title: Women's empowerment and choice of contraceptive methods in selected African countries.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA. mdo@tulane.edu
authors.forename: Mai
authors.initials: M
authors.lastname: Do
authors.forename: Nami
authors.initials: N
authors.lastname: Kurimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002755:Choice Behavior; D003268:Contraception Behavior; D003657:Decision Making; D003906:Developing Countries; D004522:Educational Status; D005260:Female; D005869:Ghana; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011209:Power, Psychological; D011594:Psychometrics; D012306:Risk; D014454:Uganda; D016387:Women's Health; D014933:Women's Rights; D055815:Young Adult; D015024:Zambia