Women's empowerment and family planning use: Effects of Standard Days Method integration in India and Peru

The Millennium Development Goals include both empowering women and improving maternal health. Family planning (FP) use is generally considered to contribute to both goals. Applying multivariate analyses to survey data from a study in India and Peru we determine if introducing the Standard Days Method (SDM) into the FP method mix promotes women's empowerment and increases FP use. SDM, a fertility awareness-based FP method, was introduced in Jharkand, India, and San Martin, Peru on a regional scale in 2005. Community surveys in the intervention and in control areas, before the intervention began and two years later, explored the effect at the community level of adding the new FP method to the method mix. We measured empowerment through indices of decision making (who makes certain household decisions), attitudes toward gender based violence, and attitudes toward the wife refusing to have sex in certain circumstances. Interviews with women in India show that the intervention increased women's perception of their empowerment in each of these three areas. Controlling for respondents' age and education did not change the observed trends. Interviews with men show improvement only in increased recognition that women are empowered to refuse to have sex, with no change in the other indices. In Peru, however, the intervention did not affect women's empowerment. Similarly, contraceptive prevalence increased in the intervention areas in India, but did not significantly change in Peru. We conclude that introducing SDM into services can, in some socio-cultural and service delivery contexts, improve women's empowerment and increase contraceptive prevalence.