Abstract
BACKGROUND: The relationship between women's empowerment and modern contraception utilization is well documented; however, they focused on all reproductive-aged women and lacked dimensions of empowerment. Research focusing only on women who have no desire for more children is scarce. Understanding the use of modern contraceptives and their relationship to women's empowerment in this demographic is critical for reducing unwanted pregnancies, abortions, and fertility rates. OBJECTIVE: This study aimed to investigate the relationship between women's empowerment and the use of modern contraception among South Asian women who have no desire to have more children. DESIGN: A cross-sectional study design utilizing Demographic and Health Survey data from 2015 to 2022 across five South Asian countries was employed. METHODS: This investigation examined aggregated data from 42,573 currently married, fecund, non-sterilized, non-pregnant South Asian (Afghanistan, Bangladesh, India, Nepal, and Pakistan) women aged 15-49 who had no desire for additional children. The survey-based women's empowerment composite index was employed to assess empowerment. A multilevel mixed-effects logistic regression analysis was utilized to explore the relationship of interest. RESULTS: The prevalence of modern contraception usage among South Asian women without a desire for more children stands at 45.8%, with Pakistan exhibiting the lowest rate at 31.8% and Bangladesh the highest at 67.8%. In South Asia, high empowerment among women regarding attitudes toward violence (adjusted odds ratio: 1.17; 95% confidence interval: 1.08-1.25), social independence (adjusted odds ratio: 1.22; 95% confidence interval: 1.13-1.33), and decision-making (adjusted odds ratio: 1.11; 95% confidence interval: 1.01-1.23) is associated with a greater likelihood to utilize modern contraception compared to their less empowered counterparts. A comparable pattern of correlation appeared in specific countries, with few exceptions. CONCLUSIONS: The degree of women's empowerment shows a positive correlation with the use of modern contraception in patriarchal and conservative South Asian contexts, a circumstance, that is, pertinent in developing nations with various cultures. Family planning initiatives in South Asia should focus on integrating women's empowerment.