Department of Geography, Faculty of the Social Sciences, University of Nigeria, Nsukka, Nigeria.
Demography and Population Studies Programme, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Afr J Reprod Health. 2022 Nov;26(11):141-153. doi: 10.29063/ajrh2022/v26i11.13.
The impacts of gender relations (GR) on reproductive health in sub-Saharan Africa (SSA) have received little attention. Virtually non-existent are studies that take cognizance of the socio-cultural diversity of SSA countries in assessing the impacts. Using Demographic and Health Survey data from Namibia, Kenya and Nigeria, this study investigated whether feminine gender relations (FGR) predict higher uptake of contraceptives and antenatal care services (ANC) in SSA. Results from univariate, bivariate and multivariate analyses showed that Namibia had the highest prevalence of FGR (20.0%) and contraceptive use (57.8%) while Nigeria had the lowest FGR (5.7%) but highest ANC utilization (42.1%). At the unadjusted levels, FGR predicted higher contraceptive use in Namibia and Nigeria but became insignificant when sociodemographic confounders were controlled for. Masculine gender relations (MGR) however predicted increased contraceptive and ANC utilization in the three countries at the unadjusted levels and contraceptive use in Kenya and Nigeria when adjusted. That MGR predicted higher odds of using contraceptives in a largely gender egalitarian Kenya and patriarchal Nigeria while FGR was insignificant even in the largely feministic Namibia, suggests that promoting equality in GR, rather than emphasizing female autonomy, possesses greater capacity for improving reproductive health outcomes in SSA.
在撒哈拉以南非洲（SSA），性别关系（GR）对生殖健康的影响很少受到关注。几乎没有研究在评估影响时考虑到 SSA 国家的社会文化多样性。本研究使用来自纳米比亚、肯尼亚和尼日利亚的人口与健康调查数据，调查了女性性别关系（FGR）是否可以预测 SSA 地区更高的避孕和产前护理服务（ANC）利用率。单变量、双变量和多变量分析的结果表明，纳米比亚的 FGR（20.0%）和避孕药具使用率（57.8%）最高，而尼日利亚的 FGR 最低（5.7%）但 ANC 利用率最高（42.1%）。在未调整的水平上，FGR 预测纳米比亚和尼日利亚的避孕使用率更高，但在控制了社会人口统计学混杂因素后，其变得不显著。然而，在未调整的水平上，MGR 预测了三个国家的避孕药具和 ANC 利用率增加，在肯尼亚和尼日利亚调整后预测了避孕使用率增加。MGR 预测在性别平等程度较高的肯尼亚和父权制的尼日利亚，使用避孕药具的可能性更高，而在很大程度上强调女性自主的 FGR 即使在女性主义盛行的纳米比亚也不显著，这表明促进 GR 平等，而不是强调女性自主权，更有能力改善 SSA 的生殖健康结果。
