Abstract
BackgroundIt has been proposed that the autonomy of women is one of the mechanisms of how education influences contraceptive use in developing countries. We tested this hypothesis in a national sample of women in Pakistan.MethodsWe used the 2000 Pakistan Reproductive Health and Family Planning Survey, which interviewed a national sample of ever married women aged 15–49 years (n = 6579). Women's decision autonomy was estimated from 9 questions on who makes decisions at home; movement autonomy was based on 6 questions on whether women need permission to visit places outside home. A number of socio-demographic variables were used in multivariate analysis to investigate the independent association between autonomy and lifetime and current contraception use and to assess the extent to which autonomy mediates the association between education and contraception use.ResultsDecision autonomy was significantly associated with both lifetime and current contraception use; after controlling for covariates, the odds ratios for the highest vs. the lowest quintile were 1.8 (1.4–2.4) and 2.0 (1.4–2.8), respectively. Movement autonomy was not consistently associated with contraceptive use. Contraceptive use was strongly associated with women's education but this relation was not mediated by women's autonomy.ConclusionWomen's decision autonomy is significantly associated with contraceptive use but it does not appear to mediate the link between woman's education and contraception.
Highlights
Planning is an important issue for many developing countries worldwide, including South Asia
In parts of South Asia, and elsewhere, women have a considerably lower social status and autonomy than men [47], and their low status and autonomy seems to be associated with lower fertility control [4,6,8]
Of the several dimensions of women's autonomy described in the literature [4,7], two were assessed in this study: decision autonomy and movement autonomy
Summary
Planning is an important issue for many developing countries worldwide, including South Asia. In Pakistan, despite a governmental programme supporting family planning and despite the improvements over the last few decades, total fertility rate remains high (4.8 in 2000) and current contraception use remains relatively low (20% in 2000) [1]. Improving women's education has been seen one way to increase their status and autonomy [4,5,7,11], and it has been proposed that autonomy acts as a mediator of the link between education and contraception use [4,8,12]. It has been proposed that the autonomy of women is one of the mechanisms of how education influences contraceptive use in developing countries. We tested this hypothesis in a national sample of women in Pakistan
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