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Published in: BMC Women's Health 1/2018

Open Access 01-12-2018 | Research article

Married women’s autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo

Authors: Yuji Sano, Roger Antabe, Kilian Nasung Atuoye, Joseph A. Braimah, Sylvester Z. Galaa, Isaac Luginaah

Published in: BMC Women's Health | Issue 1/2018

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Abstract

Background

Although use of modern contraception is considered beneficial in lowering maternal and child mortality rates, the prevalence of contraceptive use remains low in the Democratic Republic of Congo. This study examined modern contraceptive use and its linkage to women’s autonomy.

Methods

Data were drawn from the 2013–2014 Democratic Republic of Congo Demographic and Health Survey. We selected unsterilized and non-pregnant married women who have given birth in the last three years (N = 6680). Logistic regression models were fitted to explore the relationship between women’s autonomy and modern contraceptive use.

Results

The study found that only 7.1% of married women who had delivered within three years used modern contraceptive methods. After controlling for socioeconomic and demographic factors, the association between women’s autonomy and modern contraceptive use remained positively significant (OR = 1.16; 95% CI = 1.05, 1.29).

Conclusion

The findings from this study indicate that it is not enough to provide women with educational and employment opportunities to increase the uptake of modern contraception, but also to enhance women’s assertiveness to make their own decisions regardless of their partners’ preferences within household settings. It is critical for government and other stakeholders to roll out programs aimed at reducing gender inequality and improving women’s autonomy in decision-making about reproductive health.
Literature
1.
go back to reference Singh S, Sedgh G, Hussain R. Unintended pregnancy: worldwide levels, trends, and outcomes. Stud Fam Plan. 2010;41:241–50. Wiley Online LibraryCrossRef Singh S, Sedgh G, Hussain R. Unintended pregnancy: worldwide levels, trends, and outcomes. Stud Fam Plan. 2010;41:241–50. Wiley Online LibraryCrossRef
2.
go back to reference Hubacher D, Mavranezouli I, McGinn E. Unintended pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it. Contraception. 2008;78:73–8. Hubacher D, Mavranezouli I, McGinn E. Unintended pregnancy in sub-Saharan Africa: magnitude of the problem and potential role of contraceptive implants to alleviate it. Contraception. 2008;78:73–8.
3.
go back to reference Ministry of Health. National Strategic Plan For Family Planning. Kinshasha: Published by Government of DRC; 2014. Ministry of Health. National Strategic Plan For Family Planning. Kinshasha: Published by Government of DRC; 2014.
4.
go back to reference Ministère du Plan et Suivi de la Mise en oeuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP); ICF International. Enquéte démographique et de santé en République Démocratique du Congo 2013–2014. Rockville (MD): ICF International; 2014. Co-published by MPSMRM and MSP. Ministère du Plan et Suivi de la Mise en oeuvre de la Révolution de la Modernité (MPSMRM), Ministère de la Santé Publique (MSP); ICF International. Enquéte démographique et de santé en République Démocratique du Congo 2013–2014. Rockville (MD): ICF International; 2014. Co-published by MPSMRM and MSP.
5.
go back to reference Kandala N-B, Lukumu FK, Mantempa JN, Kandala JD, Chirwa T. Disparities in modern contraception use among women in the Democratic Republic of Congo: a cross-sectional spatial analysis of provincial variations based on household survey data. J Biosoc Sci. 2015;47:345–62. Cambridge Univ PressCrossRefPubMed Kandala N-B, Lukumu FK, Mantempa JN, Kandala JD, Chirwa T. Disparities in modern contraception use among women in the Democratic Republic of Congo: a cross-sectional spatial analysis of provincial variations based on household survey data. J Biosoc Sci. 2015;47:345–62. Cambridge Univ PressCrossRefPubMed
6.
go back to reference Mukaba T, Binanga A, Fohl S, Bertrand JT. Family planning policy environment in the Democratic Republic of the Congo: levers of positive change and prospects for sustainability. Glob Health Sci Pract. 2015;3:163–73. Johns Hopkins University-Global Health. Bloomberg School of Public Health, Center for Communication ProgramsCrossRefPubMedPubMedCentral Mukaba T, Binanga A, Fohl S, Bertrand JT. Family planning policy environment in the Democratic Republic of the Congo: levers of positive change and prospects for sustainability. Glob Health Sci Pract. 2015;3:163–73. Johns Hopkins University-Global Health. Bloomberg School of Public Health, Center for Communication ProgramsCrossRefPubMedPubMedCentral
