Women’s Empowerment and Contraceptive Method Use in Egypt
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Egypt’s fertility rate reached a 25-year high of 3.5 births per woman in 2014. Women’s use of long-acting reversible contraceptive (LARC) methods such as intrauterine devices (IUDs)—which are associated with fewer unplanned pregnancies and declines in fertility rates compared to short-acting methods like oral contraceptive pills—increased steadily between 1984 and 2000. However, the Ministry of Health and Population has observed a shift from IUDs to oral contraceptive pills in public health clinics since 2011. Globally, it is assumed that women’s empowerment plays an important role in women’s choice of a specific contraceptive method. Women’s empowerment is the process through which women acquire resources that may enhance women’s agency, such as education, or increase their ability to define their life choices. However, no study has explored the relationship between women’s empowerment and women’s choices between short-acting methods such as the oral contraceptive pill and long-acting reversible methods such as the IUD. Using data from the 2005, 2008 and 2014 nationally representative Egyptian Demographic and Health Surveys, this research brief reports on a study that examines patterns of contraceptive choices over time in Egypt and uses indicators of women’s agency to explore how women’s empowerment is associated with the choice of contraceptive methods. Women’s agency is measured as high levels of household decision-making and low tolerance of intimate partner violence. The analysis focuses on two groups: 1) 47,545 married women across the three surveys in their childbearing years who, because neither the woman nor her husband are sterilized, could become pregnant, and 2) 43,031 women who make at least one household decision. The second group excludes women who did not make any decisions, allowing for exploration of the differences in contraceptive method choice among decision-makers.