J Biosoc Sci. 2017 Jul;49(4):423-434. doi: 10.1017/S0021932016000377. Epub 2016 Aug 11.


Gender inequality is often cited as a barrier to improving women's sexual and reproductive health outcomes, including contraceptive use, in low- and middle-income countries such as those in sub-Saharan Africa. To date there is limited, recent, evidence available regarding women's empowerment, household status and contraceptive use in Ghana. The objective of this study was to investigate whether women's empowerment and status in the household were associated with contraceptive use and unmet need for contraception using the 2014 Ghana Demographic and Health Survey. The study sample consisted of 1828 women aged 15-49. Women's empowerment was measured based on two composite indexes created by the DHS: attitudes towards intimate partner violence and decision-making. Women's status in the home was measured using indicators of work status, relationship to household head, control over monetary earnings and land ownership. Decision-making was found to be positively associated with contraceptive use and not having unmet need for contraception. Women who justified wife beating in one or more instances were less likely to use contraception, and more likely to have unmet need for contraception. Current or past employment and higher levels of male partner education were associated with contraceptive use. This study indicates that women's empowerment and household status are influential for contraceptive indicators. Future interventions aimed at improving contraceptive uptake and use should promote women's empowerment, i.e. decision-making, self-worth and education.

MeSH terms

  • Adolescent
  • Adult
  • Contraception Behavior / psychology
  • Contraception Behavior / statistics & numerical data*
  • Developing Countries*
  • Family Characteristics*
  • Ghana
  • Humans
  • Middle Aged
  • Ownership
  • Power, Psychological*
  • Risk Factors
  • Socioeconomic Factors*
  • Spouse Abuse / psychology
  • Spouse Abuse / statistics & numerical data
  • Statistics as Topic
  • Women's Rights / statistics & numerical data*
  • Young Adult