Women’s empowerment and fertility decision-making in 53 low and middle resource countries: a pooled analysis of demographic and health surveys

Haque, Rezwanul and Alam, Khorshed ORCID: https://orcid.org/0000-0003-2232-0745 and Rahman, Syed Mahbubur and Keramat, Syed Afroz and Al-Hanawi, Mohammed Khaled (2021) Women’s empowerment and fertility decision-making in 53 low and middle resource countries: a pooled analysis of demographic and health surveys. BMJ Open, 11 (6):e045952. pp. 1-12.

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Objective: Women’s empowerment and its association with fertility preference are vital for central-level promotional health policy strategies. This study examines the association between women’s empowerment and fertility decision-making in low and middle resource countries (LMRCs).

Design: This cross-sectional study uses the Demographic and Health Survey database.

Settings: 53 LMRCs from six different regions for the period ranging from 2006 to 2018.

Participants: The data of women-only aged 35 years and above is used as a unit of analysis. The final sample consists of 91 070 married women.

Methods: We considered two outcome variables: women’s perceived ideal number of children and their ability to achieve preferred fertility desire and the association with women empowerment. Women empowerment was measured by their participation in household decision-making and attitude towards wife-beating. The negative binomial regression model was used to assess women’s perceived ideal number of children, and multivariable logistic regression was used to evaluate women’s ability to achieve their preferred fertility desire.

Results: Our study found that empowered women have a relatively low ideal number of children irrespective of the measures used to assess women empowerment. In this study, the measures were participation in household decision-making (incidence rate ratio (IRR): 0.92, 95% CI: 0.91 to 0.93) and attitude towards wife-beating (IRR: 0.96, 95% CI: 0.95 to 0.97). In the LMRCs, household decision-making and negative attitude towards wife-beating have been found associated with 1.12 and 1.08 times greater odds of having more than their ideal number of children.

Conclusion: Our findings suggest that women’s perceived fertility desire can be achieved by enhancing their empowerment. Therefore, a modified community-based family planning programme at the national level is required, highlighting the importance of women’s empowerment on reproductive healthcare as a part of the mission to assist women and couples to have only the number of children they desire.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http:// creativecommons. org/ licenses/ by- nc/ 4. 0/.
Faculty/School / Institute/Centre: Current - Faculty of Business, Education, Law and Arts - School of Business (18 Jan 2021 -)
Faculty/School / Institute/Centre: Current - Institute for Resilient Regions - Centre for Health Research (1 Apr 2020 -)
Date Deposited: 22 Jun 2021 06:36
Last Modified: 23 Aug 2022 05:10
Uncontrolled Keywords: women empowerment; fertility preferences; negative Binomial Regression Model; low resource countries
Fields of Research (2008): 11 Medical and Health Sciences > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111712 Health Promotion
14 Economics > 1402 Applied Economics > 140208 Health Economics
Fields of Research (2020): 42 HEALTH SCIENCES > 4203 Health services and systems > 420311 Health systems
38 ECONOMICS > 3801 Applied economics > 380108 Health economics
42 HEALTH SCIENCES > 4206 Public health > 420606 Social determinants of health
Socio-Economic Objectives (2020): 20 HEALTH > 2004 Public health (excl. specific population health) > 200407 Health status (incl. wellbeing)
20 HEALTH > 2005 Specific population health (excl. Indigenous health) > 200509 Women's and maternal health
20 HEALTH > 2002 Evaluation of health and support services > 200207 Social structure and health
Identification Number or DOI: https://doi.org/10.1136/bmjopen-2020-045952
URI: http://eprints.usq.edu.au/id/eprint/42295

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