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WOMEN’S EMPOWERMENT, HOUSEHOLD STATUS AND CONTRACEPTION USE IN GHANA

Published online by Cambridge University Press:  11 August 2016

Sarah R. Blackstone
Sarah R. Blackstone*
Affiliation:
Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois Urbana-Champaign, USA
*
1Email: [email protected]
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Summary

Gender inequality is often cited as a barrier to improving women’s sexual and reproductive health outcomes, including contraceptive use, in low- and middle-income countries such as those in sub-Saharan Africa. To date there is limited, recent, evidence available regarding women’s empowerment, household status and contraceptive use in Ghana. The objective of this study was to investigate whether women’s empowerment and status in the household were associated with contraceptive use and unmet need for contraception using the 2014 Ghana Demographic and Health Survey. The study sample consisted of 1828 women aged 15–49. Women’s empowerment was measured based on two composite indexes created by the DHS: attitudes towards intimate partner violence and decision-making. Women’s status in the home was measured using indicators of work status, relationship to household head, control over monetary earnings and land ownership. Decision-making was found to be positively associated with contraceptive use and not having unmet need for contraception. Women who justified wife beating in one or more instances were less likely to use contraception, and more likely to have unmet need for contraception. Current or past employment and higher levels of male partner education were associated with contraceptive use. This study indicates that women’s empowerment and household status are influential for contraceptive indicators. Future interventions aimed at improving contraceptive uptake and use should promote women’s empowerment, i.e. decision-making, self-worth and education.

Type
Research Article
Information
Journal of Biosocial Science , Volume 49 , Issue 4 , July 2017 , pp. 423 - 434
Copyright
Copyright © Cambridge University Press, 2016 

