Determinants of contraceptive decision making among married women in Sub-Saharan Africa from the recent Demographic and Health Survey data

Abstract

Background Different evidence suggested that couples often disagree about the desirability of pregnancy and the use of contraceptives. Increased women's decision-making on contraceptives is identified as a key solution that can change the prevailing fertility and contraceptive utilization pattern in SSA. Therefore, this study aimed to determine determinants of contraceptive decision-making among married women in Sub-Saharan Africa. Methods The data source of this study was the standard demographic and health survey datasets of 33 Sub-Saharan Africa countries. Reproductive age group women aged (15–49 years) currently married who are not pregnant and are current users of contraceptive preceding three years the survey was included from the individual record (IR file) file between 2010 and 2018. Since the outcome variable is composed of polychotomous categorical having multiple-choice, the Multinomial logistic regression (MNLR) model was applied. Results A total of 76,516 married women were included in this study. Maternal age 20–35 and 36–49 years were more likely to had decision making on contraceptive use in both women-only and joint (women and husband/partner category (referance = husband/partner) (RRR = 1.2; 95% CI = 1.05–1.41, RRR = 1.18; 1.04–1.33 and RRR = 1.38; 95% CI = 1.17–1.61, RRR = 1.27; 1.11–1.47)] respectively. Married women with higher education were more likely to decide by women-only category on contraceptive use (referance = husband/partner) (RRR = 1.26; 95% CI = 1.06–1.49). Women only decision-making to use contraceptives relative to the husband/partner only decreases by a factor of 0.86 (95% CI = 0.80–0.93) among rural than urban residences. Women only or joint decision making to use contraceptives was 1.25 and 1.35 times more likely relative to husband/partner decision making respectively among women who had work than that of had no work. The relative risk of women's decision to use family planning relative to husband increased among couples who had a marital duration of ≥ 10 years (RRR = 1.14; 95% CI = 1.06–1.22). But it has no significant effect on joint decision making. Respondents found in the richest wealth index category increase the relative risk of joint decision-making relative to husband/partner (RRR = 1.33; 95% CI = 1.20–1.47) compared to the poorest category. Conclusions Decision-making to use contraceptives among married women varies greatly by socio-demographic characteristics. The finding of this study showed that women's age, women educational status, residence, duration of the marriage, family economy, and country income were significantly associated with contraceptive decision-making. Therefore to promote ideal family planning decision making, there is a need to formulate policies and design programs that target women's socio-demographic characteristics and modern contraceptive interventions should be promoted by considering empowering women on decision making.

Women’s and male partners’ socio-demographic and economic characteristics associated with contraceptive decision making in Nigeria

“…However, joint decision contraceptive decision-makers constituted the largest proportion among the women. This is consistent with earlier studies in Nigeria [ 11 ], sub-Saharan Africa [ 28 ], and the United States of America [ 37 ].…”

“…On the other hand, women's wealth should increase their odds of making household decision-making because wealthy women are not only socio-economically empowered, they also command attention from their society and can influence their household decisions [22,23]. Therefore, it was expected that wealth should improve women's ability to make or participate in contraceptive decision-making just like in a similar recent study on sub-Saharan Africa (SSA) [28]. However, the result was contrary to expectations and further implies that there need for state-level analyses of women's contraceptive decision-making because analyses at the SSA level may conceal interesting state-specific evidence that can inform state-specific interventions.…”

“…Table 1 describes the variables considered in this study and how each of them was generated. The selection of the explanatory variables was informed by previous studies on contraceptive decision making and contraceptive use [1,[25][26][27][28][29]. The outcome variable is contraceptive decision making.…”

The Effect of Postpartum Gymnastics on the Decreased Uterine Fundal Height in Postpartum Mothers in the Work Area of the Ulaweng Health Center

“…better muscle stretch. Tesfa et al (2022) stated that the age of 20-35 years of age is the most ideal reproductive group from the health aspect, when viewed from the task and human development, that age is early adulthood which is a period of productive age. At the age of more than 35 years, the elasticity of the uterine muscle decreases, complications often occur before and after birth because the elasticity of the uterine muscle has decreased, causing uterine contractions not optimal.…”

Contraceptive Adoption and Changes in Empowerment in Kenya, Nigeria, and Senegal

“…2022; Tesfa et al. 2022). While these associations have important implications for family planning programming, cross‐sectional associations cannot provide insight into the causal role that family planning plays in the empowerment of women and girls.…”