7.
go back to reference Shapiro D, Tambashe BO. The impact of women’s employment and education on contraceptive use and abortion in Kinshasa, Zaire. Stud Fam Plann. 1994;25:96–110.CrossRefPubMed Shapiro D, Tambashe BO. The impact of women’s employment and education on contraceptive use and abortion in Kinshasa, Zaire. Stud Fam Plann. 1994;25:96–110.CrossRefPubMed
8.
go back to reference Mathe JK, Kasonia KK, Maliro AK. Barriers to adoption of family planning among women in Eastern Democratic Republic of Congo. Afr J Reprod Health. 2011;15:69–77.PubMed Mathe JK, Kasonia KK, Maliro AK. Barriers to adoption of family planning among women in Eastern Democratic Republic of Congo. Afr J Reprod Health. 2011;15:69–77.PubMed
9.
go back to reference Muanda MF, Ndongo GP, Messina LJ, Bertrand JT. Barriers to modern contraceptive use in rural areas in DRC. Cult Health Sex. 2017;19:1011–23.CrossRefPubMed Muanda MF, Ndongo GP, Messina LJ, Bertrand JT. Barriers to modern contraceptive use in rural areas in DRC. Cult Health Sex. 2017;19:1011–23.CrossRefPubMed
10.
go back to reference Zah BT. Variations socio-économiques de la fécondité en Côte d’Ivoire: quels groupes ont commencé à réguler leurs naissances? Cah. québécois démographie. Association des démographes du Québec. 2010;39:115–43. Zah BT. Variations socio-économiques de la fécondité en Côte d’Ivoire: quels groupes ont commencé à réguler leurs naissances? Cah. québécois démographie. Association des démographes du Québec. 2010;39:115–43.
11.
go back to reference Rahman MM, Mostofa MG, Hoque MA. Women’s household decision-making autonomy and contraceptive behavior among Bangladeshi women. Sex Reprod Healthc. 2014;5:9–15. ElsevierCrossRefPubMed Rahman MM, Mostofa MG, Hoque MA. Women’s household decision-making autonomy and contraceptive behavior among Bangladeshi women. Sex Reprod Healthc. 2014;5:9–15. ElsevierCrossRefPubMed
12.
go back to reference Dyson T, Moore M. On kinship structure, female autonomy, and demographic behavior in India. Popul Dev Rev. 1983;9:35–60.CrossRef Dyson T, Moore M. On kinship structure, female autonomy, and demographic behavior in India. Popul Dev Rev. 1983;9:35–60.CrossRef
13.
go back to reference Acharya DR, Bell JS, Simkhada P, van Teijlingen ER, Regmi PR. Women’s autonomy in household decision-making: a demographic study in Nepal. Reprod Health. 2010;7:1. BioMed CentralCrossRef Acharya DR, Bell JS, Simkhada P, van Teijlingen ER, Regmi PR. Women’s autonomy in household decision-making: a demographic study in Nepal. Reprod Health. 2010;7:1. BioMed CentralCrossRef
14.
go back to reference Mason KO. The status of women: Conceptual and methodological issues in demographic studies. Sociol Forum. 1986;1:284–300.CrossRef Mason KO. The status of women: Conceptual and methodological issues in demographic studies. Sociol Forum. 1986;1:284–300.CrossRef
15.
go back to reference Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic status, education and empowerment: Implications for maternal health service utilization in developing countries. PLoS One. 2010;5:1–6. Ahmed S, Creanga AA, Gillespie DG, Tsui AO. Economic status, education and empowerment: Implications for maternal health service utilization in developing countries. PLoS One. 2010;5:1–6.
16.
go back to reference Anderson S, Eswaran M. What determines female autonomy? Evidence from Bangladesh. J Dev Econ. 2009;90:179–91. ElsevierCrossRef Anderson S, Eswaran M. What determines female autonomy? Evidence from Bangladesh. J Dev Econ. 2009;90:179–91. ElsevierCrossRef
17.
go back to reference Bloom SS, Wypij D, Das Gupta M. Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography. 2001;38:67–78. SpringerCrossRefPubMed Bloom SS, Wypij D, Das Gupta M. Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography. 2001;38:67–78. SpringerCrossRefPubMed
18.
go back to reference Hogan DP, Berhanu B, Hailemariam A. Household organization, women’s autonomy, and contraceptive behavior in southern Ethiopia. Stud Fam Plan. 1999;30:302–14. Wiley Online LibraryCrossRef Hogan DP, Berhanu B, Hailemariam A. Household organization, women’s autonomy, and contraceptive behavior in southern Ethiopia. Stud Fam Plan. 1999;30:302–14. Wiley Online LibraryCrossRef
19.
go back to reference Oheneba-Sakyi Y, Takyi BK. Effects of couples’ characteristics on contraceptive use in SUb-Saharan Africa: the Ghanaian example. J Biosoc Sci. 1997;29:33–49. Cambridge Univ PressCrossRefPubMed Oheneba-Sakyi Y, Takyi BK. Effects of couples’ characteristics on contraceptive use in SUb-Saharan Africa: the Ghanaian example. J Biosoc Sci. 1997;29:33–49. Cambridge Univ PressCrossRefPubMed
20.
