Predictive factors of women's empowerment in reproductive autonomy of married women at Banshkhali Subdistrict in South East Coastal region of rural Bangladesh

Abstract

Despite the recent development of women's status in Bangladesh, the reproductive autonomy is almost a taboo in the patriarchal conservative Muslim society in rural areas. The reproductive health and reproductive right are deeply interweaved with different dimensions of women's empowerment. This cross-sectional analytic study based on multistage simple random sampling was conducted in Banshkhali Sub district in Bangladesh between August 2017 and July 2018. A structured questionnaire was administered to 422 married women of reproductive age to examine the level and predictive factors of reproductive autonomy and women's empowerment and association between women's empowerment and reproductive autonomy. The results revealed that more than half of the respondents (54%) have low level of reproductive autonomy and age group >30 years (AOR:0.477; 95%CI:0.271- 0.838), education (AOR:1.811; 95%CI:1.073-3.057), paid occupation (AOR:3.305; 95% CI:1.783-6.126), exposure to social media (AOR:2.331, 95% CI: 1.087-5.000) and spousal communication (AOR:1.887; 95%CI=1.058-3.367) are the predictive factors of reproductive autonomy. In women's empowerment scale, around two thirds (68.5%) of respondents have low decision-making autonomy, low mobility (63.7%), low resource control (63.0%) but only in one indicator, most of the respondents showed high score and that is self-esteem (52.8%). The predictors of women's empowerment show that different factors are responsible for different domain of women's empowerment. Paid occupation, social media exposure, spousal communication, and religious influence are the significant predictors for decision making. Occupation, spousal participation, accessibility to health care, family type and religious influence are the predictor for mobility in empowerment domain. For self-esteem, religious influence, exposure to TV, exposure to social media and cultural barrier are found to be the most significantly associated. In women's empowerment scale, out of 4 indicators three of them are strongly associated with reproductive autonomy. These are decision making (AOR:2.589; 95%CI=1.494-4.489), self-esteem (AOR:3.560; 95%CI=2.135-5.936) and mobility (AOR:1.824; 95%CI=1.165-2.855). The study suggests that improvement of the level of education, pulling women in workforce, mass media exposure and women centered policy can change their status and improve the reproductive health and health care utilization in the study area.