Women's Sexual Empowerment and Contraceptive Use in Ghana

TLDR

Gendered inequities in Ghana give men disproportionate power over women, especially in sexual matters. The study hypothesizes that limited sexual empowerment hinders reproductive health and family planning uptake. The authors analyze 2008 Ghana Demographic Health Survey data on nonpregnant married or partnered women who do not wish to conceive, assessing the link between sexual empowerment and contraceptive use. Higher sexual empowerment is linked to greater contraceptive use, even after controlling for demographics, with wealth moderating the association; formal education, higher wealth, and unmarried partnership increase use, while Muslim women are less likely than Christian women, indicating that addressing gendered empowerment disparities, especially among economically disadvantaged women, is essential for universal reproductive health access.

Abstract

Pervasive gendered inequities and norms regarding the subordination of women give Ghanaian men disproportionately more power than women, particularly in relation to sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the 2008 Ghana Demographic Health Survey, we examine the association between women's sexual empowerment and contraceptive use in Ghana among nonpregnant married and partnered women not desiring to conceive in the next three months. Increasing levels of sexual empowerment are found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Christian. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed