Association between women's empowerment and modern contraception uptake in Bangladesh: Evidence from Bangladesh Demographic and Health survey

Abstract Background While women's empowerment is recognized as a significant factor influencing maternal and child health outcomes, there is insufficient evidence regarding its link with the utilization of modern contraceptive methods in Bangladesh. This study aims to investigate the association between women's empowerment and the uptake of modern contraceptives among reproductive-aged women in Bangladesh. Methods Data of 17,780 married reproductive-aged women were analyzed from the 2017/18 Bangladesh Demographic and Health Survey. The outcome variable considered was the uptake of modern contraceptive methods (yes, no). Women’s empowerment (not empowered, moderately empowered, highly empowered) was considered the major explanatory variable. The variable was generated based on women’s responses to three key areas: access to healthcare, significant household purchases, and visits to family or relatives. A multilevel mixed-effect logistic regression model was used to assess the association between the outcome and explanatory variables, adjusted for covariates. Results The reported prevalence of modern contraceptive method use was 55.3%, and 51.6% among all women and women who were not empowered, respectively. Women classified as not empowered had a 13% (aOR 0.87, 95% CI: 0.79–0.97) reduced odds of using modern contraceptive methods compared to those who were highly empowered. Women who made joint decisions with their husbands on individual dimensions of empowerment consistently showed a higher likelihood of using modern contraceptive methods. Conclusion The findings of this study emphasize the significance of collaborative decision-making to enhance the uptake of modern contraception. Family planning policies and programs should prioritize addressing this issue.