Relationship between women’s decision-making power over their own health care and use of modern contraception in the Democratic Republic of the Congo: a cross-sectional secondary data analysis

Abstract

Background In sub-Saharan Africa, the use of modern contraception (MC) is a critical intervention aimed at reducing mortality rates associated with unintended, high-risk pregnancies. However, among Congolese women aged 15–49, the prevalence of MC use is low. Research suggests that women’s general participation in decision-making is important in increasing MC use. However, little is known about the specific role of women’s decision-making power over their own health care and how it relates to MC use. Thus, this study aimed to investigate the relationship between women’s decision-making power over their own health care and use of MC. Methods A cross-sectional secondary data analysis was conducted using the most recent data from the 2013–2014 Democratic Republic of the Congo (DRC) Demographic and Health Survey. Women who were considered in need of contraception based on their family planning preferences were included in the study population (N = 6422). Multivariate logistic regression was used to determine whether women’s decision-making power over their own health care was associated with the use of MC. Results Only one in ten women reported using a modern method of contraception. Logistic regression showed that women who made decisions alone regarding their own health care were more likely to use MC than women who had no say in these decisions, even after controlling for important covariates (OR 1.48; 95% CI 1.00, 2.17). Conclusion The results of this study lend further support that promoting women’s autonomy and right to independently make decisions regarding their own health may be important in increasing the use of MC in the DRC. However, in order to effectively empower women to negotiate for the use of MC, qualitative research is needed to further assess the relationship between decision-making power and MC use.

Women’s involvement in decision-making and association with reproductive health behaviors: findings from a cross-sectional survey in Niger

“…We also found that women who are involved in decisionmaking tend to be wealthier, or in a polygamous union. These expected demographic factors were significantly associated with women's involvement in decision-making and are seen in similar studies from across the sub-Saharan region [4,8,9,12,27]. In addition, women in our sample who were involved in household decision-making had listened to radio programming or had participated in their own marriage decision, compared to women who were not involved in decision-making.…”

“…Previous investigations of women’s decision-making as a predictor for a range of RH outcomes in diverse African contexts have found mixed effects. Research on modern family planning (FP) use found that women with greater wealth, educated partners, and decision-making power were more likely to have used contraceptives [ 4 ] and autonomous decision-making among women for their own health increased the odds of modern FP compared to women who were not involved in such decisions [ 8 ]. For instance, a study of 32 sub-Saharan African countries found that female adolescents who exhibit “reproductive health decision-making capacity”—as measured by self-reported ability to refuse sexual intercourse and ask partner to use a condom—had higher odds of using contraceptives and this increased with age, wealth, education, urban dwelling and if the adolescent was cohabitating and not married [ 9 ].…”

Married Women’s Decision Making Power in Familly Planning Utlization and Associated Factors in Addis Ketema Sub City Addis Abeba 2022

“…Furthermore, 14.5 percent of women who used MC made health care decisions on their own, compared to 9.5 percent of those who did not. Finally, more over half of MC users decided on their partner's earnings together (56.4 percent) (23).…”

Women Alone Modern Contraceptive use decision making and its correlates, evidence from PMA CS 2021 Survey

“…As a result, though reproductive, maternal, neonatal, and child healthcare care in general and contraceptive method in particular are available, easily accessible, and mostly free of charge in Ethiopia as well (6, 25, 28, 37-40), uptake is not always ideal. Therefore, during the last seven years, the global and the national communities have shown a paradigm shift in ensuring the optimum use of contraceptive services (41). This is shown by the fact that goal 5.6.1 of the women's empowerment main agenda lists the right of women to make decisions about contraceptive as a top SDG sub-agenda (8, 9, 24, 42) In Ethiopia, contraceptive method decision making received minimal or no attention likewise.…”