Do women's status and empowerment affect contraceptive use and fertility? Evidence from West Africa using Structural Equation Modeling

Background. Fertility remains high in sub-Saharan Africa, and modern contraceptive use is persistently low especially in West Africa. Despite global evidence and theory on the linkages between women’s empowerment, contraceptive use, and fertility, studies are particularly limited from African settings and that employ Structural Equation Modeling (SEM) to examine these complex and multidimensional pathways.

Aims.This study aims to investigate mechanisms by which multiple dimensions of women’s empowerment affect fertility and modern contraceptive use in Senegal.

Methods. The 2010-2011 Senegal Demographic and Health Survey is used (women n=10,626). A SEM is used to test mechanisms predicting fertility and current modern contraceptive use individually. Multiple and sequential pathways are assessed, from women’s status and empowerment (i.e., age at first marriage, decision-making, gender-role attitudes against violence and for sex negotiation).

Results.Women’s higher education is related to lower fertility (standardized b=-0.09) and higher likelihood of modern contraceptive use (b=0.07). Older age at first marriage is also related to lower fertility (b=-0.39), but not modern contraceptive use. Neither decision-making nor gender-role attitudes are related to fertility or contraceptive use. Mediation analysis shows a sequential pathway from education to age at first marriage, which in turn affects fertility.

Conclusion. Women’s status and empowerment have significant, though disparate, influences on fertility and modern contraceptive use in Senegal. Results indicate that policy interventions to prevent early marriage are important for fertility reduction. Yet some empowerment measures affect neither fertility nor contraceptive use, suggesting the multi-dimensionality of empowerment and the need of contextually-tailored empowerment interventions to address these outcomes.