Women's Empowerment and Contraceptive Use: The Role of Independent versus Couples' Decision-Making, from a Lower Middle Income Country Perspective
Women's Empowerment and Contraceptive Use: The Role of Independent versus Couples' Decision-Making, from a Lower Middle Income Country Perspective
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DOI：
10.1371/journal.pone.0104633
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发表时间：
2014-08-13
期刊：
影响因子：
3.7
通讯作者：
Avan, Bilal Iqbal
中科院分区：
文献类型：
--
作者：
Hameed, Waqas;Azmat, Syed Khurram;Avan, Bilal Iqbal
简介：目前几乎没有证据表明，妇女赋权的各个方面与避孕药具的使用之间存在联系，也没有证据表明妇女的社会经济和人口状况如何影响这些联系。我们评估了这些现象在巴基斯坦使用结构化框架approach.Methods：我们分析了2,133名妇女的数据，她们要么使用任何形式的避孕药具，要么生活在避孕需求未得到满足的情况下。调查于2012年5月至6月进行，对象是旁遮普三个区的已婚育龄妇女（15-49岁）。增强权能的各个方面大致分为：经济决策、家庭决策和妇女流动。为每个层面和总体赋权制定了两项措施：妇女独立决定和夫妇共同决定。根据一种方法是否需要丈夫的意识或某种支持和合作，将避孕药具的使用分为仅限女性使用的方法或夫妇使用的方法。多项回归，通过比值比（OR），以评估授权的尺寸和女性只有和夫妇避孕方法之间的关联：结果：总体而言，妇女往往会得到更高的决策权，随着年龄的增长，更高的识字率，更多的孩子，或在一个家庭，具有上级的社会经济地位。对夫妇全面赋权决策及其每个层面的衡量都显示出与夫妇方法以及仅限女性的方法之间的正相关。唯一的例外是经济赋权的措施，这是只与夫妇method.Conclusion：夫妇的共同决策是一个更强的决定因素，使用避孕方法比妇女唯一的决策。除了妇女的社会人口和经济地位的贡献之外，情况也是如此。需要作出努力，平等地教育妇女及其丈夫，特别注重高效避孕方法。
Introduction: There is little available evidence of associations between the various dimensions of women's empowerment and contraceptive use having been examined - and of how these associations are mediated by women's socio-economic and demographic statuses. We assessed these phenomena in Pakistan using a structured-framework approach.Methods: We analyzed data on 2,133 women who were either using any form of contraceptive or living with unmet need for contraception. The survey was conducted during May - June 2012, with married women of reproductive age (15-49 years) in three districts of Punjab. The dimensions of empowerment were categorized broadly into: economic decision-making, household decision-making, and women's mobility. Two measures were created for each dimension, and for the overall empowerment: women's independent decisions, and those taken jointly by couples. Contraceptive use was categorized as either female-only or couple methods on the basis of whether a method requires the awareness of, or some support and cooperation from, the husband. Multinomial regression was used, by means of Odds Ratios (OR), to assess associations between empowerment dimensions and female-only and couple contraceptive methods.Results: Overall, women tend to get higher decision-making power with increased age, higher literacy, a greater number of children, or being in a household that has superior socio-economic status. The measures for couples' decision-making for overall empowerment and for each dimension of it showed positive associations with couple methods as well as with female-only methods. The only exception was the measure of economic empowerment, which was associated only with the couple method.Conclusion: Couples' joint decision-making is a stronger determinant of the use of contraceptive methods than women-only decision-making. This is the case over and above the contribution of women's socio-demographic and economic statuses. Effort needs to be made to educate women and their husbands equally, with particular focus on highly effective contraceptive methods.