COVID-19 pandemic. We did not find evidence of a decline in women's involvement in food purchase decisions, nor women's autonomy over use of household income. The change in women's outside employment is neither statistically related to changes in women's involvement in food purchase decisions, changes women's autonomy over use of household income, nor changes in women's diet diversity. Change in women's involvement in food purchase decisions is positively related with change in women's diet diversity and change in women's autonomy over income use is negatively related with change in women's diet diversity.
| S-EPMC9650256 | biostudies-literature
Project description:ObjectiveTo describe a group of young sexual minority women's experiences with and preferences for sexual identity disclosure in the context of contraceptive care.MethodsIn Chicago, Illinois, Salt Lake City, Utah, and Madison, Wisconsin, investigators conducted five focus groups (n=22) and 11 interviews with women aged 20-30 years who identified as something other than heterosexual. Focus groups explored social norms regarding contraceptive care; interviews documented individual experiences with contraceptive care. Using a qualitative descriptive approach and combined deductive and inductive content analysis, investigators coded transcripts for themes related to disclosing sexual orientation to contraceptive providers.ResultsParticipants described the process of sexual identity disclosure in contraceptive care in three stages: 1) listening for whether, when, and how health care providers asked about sexual orientation, 2) deciding whether or not to disclose sexual identity to providers, and 3) evaluating responses from providers after disclosure. Participants wanted providers to: avoid assumptions and ask about both sexual identity and sexual behaviors, signal their openness and competence around the health of sexual minority women during contraceptive encounters, and focus discussions on the individual patient's priorities and needs for contraceptive care.ConclusionDecisions made by sexual minority women about sexual identity disclosure in contraceptive contexts are influenced by previous and current interactions with health care providers. Contraceptive providers should ask all patients about sexual identity and sexual behavior, avoid assumptions about use of and need for contraception, and acknowledge the prevalence of marginalization, discrimination, and stigma experienced by sexual minority women and their communities in health care contexts.
| S-EPMC6483879 | biostudies-literature
Project description:BackgroundWith half a female population, empowering women can be a key factor in our country's global advancement. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how different socio-economic and demographic factors associated with women's empowerment evolve over the past decade in Bangladesh (from BDHS 2007 to BDHS 2017-18).MethodsData from four waves of Bangladesh Demographic and Health Survey (BDHS, 2007 to BDHS, 2017-18) were used in this study. We put forth two domains-household decision-making and attitudes toward domestic violence-to assess women's empowerment. Principal component analysis (PCA) was employed to create women's empowerment index. To assess the unadjusted association between the selected covariates and women's empowerment, Pearson Chi-square test and ANOVA F test have been used, while adjusted association has been analyzed through proportional odds model (POM).ResultsIn BDHS 2017-18, women from urban areas experienced 'high' empowerment than women in rural areas (56.08% vs. 45.69%). A notable change has been observed in the distribution of women's empowerment index by education over the survey years. Findings also showed that in all the survey years, division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head have been found to have significant association with women's empowerment index. For instance, women who completed secondary education in 2007, 2011, 2014, and 2017-18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, age at first marriage, spousal age gap, NGO membership etc. emerged as a contributing factor in specific survey years.ConclusionOur study affirmed that, over a ten-year period, women were more likely to protest against physical violence and to participate in various decision-making regarding their personal and social life. Empowerment is notably higher among women in urban residents, those with secondary education, 1-2 children, media exposure, and employment. Policy recommendations should emphasize targeted measures to raise awareness and empower uneducated, unemployed, economically disadvantaged, and physically oppressed women.
| S-EPMC10980244 | biostudies-literature
Project description:BackgroundDespite the availability of copious information regarding contraceptive use benefits and the factors that influence the uptake of the services, there is little evidence revealing the lived experiences of rural women. Thus, this study was conducted with the purpose of exploring the lived experiences of women regarding contraceptive use and related benefits towards women's empowerment.MethodsInterpretative phenomenological qualitative methodology was employed to explore the lived experiences of women. Data were collected through focus group discussions and in-depth individual interviews and analyzed using an interpretive phenomenological framework including phases of data immersion, transcribing, coding, theme development and phenomenological interpretation through hermeneutic circle.ResultThe reported lived experiences of rural women revealed that their livelihoods greatly improved in different ways after they began to use contraceptives. The benefits included securing more time, energy and social engagements. Contraceptive use helped women postpone unwanted pregnancies and child births and engage in various income generation activities that not only boosted family incomes but also created opportunity to mobilize the resources for different expenses without waiting for the handouts from their husbands. The women's experiences also indicated that contraceptive use improved the educational status of their daughters and they experienced improved self-image, better social standing and improved family relations. The experiences further illustrated that contraceptive use was not only emancipatory and transformative, but also created peace and stability in their lives.ConclusionThe study concludes that contraceptive use, which is part of a woman's life experience, created remarkable opportunities and achievements. One of these was that women were able to control their bodies, reproduction and fertility which resulted in a higher degree of empowerment. The control of reproduction and fertility has liberated them from worries and entrapment of unplanned and unwanted pregnancies. Moreover, contraceptive use led to wider opportunities in the community, by improving their status and building a sense of empowerment. Creating awareness around the benefits of contraceptive use has the potential to improve community and national development. Based on the result, the study recommends that systems should be established to capitalize on the lessons learned about the lives of current users and expand the remarkable achievements and experiences to non-user counterparts.
| S-EPMC6136733 | biostudies-literature
Project description:Women's empowerment is an important policy agenda that is critical for developing countries like Bangladesh to achieve sustainable development goals (SDGs). The prime objective of this paper was to examine whether community savings groups can truly improve the economic conditions of women which turns into women's empowerment in fishing communities or not. The propensity score matching (PSM) and logistic regression technique were incorporated, and required data were collected from Community Savings Groups (CSG) interventions and non-CSG villages of coastal Bangladesh. Quantitative data were collected from 615 women comprising 306 CSG participants (treatment group) and 309 non-participants (control group). The results affirm CSG group members were economically more solvent and less dependent on borrowed money than non-CSG group members. Improved economic indicators (savings, income and expenditure) of CSG households make the foundation of attaining women's empowerment for the intervened group. The findings revealed that CSG women performed better in various dimensions of leadership capacity than non-CSG women. Econometric analysis confirmed positive impacts of CSG interventions on savings, gross household income, earning from catching fish, alternative income-generating activities (AIGAs), expenditure, and women's empowerment. The initiatives of CSG not only generate economic well-being but also contribute to women's empowerment. Financial access, improved literacy and an enabling environment for the productive engagement of women reduce gender inequality in fishing communities. To sustain the benefits of CSG, establishing institutional linkages (advisory and financial), legality/registration of CSGs from the government authority, and facilitation of alternative IGAs are crucial.
| S-EPMC10990856 | biostudies-literature