Increasing literate and illiterate women's met need for contraception via empowerment: a quasi-experiment in rural India

• Published in: Reproductive health Vol. 11; no. 1; p. 74
• Main Authors: León, Federico R, Lundgren, Rebecka, Sinai, Irit, Sinha, Ragini, Jennings, Victoria
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 21.10.2014; BioMed Central
• Subjects: Adolescent; Adult; Analysis; Birth control; Contraception - psychology; Contraception - utilization; Contraception Behavior; Decision Making; Educational Status; Family planning; Family Planning Services - organization & administration; Female; Health Services Needs and Demand; Humans; India; Information management; Marketing research; Middle Aged; Needs Assessment; Power (Psychology); Psychological aspects; Reproductive health; Rural Health; Socioeconomic Factors; Women's rights; Womens health; Young Adult; India; Washington DC; United States > US
• ISSN: 1742-4755; 1742-4755
• DOI: 10.1186/1742-4755-11-74

Virtually all the evidence on the relationship between women's empowerment and use of contraception comes from cross-sectional studies that have emphasized macrosocial factors.This analysis tested whether literate and illiterate women are empowered by an intervention designed to provide information addressing technical and gender concerns and expand contraceptive choice, and evaluated the effects of women's decision-making power on contraceptive behavior. The data came from a three-year quasi-experiment conducted in two comparable, yet not equivalent, rural blocks in Jharkhand, India. At the intervention block, a new contraceptive method was introduced at Ministry of Health health centers, providers were trained to offer family planning information and services which took into consideration gender power dynamics, and promotional messages and information about contraception were disseminated community-wide. Married women ages 15-49 who lived in the intervention and control blocks were sampled and interviewed before and after the intervention by a professional research firm. Data analyses included generalized linear models with interactions and covariate control. Women's normative beliefs concerning wives' power in decisions regarding money earned and visits to relatives and friends vis-à-vis their husbands' power were increased by the intervention; similar was the case among illiterate, but not literate, women regarding decisions related to childbearing. Concerning met need for contraception, the change for women with relatively more power who were illiterate was greater in the intervention than in the control area. The findings suggest that women were empowered by outreach visits that addressed gender dynamics and that their empowerment contributed to their met need for contraception. Generalizations to other settings, however, may be limited by cultural differences.