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References

Abiodun, O. & Balogun, O. (2008) Sexual activity and contraceptive use among young female students of tertiary educational institutions in Ilorin, Nigeria. Contraception 79(2), 146–149.Google Scholar
Adongo, P. B., Tabong, P. T. N., Azongo, T. B., Phillips, J. F., Sheff, M. C., Stone, A. E. & Tapsoba, P. (2014) A comparative qualitative study of misconceptions associated with contraceptive use in Southern and Northern Ghana. Frontiers in Public Health. URL: http://dx.doi.org/10.3389/fpubh.2014.00137.CrossRefGoogle ScholarPubMed
Ahmed, S., Creange, A., Gillespie, D. & Tsui, A. O. (2010) Economic status, education and empowerment: implications for maternal health serice utilization in developing countries. PLoS One 5(6), e11190.Google Scholar
Bankole, A., Keogh, S., Akinyemi, O., Dzekedzeke, K., Awolude, O. & Adewole, I. (2014) Differences in unintended pregnancy, contraceptive use and abortion by HIV status among women in Nigeria and Zambia. International Perspectives on Sexual and Reproductive Health 40(1), 28–38.Google Scholar
Bankole, A. & Oye-Adeniran, B. S. (2006) Unwanted Pregnancies and Induced Abortion in Nigeria: Causes and Consequences. Document No. 311189. Guttmacher Institute, New York.Google Scholar
Bloom, S., Wypij, D. & Gupta, M. (2001) Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography 38, 67–78.CrossRefGoogle Scholar
Bouyou-Akotet, M., Mawili-Mboumba, D. & Kombila, M. (2013) Antenatal care visit attendance, intermittent preventive treatment and bed net use during pregnancy in Gabon. BMC Pregnancy and Childbirth 13(1), 52–58.CrossRefGoogle ScholarPubMed
Crissman, H. P., Adanu, R. M. & Harlow, S. D. (2012) Women’s sexual empowerment and contraceptive use in Ghana. Studies in Family Planning 43(3), 201–212.CrossRefGoogle ScholarPubMed
Do, M. & Kurimoto, N. (2012) Women’s empowerment and choice of contraceptive methods in selected African countries. International Perspectives on Sexual and Reproductive Health 38(1), 23–33.Google Scholar
Eliason, S., Baiden, F., Yankey, A. & Awusabo-Asare, K. (2014) Determinants of unintended pregnacies in rural Ghana. BMC Pregnancy and Childbirth 14(1), 261–270.Google Scholar
Fathalla, M. (2006) Human rights aspects of safe motherhood. Best Practice & Research Clinical Obstetrics & Gynaecology 20, 409–419.Google Scholar
Fawole, O. & Adeoye, I. (2015) Women’s status within the household as a determinant of maternal health care use in Nigeria. African Health Sciences 15(1), 217–225.Google Scholar
Fayehun, O., Omololu, O. & Isiugo-Abanihe, U. (2011) Sex of preceding child and birth spacing among Nigerian ethnic groups. African Journal of Reproductive Health 15(2), 79–89.Google Scholar
Furuta, M. & Salway, S. (2006) Women’s position within the household as a determinant of maternal health care use in Nepal. International Family Planning Perspectives 32(1), 17–27.Google Scholar
Grown, C., Gupta, C. & Pande, R. (2005) Taking action to improve women’s empowerment. Lancet 365, 541–543.Google Scholar
Ghana Statistical Services (GSS) (2009) Report of the Ghana Demographic and Health Survey 2008. Ghana Statistical Services.Google Scholar
Hameed, W., Azmat, S. K., Ali, M., Sheikh, M. I., Abbas, G., Temmerman, M. & Avan, B. I. (2014) Women’s empowerment and contraceptive use: the role of independent versus couples’ decision-making, from a lower middle income country perspective. PLoS One 9(8), e104633.Google Scholar
Hindin, M. J. (2012) The influence of women’s early childbearing on subsequent empowerment in sub-Saharan Africa: a cross-national meta analysis. International Center for Research on Women Fertility and Empowerment Working Paper Series 003‐2012‐ICRW‐FE, pp. 1–31. URL: http://www.icrw.org/files/publications/The-Influence-of-Women’s-Early-Childbearing-on-Subsequent-Empowerment-in-Sub-Saharan-Africa-A-Cross-National-Meta-Analysis-Hindin.pdf (accessed 12th November 2015).Google Scholar
Johnson, F. & Madise, N. (2011) Targeting women at risk of unintended pregnancy in Ghana: should geography matter? Sexual and Reproductive Health Care 2(1), 29–35.Google Scholar
Kabeer, N. (1999) Resources, agency, achievements: reflections on the measurements of women’s empowerment. Developmental Changes 30, 435–464.Google Scholar
Kabeer, N., McFadden, P., Arnfried, S., Dominguez, E. & Saaadallah, S. (2001) Discussing Women’s Empowerment – Theory and Practice. Sida Studies, Stockholm.Google Scholar
Khan, K., Wojdyla, D., Say, I., Gulmezoglu, A. & Van Look, P. (2006) World Health Organization analysis of causes of maternal death: a systematic review. Lancet 367, 1066–1074.Google Scholar
Kishor, S. & Subaiya, L. (2008) Understanding women’s empowerment: a comparative analysis of Demographic and Health Surveys (DHS) data. DHS Comparative Report. Macro International, MD, USA.Google Scholar
Lee-Rife, S. (2010) Women’s empowerment and reproductive experiences over lifecourse. Social Science & Medicine 71, 634–642.Google Scholar
León, F. R. (2013) Predicting contraceptive use from an egalitarian model of women’s overall household power vis-à-vis conventional power models and third variables. Journal of Biosocial Science 45, 497–515.Google Scholar
