Social and Demographic Predictors of Gender Inequality Among Heterosexual Couples Expecting a Child in Central Kenya

Abstract

Imbalance of power and equality in sexual relationships is linked to health in various ways, including (1) reduced ability to get information or take action, (2) increased violence between partners, and (3) influence on the reduced use of health services. While there has been research assessing multiple social and economic variables related to gender inequality, studies have used many different definitions of gender inequality, and there is a lack of this research within a pregnancy context. Here, we attempt to identify social and economic predictors of gender inequality (measured by decision-making power and acceptance of intimate partner violence) within heterosexual couples expecting a child in central Kenya. We ran a secondary data analysis using data from a three-arm individually randomized controlled HIV self-testing intervention trial conducted in 14 antenatal clinics in central and eastern Kenya among 1410 women and their male partners. The analysis included Cochran Mantel-Haenszel, logistic regression, proportional odds models, and generalized linear mixed model (GLMM) framework to account for site-level clustering. Overall, we show that there are significant social and economic variables associated with acceptance of intimate partner violence including higher age, being married, Bother^religion, lower partner education, higher wealth status, and variables associated with decision-making power including lower partner education and lack of equality in earnings. This study contributes to the literature on the influence of social and economic factors on gender inequality, especially in Kenya which has a high burden of HIV/AIDS. Our results show some areas to improve these specific factors (including education and employment opportunities) or create interventions for targeted populations to potentially improve gender equality in heterosexual pregnant couples in Kenya.

Socio-demographic predictors of gender inequality among heterosexual couples expecting a child in south-central Uganda

“…Lower education was found to be associated with both higher acceptance of intimate partner violence and lower woman's decision-making power in our results. Similar results regarding education have been reported and shown not only for support for gender equality 8 , 9 , 23 , 24 , reproductive autonomy 25 , but also perpetration of intimate partner violence 26 – 28 , and we found similar results in our study in central Kenya among heterosexual couples expecting a child 19 .…”

“…However, there has been a relative lack of studies assessing sociodemographic variables associated with gender inequality within the context of a pregnancy. We recently performed an analysis of social and economic variables and gender inequality among heterosexual couples expecting a child in central Kenya, which had some promising results and areas to target for improvement of these gender inequality measures 19 . Therefore, we attempted to identify potential associations between social and economic variables and gender inequality (which in this case were measured as high acceptance of intimate partner violence and low women's decision-making power), within the context of heterosexual couples expecting a child in south-central Uganda.…”

Relationship Gender Equality and Couples' Uptake of Oral Human Immunodeficiency Virus Self-Testing Kits Delivered by Pregnant Women in Kenya

“…23 Many of these covariates were found to be associated with the 2 primary exposures of attitudes toward IPV and decision making power in our previously published analyses, so they were included in this study. 27…”