title: Women's empowerment and ideal family size: an examination of DHS empowerment measures in Sub-Saharan Africa.
abstract: BACKGROUND
  The Demographic and Health Survey (DHS) program collects data on women's empowerment, but little is known about how these measures perform in Sub-Saharan African countries. It is important to understand whether women's empowerment is associated with their ideal number of children and ability to limit fertility to that ideal number in the Sub-Saharan African context.
  
  
  METHODS
  The analysis used couples data from DHS surveys in four Sub-Saharan African countries: Guinea, Mali, Namibia and Zambia. Women's empowerment was measured by participation in household decision making, attitudes toward wife beating and attitudes toward refusing sex with one's husband. Multivariable linear regression was used to model women's ideal number of children, and multivariable logistic regression was used to model women's odds of having more children than their ideal.
  
  
  RESULTS
  In Guinea and Zambia, negative attitudes toward wife beating were associated with having a smaller ideal number of children (beta coefficients, -0.5 and -0.3, respectively). Greater household decision making was associated with a smaller ideal number of children only in Guinea (beta coefficient, -0.3). Additionally, household decision making and positive attitudes toward women's right to refuse sex were associated with elevated odds of having more children than desired in Namibia and Zambia, respectively (odds ratios, 2.3 and 1.4); negative attitudes toward wife beating were associated with reduced odds of the outcome in Mali (0.4).
  
  
  CONCLUSIONS
  Women's empowerment--as assessed using currently available measures--is not consistently associated with a desire for smaller families or the ability to achieve desired fertility in these Sub-Saharan African countries. Further research is needed to determine what measures are most applicable for these contexts.
authors: Bixby Center for Global Reproductive Health, University of California, San Francisco, CA, USA. upadhyayu@obgyn.ucsf.edu
authors: Ushma D
authors: UD
authors: Upadhyay
authors: Deborah
authors: D
authors: Karasek
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D003657:Decision Making; D005191:Family Characteristics; D005193:Family Planning Services / Q000379:methods / Q000592:standards / Q000639:trends*; D005260:Female; D005783:Gender Identity; D006306:Health Surveys; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011209:Power, Psychological; D012725:Sexual Behavior; D013179:Spouse Abuse / Q000523:psychology* / Q000706:statistics & numerical data; D014933:Women's Rights / Q000592:standards / Q000639:trends*; D055815:Young Adult