Association between women's empowerment and use of modern contraception methods in Bangladesh: evidence from Bangladesh demographic and health survey 2022.

Background: While women's empowerment is widely recognized as a significant factor influencing the use of modern contraception, most studies focus primarily on women's decision-making autonomy as a measure of empowerment, often overlooking other dimensions such as social independence. This study aims to explore the association between multiple dimensions of women's empowerment and the use of modern contraceptives among reproductive-aged women in Bangladesh.

Methods: Data of 17,848 currently married reproductive-aged women were analyzed from the 2022 Bangladesh Demographic and Health Survey. The outcome variable considered was the use of modern contraceptive methods (yes, no). The survey-based women's emPowERment index (SWPER) was considered as main explanatory variable. The index encompasses three domains: (i) attitude to violence, (ii) social independence, and (ii) decision-making. These domains were classified as low, medium, and high empowerment. Multilevel mixed-effect logistic regression model was used to assess the association between SWPER index and use of modern contraception methods adjusted for confounding factors.

Results: The prevalence of modern contraceptive method use was 58.3% (95% CI: 57.3-59.4). Women with higher empowerment in the attitude toward violence and decision-making domains had slightly higher prevalence rates of 58.5% (95% CI: 57.4-59.6) and 58.9% (95% CI: 57.7-60.2), respectively. Conversely, among women with high empowerment in the social independence domain, the prevalence of modern contraceptive use was lower at 52.5% (95% CI: 50.3-54.6). While no significant associations were observed in the attitude toward violence and decision-making domains, women with high empowerment in these areas had 1.14 times (95% CI: 0.97-1.34) and 1.05 times (95% CI: 0.95-1.15) higher odds of using modern contraception, respectively, compared to those with low empowerment. In contrast, women with high empowerment in the social independence domain had 14% lower odds of using modern contraception (aOR: 0.86; 95% CI: 0.79-0.95) compared to their counterparts.

Conclusion: These findings suggest that different dimensions of women's empowerment may have varying influences on contraceptive use, highlighting the need for targeted interventions to improve reproductive health outcomes.