The Empowerment Effect

In sub-Saharan Africa, condom use is very low and the most popular forms of contraception are injectables and pills—and often family planning decisions are left to women.

In a panel on Monday, Carie Muntifering, a doctoral student at the Johns Hopkins Bloomberg School of Public Health, presented findings from a study of the effect of women’s empowerment on their sexual activity and use of contraception. The data was extracted from Demographic and Health Surveys (DHS) data.

The study compared data among married women in Ghana, Malawi, Mali, Rwanda, Uganda and Zimbabwe, which represent varied rates of continuous contraceptive use. Household autonomy was measured and ranked according to three factors from the DHS data: who in the married couple makes health care decisions, who makes purchases and who makes decisions about visiting families in the household.

One finding is that the higher the empowerment score, the less likely women were to have reported having recent sexual activity. This was true across all six countries. Muntifering theorizes that empowered women have more ability to negotiate sex, and in many African countries, sex is often uncomfortable or painful because of genital mutilation (also known as female circumcision).

Another finding is that greater women’s autonomy and joint decision-making was found to be associated with higher modern contraceptive use in four of the six countries—Rwanda, Zimbabwe, Malawi and Uganda.