Untangling Empowerment and Contraceptive Use Longitudinally in Five African Settings
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Objective
Empowerment impacts reproductive health behaviors profoundly. Similarly, contraceptive access and use result in broader social and economic opportunities. We aimed to quantify the directionality of this cyclical relationship.
Study design
This study utilizes data from the Performance Monitoring for Action (PMA) surveys in Kenya, Nigeria (Kano), Burkina Faso, Democratic Republic of Congo (DRC), and Uganda. Using annual longitudinal data (2019-2021), we employed cross-lagged panel models (CLPM) to analyze the bidirectional relationship between women’s empowerment and contraceptive use.
Results
There was a significant positive impact of contraceptive use on women’s empowerment. In Kenya and Kano, contraceptive use was associated with a 10.1% and 12.0% increase in paid work and 14.5% and 14.8% greater control over wages, respectively. In Kenya, women doing paid work with wage control were 5.2% more likely to use contraception the following year. In Kano, control over partner’s wages increased contraceptive use by 9.6%. Additionally, having savings, financial goals, increased financial autonomy, and knowledge of financial information were associated with higher future contraceptive use.
Conclusions
Contraceptive use can act as a catalyst for empowerment, while empowerment, particularly decision-making autonomy over finances, enhances contraceptive use. However, these dynamics vary across different settings, emphasizing the need for context-specific strategies.