Malhotra, A., Shuler, S. & Boender, C. (2002) Measuring women’s empowerment as a variable in international development. World Bank Workshop on Poverty and Gender: New Perspectives. URL: http://siteresources.worldbank.org/INTGENDER/Resources/MalhotraSchulerBoender.pdf (accessed 14th November 2015).Google Scholar
Melka, A. S., Tekelab, T. & Wirtu, D. (2015) Determinants of long acting and permanent contraceptive methods utilization among married women of reproductive age groups in western Ethiopia: a cross-sectional study. Pan African Medical Journal 21, 246.Google Scholar
Moronkola, O. A., Ojediran, M. M. & Amosu, A. (2006) Reproductive health knowledge, beliefs and determinants of contraceptives use among women attending family planning clinics in Ibadan, Nigeria. African Health Sciences 6(3), 155–159.Google Scholar
Na, M., Jennings, L., Talegawkar, S. & Ahmed, S. (2015) Associations between women’s empowerment and infant and child feeding practices in sub-Saharan Africa: an analysis of the Demographic and Health Surveys. Public Health Nutrition 18(17), 3155–3165.Google Scholar
Oheneba-Sakyi, Y. (1992) Determinants of current contraceptive use among Ghanian women at the highest risk of pregnancy. Journal of Biosocial Science 24(4), 463–475.Google Scholar
Okereke, E., Ahonsi, B., Tukur, J., Ishanku, S. & Oginni, A. (2012) Benefits of using magnesium sulphate for eclampsia management and maternal mortality reduction: lessons from Kano State in Northern Nigeria. BMC Research Notes 8(5), 421.Google Scholar
Omane-Adjepong, M., Oduro, F. & Annin, K. (2012) A multinomial regression analysis of unplanned pregnancies in Ahafo Ano South District, Ghana. American International Journal of Contemporary Research 2(12), 90–97.Google Scholar
Pandey, S., Lama, G. & Lee, H. (2012) Effect of women’s empowerment on their utilization of health services: a case in Nepal. International Social Work 55(4), 554–573.Google Scholar
Population Council (2008) Sexual and Gender Based Violence in Africa: Literature Review. Population Council, New York.Google Scholar
Quisumbing, A. & Maluccio, J. (2003) Resources at marriage and intrahousehold allocation: evidence from Bangladesh, Ethiopia, Indonesia, and South Africa. Oxford Bulletin of Economics and Statistics 65, 283–327.Google Scholar
Sado, L., Spaho, A. & Hotchkiss, D. R. (2014) The influence of women’s empowerment on maternal health care utilization: evidence from Albania. Social Science & Medicine 114, 169–177.Google Scholar
Safilios-Rothschild, C. (1982) Female power autonomy and demographic change in the Third World. In Anker, R., Buvinic, M. & Youssef, N. (eds) Women’s Roles and Population Trends in the Third World. Routledge, London.Google Scholar
Shimamato, K. & Gipson, J. (2015) The relationship of women’s status and empowerment with skilled birth attendant use in Senegal and Tanzania. BMC Pregnancy Childbirth 15(1), 154–165.CrossRefGoogle Scholar
Singh, K., Bloom, S. & Brodish, P. (2013) Gender equality as a means to improve maternal and child health in Africa. Health Care for Women International 3(1), 57–69.Google Scholar
Sorbye, I., Vangen, S., Oneka, O., Sundby, J. & Bergsjo, P. (2011) Caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, north-eastern Tanzania. BMC Pregnancy Childbirth 28(11), 55.Google Scholar
Tawaih, E. (1997) Factors affecting contraceptive use in Ghana. Journal of Biosocial Science 29(2), 141–149.Google Scholar
Tekelab, T., Melka, A. S. & Wirtu, D. (2015) Predictors of modern contraceptive methods use among married women of reproductive age groups in Western Ethiopia: a community based cross-sectional study. BMC Women’s Health 15(1), 1–8.Google Scholar
Thaddeus, S. & Maine, D. (1994) Too far to walk: maternal mortality in context. Social Science & Medicine 38(8), 1091–1110.Google Scholar
UNFPA & UNIFEM (2005) Combating Gender-Based Violence: A Key to Achieving the Millenium Development Goals. UNFPA & UNIFEM, New York.Google Scholar
UNICEF (2010) Ghana: PMTCT. URL: http://www.unicef.org/aids/files/Ghana_PMTCTFactsheet_2010.pdf Google Scholar
Upadhyay, U., Gipson, J., Withers, M., Lewis, S., Ciaraldi, E. & Fraser, A. (2014) Women’s empowerment and fertility: a review of the literature. Social Science & Medicine 115, 111–120.Google Scholar
van de Akker, T., van Rhenen, J., Mwagomba, B., Lommerse, K., Vinkhumbo, S. & van Roosmalen, J. (2011) Reduction of severe acute maternal morbidity and maternal mortality in Thyolo District, Malawi. PLoS One 6(6), e20776.Google Scholar
WHO (2004) Unsafe Abortion: Global and Regional Estimates of Incidence of Unsafe Abortion and Associated Morality in 2000. WHO, Geneva.Google Scholar
WHO (2010) Estimates Developed by WHOM, UNICEF, UNFA and the World Bank: Trends in maternal mortality 1990–2008.Google Scholar
WHO (2014) Trends in Maternal Mortality: 1990–2013. WHO, Geneva; UNICEF, UNFPA, the World Bank and the United Nations Population Division.Google Scholar
World Bank (2007) Addressing violence against women in middle and low income countries: a multi sectoral approach. Sector Operational Guide for the World Bank Gender and Development Group, New York.Google Scholar