Associations between women's perceptions of domestic violence and contraceptive use in seven countries in West and Central Africa

Abstract

ObjectivesThis study examined associations of women’s attitudes toward domestic violence (DV) and contraceptive use in West and Central Africa. Study designWe used data from the Multiple Indicator Cluster Surveys for women in seven countries in West and Central Africa (2009–2011, n=80,055). Main outcome measureWe measured contraceptive use as none, traditional, or modern contraceptives.DV approval was measured as no, low, or high tolerance of wife beating. Multinomial logistic regression estimated odds of using traditional or modern methods versus none, adjusting for age, education, wealth, residence, parity, marital structure, spousal age-difference, and religion. ResultsMany women had no or low DV tolerance (41%, 44%, respectively); most used no contraception (81%). In adjusted results, women with low DV tolerance had lower odds of using traditional contraceptive methods (odds ratio, OR=0.87; 95% confidence interval, CI: 0.78–0.98) or modern methods (OR=0.86; 95% CI: 0.78–0.95) compared to women with no tolerance. Women with high DV tolerance had 28% lower odds of traditional contraceptive use (95% CI: 0.60–0.90), and 38% lower odds of modern contraceptive use (95% CI: 0.59–0.88) compared to women with no tolerance. ConclusionThe high prevalence of DV approval may threaten the success of programs aimed at improving women’s reproductive health, including contraceptive use.