Optimal birth interval and empowerment: a closer look at women's agency in Kenya

Abstract

Background/Aims Birth interval is measured by the number of months between two consecutive births, and is an important factor related to maternal and child health, family planning, and empowerment. A woman's ability to regulate time between pregnancies remains a human rights issue, especially in low- and middle-income countries. This study aimed to explore the impact of autonomous decision making and attitudes about intimate partner violence on birth interval among married/partnered women in Kenya. Methods This study analysed data from fecund women (15 − 49 years old) included in the Kenya Demographic and Health Survey. Autonomy and intimate partner violence perceptions were explored and analysed. The survey included married and partnered women. Structural equation modelling was used to determine the association between individual characteristics and optimal birth intervals. Results Women with higher permissive attitudes regarding intimate partner violence were more likely to report shorter birth intervals. Specifically, the results demonstrated that each unit increase in permissive attitudes towards domestic violence was associated with a 0.033 increase in the relative log odds of having birth intervals that were shorter than optimal. More than half of surveyed women (56%) reported using modern contraceptive methods, but 55% of them had non-optimal birth intervals. Conclusions Despite the majority of women using contraception, over half of surveyed women had non-optimal birth intervals. This calls for the expansion of education regarding contraceptive use for spacing of births. Equally, a shorter birth interval was associated with more permissive attitudes towards intimate partner violence. As perceptions of intimate partner violence may be socially constructed, targeting structural inequalities to address women's health may help this issue. Investigating data specific to Kenya will benefit the development of women's health and empowerment education strategies and interventions.