Africa: Women’s control over fertility linked to education, money and digital access – study of 16 African countries

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Many married women in sub-Saharan Africa do not have the freedom to make decisions about their sexual and reproductive health. Global data It shows that only 37% of women in the region between the ages of 15 and 49 can make their own informed decisions about sexual relations, contraceptive use and reproductive healthcare in the region. In Europe, 87% of women enjoy this freedom.

These decisions determine whether a woman will survive a pregnancy, avoid unsafe abortions, stay in school, participate in paid work, and plan her family size. However, in many homes, decisions about having sex, using contraception, or seeking health care are determined strictly by husbands, in-laws, or strong social norms rather than by the women themselves.

Researchers and policy makers have studied factors that could improve how women make such decisions independently or with their husbands. Results from Previous studies It has yielded mixed and sometimes contradictory results. some Show Variables such as education, income, or technology had a positive impact on women’s sexual independence. Others found no significant effect.

A possible reason may be that these factors have been investigated individually on different occasions, focusing on each individual country each time. The question then is what happens when these three forces – education, economic independence, and digital access – are examined together in many countries.

We are population health researchers focusing on population dynamics, social determinants of health, and reproductive and maternal health. We ran research Trying to answer this question.

Our findings show how these three variables interact to influence women’s decisions. We developed a model to assess their interactive effects, using data collected from 67,437 married women across 16 countries in sub-Saharan Africa.

Our findings showed that a combination of the three variables had a strong effect on women’s reproductive autonomy. Educated women with regular income and access to digital tools can largely make independent choices about their sexual and reproductive health. They can also make real choices with their spouses compared to those without all three variables.

The results show that investing in education, digital innovation and women’s economic empowerment influences how women participate in the decision-making process with couples regarding their sexual and reproductive health.

Identify the problem

The World Health Organization reports that 164 million women worldwide have it Unmet need for contraception One in three women has it Experienced Physical or sexual violence in their lives.

Records show that 257 million women Globally, their partners force them to have sex without negotiating the use of condoms or making decisions about reproductive health care.

This affects women’s health, bodies, safety and rights.

We asked three questions in our research. First, do women with a high school education but no income have the same decision-making power as women with an education and a bank account?

Second, does access to the Internet or mobile money make a difference when women want to negotiate contraceptive use?

Third, how do these factors differ between countries in sub-Saharan Africa?

We then analyzed Demographic and Health Survey data collected in 16 African countries. Some of the countries were Nigeria, Uganda, Rwanda, Malawi, Madagascar and South Africa.

The analysis focused on four main questions asked of married women:

Can you refuse sex if you don’t want to?
Can you ask your partner to use a condom?
Who usually decides on contraception?
Who usually decides your health care?

Women who could answer “yes” to these questions or make decisions themselves or jointly with their husbands were seen as having decision-making power over their sexual and reproductive health.

What we found

education: Well-educated women were twice as likely to decide about their reproductive health with their husbands than uneducated women. Education gives women access to information about contraceptives. This in turn helps them develop confidence in using it.

Economic independence: Economically powerful women have more freedom to make reproductive decisions than women whose husbands have complete control over household spending.

Digital Access: Women who have access to digital tools, such as mobile phones for financial transactions, Internet access, or digital bank accounts, have greater freedom to make decisions about sex, contraceptive use, and reproductive health with their husbands than women who do not. These improvements were generally significant, especially in countries where mobile money is widely used.