Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Int Perspect Sex Reprod Health. 2012 Mar;38(1):23-33. doi: 10.1363/3802312.
It is generally believed that women's lack of decision-making power may restrict their use of modern contraceptives. However, few studies have examined the different dimensions of women's empowerment and contraceptive use in African countries.
Data came from the latest round of Demographic and Health Surveys conducted between 2006 and 2008 in Namibia, Zambia, Ghana and Uganda. Responses from married or cohabiting women aged 15-49 were analyzed for six dimensions of empowerment and the current use of female-only methods or couple methods. Bivariate and multivariate multinomial regressions were used to identify associations between the empowerment dimensions and method use.
Positive associations were found between the overall empowerment score and method use in all countries (relative risk ratios, 1.1-1.3). In multivariate analysis, household economic decision making was associated with the use of either female-only or couple methods (1.1 for all), as was agreement on fertility preferences (1.3-1.6) and the ability to negotiate sexual activity (1.1-1.2). In Namibia, women's negative attitudes toward domestic violence were correlated with the use of couple methods (1.1).
Intervention programs aimed at increasing contraceptive use may need to involve different approaches, including promoting couples' discussion of fertility preferences and family planning, improving women's self-efficacy in negotiating sexual activity and increasing their economic independence.
人们普遍认为，女性决策权的缺乏可能会限制其对现代避孕药具的使用。然而，很少有研究调查过非洲国家中女性赋权的不同维度与避孕措施使用之间的关系。
数据来自于 2006 年至 2008 年间在纳米比亚、赞比亚、加纳和乌干达进行的最新一轮人口与健康调查。分析了年龄在 15 至 49 岁的已婚或同居女性对赋权的六个维度的回应以及当前使用女性专用方法或夫妻方法的情况。采用双变量和多变量多项回归来确定赋权维度与方法使用之间的关联。
在所有国家中，整体赋权评分与方法使用之间存在正相关关系（相对风险比为 1.1-1.3）。在多变量分析中，家庭经济决策与使用女性专用方法或夫妻方法均相关（所有方法的比值比为 1.1），与生育偏好的一致性（比值比为 1.3-1.6）和协商性行为的能力（比值比为 1.1-1.2）也相关。在纳米比亚，女性对家庭暴力的负面态度与夫妻方法的使用相关（比值比为 1.1）。
旨在提高避孕措施使用率的干预项目可能需要采取不同的方法，包括促进夫妻双方讨论生育偏好和计划生育、提高女性在协商性行为方面的自我效能感、以及增强其经济独立性。
