Taqwim Sitta Fiakhsani, Vaezghasemi Masoud, Castel-Feced Sara, Dewi Fatwa Sari Tetra, Schröders Julia
Department of Epidemiology and Global Health, Umeå University, Umeå, 90 187, Sweden.
Department of Statistical Methods, University of Zaragoza, Zaragoza, 50005, Spain.
BMC Womens Health. 2025 Apr 30;25(1):211. doi: 10.1186/s12905-025-03748-6.
With a population of 275 million, Indonesia is the world's fourth most populous country and has made considerable efforts to reduce its Total Fertility Rate from 5.6 in 1971 to a target of 2.1 by 2024. Women's empowerment has been identified as a critical factor influencing fertility dynamics, gender equality, reproductive autonomy, and broader socioeconomic development. This study examines the association between four dimensions of women's empowerment and three fertility-related outcomes among married women aged 22 years and older in Indonesia.
We used cross-sectional data from 34,017 married women participating in the 2017 Indonesia Demographic and Health Survey (IDHS). An outcome-wide analytical approach was adopted to explore three outcomes: total number of children ever born, ideal number of children, and fertility preference alignment, i.e. whether actual fertility matched stated preferences. Four empowerment domains were assessed: household decision-making, attitudes toward wife beating, attitudes toward refusing sex, and labour force participation. Stepwise multivariate Poisson regression modelling was applied, adjusting for key demographic and socioeconomic covariates.
Our study found that the association between each type of women's empowerment and fertility-related outcomes varied, reinforcing the notion that empowerment does not uniformly affect reproductive behaviour. Among the four empowerment indicators, rejecting all justifications for wife beating emerged as the most consistent and significant predictor across all fertility outcomes. It was association with fewer children ever born (β = 0.03), a lower ideal number of children (β = 0.04), and a higher likelihood of meeting fertility preferences (PR = 1.02). Attitudes toward refusing sex were also significantly associated with fewer children (β = 0.02) and lower fertility ideals (β = 0.07). However, participation in decision-making and labour force participation showed mixed or non-significant associations, indicating that different empowerment dimensions may influence reproductive behaviour in diverse ways.
Women's empowerment - particularly in the domains of gender-based violence and sexual autonomy - is closely linked to fertility preferences and behaviours. The findings underscore that empowerment is a multidimensional construct, with varying influences across its domains. Strengthening women's autonomy and addressing gender-based violence are essential steps toward enhancing reproductive rights and achieving Sustainable Development Goal 5 in Indonesia. Gender-sensitive data systems and interventions tailored to different aspects of empowerment are urgently needed.
印度尼西亚拥有2.75亿人口，是世界上人口第四多的国家，并且已做出相当大的努力将其总生育率从1971年的5.6降至到2024年目标值2.1。妇女赋权已被视为影响生育动态、性别平等、生殖自主权以及更广泛社会经济发展的关键因素。本研究考察了印度尼西亚22岁及以上已婚妇女赋权的四个维度与三种生育相关结果之间的关联。
我们使用了来自参与2017年印度尼西亚人口与健康调查（IDHS）的34,017名已婚妇女的横断面数据。采用全结果分析方法来探究三种结果：曾生育子女总数、理想子女数以及生育偏好一致性，即实际生育情况是否符合所述偏好。评估了四个赋权领域：家庭决策、对殴打妻子的态度、对拒绝性行为的态度以及劳动力参与情况。应用逐步多元泊松回归模型，并对关键人口和社会经济协变量进行了调整。
我们的研究发现，每种类型的妇女赋权与生育相关结果之间的关联各不相同，这强化了赋权并非一致地影响生殖行为这一观点。在四个赋权指标中，拒绝所有殴打妻子的理由在所有生育结果中是最一致且显著的预测因素。它与更少的曾生育子女数（β = 0.03）、更低的理想子女数（β = 0.04）以及更高的符合生育偏好的可能性（PR = 1.02）相关。对拒绝性行为的态度也与更少的子女数（β = 0.02）和更低的生育理想（β = 0.07）显著相关。然而，参与决策和劳动力参与显示出混合或不显著的关联，表明不同的赋权维度可能以不同方式影响生殖行为。
妇女赋权——特别是在基于性别的暴力和性自主权领域——与生育偏好和行为密切相关。研究结果强调赋权是一个多维概念，在其各个领域具有不同影响。加强妇女自主权和解决基于性别的暴力是印度尼西亚增强生殖权利和实现可持续发展目标5的关键步骤。迫切需要对性别敏感的数据系统以及针对赋权不同方面的干预措施。
