Women's Empowerment and Family Planning Utilization

The International Conference on Population and Development Programme of Action in 1994 and the Beijing Conference in 1999 stressed the empowerment of women enhances their decision making capacity at all levels in all spheres of life, which helps for sustainable development and the realization of human rights for all (United Nations, 2008). Women's empowerment fundamentally about the enhancement of capabilities, the freedom to act independently, and the ability to formulate strategic life choices (Eyben et al., 2008; Jejeebhoy, 2000; Kabeer, 2001; Malhotra et al., 2002; Sen & Batliwala, 2000; World Bank, 2006).

The importance of women’s empowerment has recently emerged as a key factor in influencing family planning utilization in developing countries (Abada & Tenkorang, 2012; El-Zeini, 2008; Lee-Rife, 2010; Upadhyay & Karasek, 2012). The direct measures of women’s empowerment are access to and control over resources, participation of economic decisions, power in reproductive behaviour, self-esteem, mobility, relative weight of women’s opinion in couples, and perceived risk and frequency of domestic violence (Agarwala & Lynch, 2006; Kishor & Subaiya, 2008; Mason & Smith, 2000; Tfaily, 2004). However, women's education and employment are used as proxy measures of women's empowerment (Beegle et al., 2001; Hindin, 2000; Kishor, 2005; Upadhyay & Karasek, 2010).

Although these and other socioeconomic proxy indicators are important, it has been suggested they may not capture all aspects of empowerment and also may understate issues related to power, conflict, and negotiation within the household (Basu & Koolwal, 2005; Dharmalingam & Morgan, 1996; Jeffery R. & Jeffery P., 1997; Jejeebhoy & Sathar, 2011; Malhotra et al., 1995). Furthermore, the study of reproductive behaviour and health outcomes should use direct measures that reflect the degree of control in women’s lives and the way in which reproductive behaviour are governed (Bloom et al., 2001; Desai & Johnson, 2005; Feldman et al., 2009; Ghuman, 2004; Jejeebhoy, 1995). Despite many decades effort, sub-Saharan African countries have the lowest contraceptive prevalence, 35% in 2015. However, modern contraceptive prevalence rate in Ethiopia is the lowest in the region, 35% in 2015 (Population Reference Bureau, 2015).

In societies where gender stratification commonly observed, decisions on contraceptive use and limiting fertility depend on the husband or partner (Bawah, 2002; Mason & Smith, 2000). Women in developing countries are completely rely on their partner’s decision on issues that affect their contraceptive use (Bongaarts et al., 2012; Sedgh et al., 2014; United Nations, 2012; World Health Organization, 2015). However, it has not been set as a prerequisite for widespread adoption of contraceptives (Blanc, 2001; Dodoo & Landewijk, 2006; Mai & Kurimoto, 2012). In addition, it is still unclear which aspects of female empowerment affect contraceptive use and to what degree (Bloom et al., 2001; Furuta & Salway, 2006).

In developing countries, women still have limited decision making power, less access to resources, and faced with health services that are insensitive to their needs (Liljestrand & Gryboski, 2001; Shelah et al., 2011). In 2015, only 2 in 10 women participated in all four types of decisions (own healthcare, big purchase, daily purchase and visiting families) in developing countries (Population Reference Bureau, 2015). However, Ethiopia with the lowest women’s decision making power in the world and remains constant during the last decade, own healthcare (14% in 2005 and 15% in 2016), making major household purchases (12% in 2005 and 11% in 2016), and visits to families/relatives (10% in 2005 and 18% in 2016). In addition, in 2016 38% of ever-married women reported their husbands/partners are jealous/angry if they talk with other men, 33% insist on knowing where they are at all times, 16% limit their contact with their families, 15% not permit them to meet their female friends, and 13% frequently accuse them of being unfaithful.

Overall, 16% of ever-married women reported their husbands/partners display three or more of the specified behaviours (Central Statistical Agency & ORC Macro International, 2006; Central Statistical Agency & ICF International, 2016).