go back to reference DeRose LF, Ezeh AC. Decision-making patterns and contraceptive use: evidence from Uganda. Popul Res Policy Rev. 2010;29:423–39. SpringerCrossRef DeRose LF, Ezeh AC. Decision-making patterns and contraceptive use: evidence from Uganda. Popul Res Policy Rev. 2010;29:423–39. SpringerCrossRef
22.
go back to reference WHO. Report of a WHO technical consultation on birth spacing. Geneva: WHO Guid; 2005. WHO. Report of a WHO technical consultation on birth spacing. Geneva: WHO Guid; 2005.
23.
go back to reference World Health Organization; Department of Reproductive Health and Research. Reproductive health indicators: Guidelines for their generation, interpretation and analysis for global monitoring. Geneva: World Health Organization; 2006. World Health Organization; Department of Reproductive Health and Research. Reproductive health indicators: Guidelines for their generation, interpretation and analysis for global monitoring. Geneva: World Health Organization; 2006.
24.
go back to reference Sano Y, Sedziafa AP, Vercillo S, Antabe R, Luginaah I. Women’s household decision-making autonomy and safer sex negotiation in Nigeria: an analysis of the Nigeria demographic and health survey. AIDS Care. 2018;30:240–5. Taylor & FrancisCrossRefPubMed Sano Y, Sedziafa AP, Vercillo S, Antabe R, Luginaah I. Women’s household decision-making autonomy and safer sex negotiation in Nigeria: an analysis of the Nigeria demographic and health survey. AIDS Care. 2018;30:240–5. Taylor & FrancisCrossRefPubMed
25.
go back to reference Abada T, Tenkorang EY. Women’s autonomy and unintended pregnancies in the Philippines. J Biosoc Sci. 2012;44:703–18. Cambridge University PressCrossRefPubMed Abada T, Tenkorang EY. Women’s autonomy and unintended pregnancies in the Philippines. J Biosoc Sci. 2012;44:703–18. Cambridge University PressCrossRefPubMed
26.
go back to reference Amoyaw JA, Kuuire V, Boateng GO, Asare-Bediako Y, Ung M. Conundrum of sexual decision making in marital relationships: safer-sex knowledge, behavior, and attitudes of married women in Zambia. J Sex Res. 2015;52:868–77.CrossRefPubMed Amoyaw JA, Kuuire V, Boateng GO, Asare-Bediako Y, Ung M. Conundrum of sexual decision making in marital relationships: safer-sex knowledge, behavior, and attitudes of married women in Zambia. J Sex Res. 2015;52:868–77.CrossRefPubMed
27.
go back to reference Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression. Hoboken: Wiley; 2013.CrossRef Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logistic regression. Hoboken: Wiley; 2013.CrossRef
28.
go back to reference Alberti KP, Grellety E, Lin Y-C, Polonsky J, Coppens K, Encinas L, et al. Violence against civilians and access to health care in north Kivu, Democratic Republic of Congo: three cross-sectional surveys. Confl Heal. 2010;4:1. BioMed CentralCrossRef Alberti KP, Grellety E, Lin Y-C, Polonsky J, Coppens K, Encinas L, et al. Violence against civilians and access to health care in north Kivu, Democratic Republic of Congo: three cross-sectional surveys. Confl Heal. 2010;4:1. BioMed CentralCrossRef
29.
go back to reference Kandala N-B, Emina JB, Nzita PDK, Cappuccio FP. Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo. Soc Sci Med. 2009;68:1728–36. ElsevierCrossRefPubMed Kandala N-B, Emina JB, Nzita PDK, Cappuccio FP. Diarrhoea, acute respiratory infection, and fever among children in the Democratic Republic of Congo. Soc Sci Med. 2009;68:1728–36. ElsevierCrossRefPubMed
30.
go back to reference Bertrand JT, Kayembe P, Dikamba N, Mafuta E, Hernandez J, Hellen J, et al. Using mapping of service delivery sites to increase contraceptive availability in Kinshasa, Democratic Republic of the Congo. Int Perspect Sex Reprod Health. 2014;40:95–9. JSTORCrossRefPubMed Bertrand JT, Kayembe P, Dikamba N, Mafuta E, Hernandez J, Hellen J, et al. Using mapping of service delivery sites to increase contraceptive availability in Kinshasa, Democratic Republic of the Congo. Int Perspect Sex Reprod Health. 2014;40:95–9. JSTORCrossRefPubMed
31.
go back to reference Sano Y, Antabe R, Atuoye KN, Hussey LK, Bayne J, Galaa SZ, et al. Persistent misconceptions about HIV transmission among males and females in Malawi. BMC Int Health Hum Rights. 2016;16:1. BioMed CentralCrossRef Sano Y, Antabe R, Atuoye KN, Hussey LK, Bayne J, Galaa SZ, et al. Persistent misconceptions about HIV transmission among males and females in Malawi. BMC Int Health Hum Rights. 2016;16:1. BioMed CentralCrossRef
Metadata
Title
Married women’s autonomy and post-delivery modern contraceptive use in the Democratic Republic of Congo
Authors
Yuji Sano
Roger Antabe
Kilian Nasung Atuoye
Joseph A. Braimah
Sylvester Z. Galaa
Isaac Luginaah
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2018
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-018-0540-1

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