Women’s autonomy and modern contraceptive use in Ghana: a secondary analysis of data from the 2014 Ghana Demographic and Health Survey

Abstract

Objective Women’s empowerment and autonomy have been proven to promote women’s use of modern contraceptives. This study examined women’s autonomy as a potential factor for modern contraceptive use among Ghanaian women in a union. Method We conducted a secondary analysis of data from the 2014 Ghana Demographic and Health Survey. The main outcome measure was current modern contraceptive use from women’s self-report. Three composite indices were used to assess women’s autonomy: household decision-making, attitudes towards wife-beating, and property ownership. Results A total of 4772 non-pregnant women aged 15–49 years in a union were included in the analysis. The mean age was 34.2(±7.97) years, 53.6% received at least secondary education, 87.7% were employed, and 76.5% received family planning information within the last 12 months. The prevalence of modern contraceptive use was 24.8% (95% CI: 22.9–26.7). Women’s autonomy was independently associated with modern contraceptive use. Compared with women with low autonomy, women with moderate (AOR= 1.26, 95% CI: 1.02–1.55, p = 0.034) and high autonomy (AOR = 1.34, 95% CI: 1.01–1.79, p = 0.044) had increased odds of modern contraceptive use. Maternal age, education, number of living children, employment, region, and exposure to family planning information were also strongly associated with modern contraceptive use. Conclusions The findings from this study support the assertion that women’s autonomy may be vital in promoting the use of modern contraceptives among women in a union in Ghana and other low-income and middle-income countries and should be considered in family planning programs.