Shrestha Bidhya, Gurung Yogendra B, Shrestha Tara Lal, Lamichhane Kamala, Karki Rita, Hamal Sharadha
Central Department of Population Studies, Tribhuvan University, Kirtipur, Bagmati Province, Nepal.
Central Department of English, Tribhuvan University, Kirtipur, Bagmati Province, Nepal.
BMJ Public Health. 2025 Aug 5;3(2):e002576. doi: 10.1136/bmjph-2025-002576. eCollection 2025.
To assess how education and the use of family planning methods intersect to influence women's empowerment among currently married women of reproductive age in Nepal.
The study analysed a combined weighted sample of 21 023 currently married women in the age group (15-49 years) using data sets of two cross-sectional Nepal Demographic and Health Survey (NDHS). A weighted analysis of the samples was carried out, accounting for the complex survey design. In NDHS 2016, the sample size was 9,868, and in NDHS 2022, it was 11, 155. Thirteen indicators that have been used in previous studies were employed to measure women's empowerment. To examine the relationship between education, family planning use and women's empowerment, a multivariate binary logistic regression analysis was conducted, taking into account cluster and survey weights.
Women's empowerment is the primary outcome measure, which was assessed using a composite index of 13 indicators based on previous studies. The indicators encompassed sexual and reproductive autonomy, participation in household decision-making, control over financial decisions and attitudes towards wife-beating.
The results indicate that women with higher education and those who use family planning methods are significantly more empowered, with adjusted ORs of 3.764 (95% CI 2.894 to 4.895) in 2016 and 4.541 (95% CI 2.914 to 7.079) in 2022 compared with women without education and family planning use. This consistent pattern across both surveys highlights a significant association between education, family planning use and women's empowerment.
The study suggests the importance of advocating for education and family planning use as interlinked pathways to empower women. To fulfil Sustainable Development Goal 5-achieving gender equality and empowering all women and girls-government must ensure intersectional strategies that remove barriers to education and reproductive autonomy.
评估教育与计划生育方法的使用如何相互作用，以影响尼泊尔目前已婚育龄妇女的赋权状况。
设计、背景与参与者：该研究使用两次尼泊尔人口与健康调查（NDHS）的数据集，对年龄在15至49岁的21023名目前已婚妇女的加权样本进行了分析。对样本进行了加权分析，考虑了复杂的调查设计。在2016年的NDHS中，样本量为9868，在2022年的NDHS中，样本量为11155。采用先前研究中使用的13项指标来衡量妇女的赋权状况。为了检验教育、计划生育使用与妇女赋权之间的关系，进行了多变量二元逻辑回归分析，同时考虑了聚类和调查权重。
妇女赋权是主要的结果指标，根据先前的研究，使用由13项指标组成的综合指数进行评估。这些指标包括性与生殖自主权、参与家庭决策、对财务决策的控制权以及对殴打妻子的态度。
结果表明，受过高等教育且使用计划生育方法的妇女赋权程度显著更高，与未接受教育且未使用计划生育方法的妇女相比，2016年的调整后比值比为3.764（95%置信区间为2.894至4.895），2022年为4.541（95%置信区间为2.914至7.079）。两项调查中的这种一致模式凸显了教育、计划生育使用与妇女赋权之间的显著关联。
该研究表明，倡导将教育和计划生育的使用作为增强妇女权能的相互关联途径具有重要意义。为实现可持续发展目标5（实现性别平等并增强所有妇女和女童的权能），政府必须确保采取交叉性战略，消除教育和生殖自主权方面的障碍。
