142nd APHA Annual Meeting and Exposition

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309550
Women's empowerment and its relationship to current contraceptive use in low, lower-middle, and upper-middle income countries: A systematic review of the literature

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Courtney Peters, MPH , Hubert Department of Global Health, Emory University, Atlanta, GA
Kristin VanderEnde, MSN, CNM, PhD , Hubert Department of Global Health, Rollins School of Public Health, Atlanta, GA
Sara Thorpe, MPH , Hubert Department of Global Health, Emory University, Atlanta, GA
Lauren Bardin, MPH , Hubert Department of Global Health, Hubert Department of Global Health, Atlanta, GA
Alan Bleiberg , Hubert Department of Global Health, Emory University, Atlanta, GA
Kathryn Yount, PhD , Hubert Department of Global Health and Department of Sociology, Emory University, Atlanta, GA
Erin Johnson, MPH , Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA
This study assesses the peer-reviewed literature on women’s empowerment and its relationship to current contraceptive use in low, lower-middle, and upper-middle income countries as defined by the World Bank. Although the empirical evidence suggests a positive relationship between empowerment and contraceptive uptake, the concept of empowerment is inconsistently defined and operationalized. This study looks specifically at women’s agency, or the influence in family decisions and freedom of movement, as expressions of empowerment. Using systematic database search strategies, we identified 358 titles and abstracts for screening. Twelve full-text articles published between 1996 and 2013 met our inclusion criteria. We included quantitative studies of women ages 15-49 using current contraceptive use as an outcome. The majority of included studies used DHS or other nationally representative survey data for secondary analyses, and all studies based their analyses on cross-sectional data. Using a standardized data-extraction form and quality checklist, we discovered that the definition and measurement of women’s empowerment vary widely, which leads to variable findings when assessing current contraceptive use as an outcome. Consequently, 75% of studies showed at least one positive relationship between either decision making or freedom of movement with current contraceptive use; whereas the remainder found no association. These results were not specific to any geographic region; however, it is notable that no studies came from Latin America, Southeast Asia, or the Middle East.  Overall, this systematic review showed that higher levels of women’s empowerment are associated with higher current contraceptive use. More research is needed using consistent empowerment measures.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the impact of women's empowerment on current contraceptive use in low, lower-middle, and upper-middle income countries. Discuss the inconsistency in the definiton of women's empowerment and the effect of this variation on measurement tools and study outcomes. Identify appropriate ways to conduct an analysis using current contraceptive use as an outcome, including differentiating between "modern" and "traditional" methods.

Keyword(s): Contraception, Family Planning

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a professional colleague of the lead author, Courtney Peters, and she has requested that I present her work in her place.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.