Women's autonomy in household decision-making and safer sex negotiation in sub-Saharan Africa: An analysis of data from 27 Demographic and Health Surveys

Abstract IntroductionGlobal commitment to stop HIV and ensure access to HIV treatment call for women empowering as these efforts play a major role in mother to child transmission. We explored the association between women decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Materials and methodsWe used data from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2016 in 30 countries within SSA. At the descriptive level, we calculated the prevalence of women who had undergone HIV testing and decision-making capacity in each of the countries as well as prevalence of HIV testing across their socio-demographic characteristics. We used Binary Logistic Regression to explore the likelihood of HIV testing by decision-making capacity and socio-demographic characteristics at 5% margin of error. The results were presented as Crude Odds Ratios (CORs) and Adjusted Odds Ratios (AORs). ResultsWe found that overall, 10.0% of women had decision-making with Nigeria (4.5%) and Zimbabwe (21.3%) recording the least and the highest respectively. In terms of HIV testing, the prevalence of HIV testing in the 30 SSA countries was 64.4%, with Guinea (12.8%) having the least. The highest occurred in Lesotho (99%) and Rwanda (99%). Women who had capacity to make decisions had higher likelihood of HIV testing [AOR=1.04, CI=1.02–1.09]. Women from Rwanda had the highest likelihood of HIV testing [AOR=53.92, CI=41.31–70.37] with women from Guinea having the least likelihood [AOR=0.10, CI=0.08–0.11]. Other determinants to HIV testing were level of education, wealth status, believing that a healthy-looking person can have HIV, watching television almost every day, age and place of residence.Conclusion SSA countries intending to improve HIV testing need to incorporate women decision-making capacity strategies in terms of education and counselling into the available policies. This is essential because our study indicates that as women are able to make decisions in their households, the possibility for them to test for their HIV status increases.

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Dynamics of Women’s Autonomy in Household Decision-Making in Ghana

Journal of Comparative Family Studies ◽

10.3138/jcfs.50.4.002 ◽

2019 ◽

Vol 50 (4) ◽

pp. 293-312

Author(s):

Kamil Fuseini ◽

Ishmael Kalule-Sabiti ◽

Charles Lwanga

Keyword(s):

Decision Making ◽

Women’S Autonomy ◽

Women's Autonomy ◽

Household Decision ◽

Household Decision Making

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Women’s reproductive health decision-making: A multi-country analysis of demographic and health surveys in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0209985 ◽

2019 ◽

Vol 14 (1) ◽

pp. e0209985 ◽

Cited By ~ 12

Author(s):

Eugene Kofuor Maafo Darteh ◽

Kwamena Sekyi Dickson ◽

David Teye Doku

Keyword(s):

Decision Making ◽

Reproductive Health ◽

Health Surveys ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Health Decision Making ◽

Health Decision ◽

Country Analysis ◽

Sub Saharan ◽

Women’S Reproductive Health

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Lineage and Women’s Autonomy in Household Decision-making in Ghana

Journal of Human Ecology ◽

10.1080/09709274.2016.11906953 ◽

2016 ◽

Vol 53 (1) ◽

pp. 29-38 ◽

Cited By ~ 1

Author(s):

Kamil Fuseini ◽

Ishmael Kalule-Sabiti

Keyword(s):

Decision Making ◽

Women’S Autonomy ◽

Women's Autonomy ◽

Household Decision ◽

Household Decision Making

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Factors Affecting Women’s Autonomy in Household Decision-Making among Married Women in Zambia

Journal of Scientific Research and Reports ◽

10.9734/jsrr/2020/v26i430252 ◽

2020 ◽

pp. 109-123

Author(s):

Kusanthan Thankian

Keyword(s):

Decision Making ◽

Urban Areas ◽

Secondary Data ◽

Married Women ◽

Wife Beating ◽

Women’S Autonomy ◽

Her Family ◽

Women's Autonomy ◽

Household Decision ◽

Household Decision Making

The main aim of the study was to examine factors that affect women’s household decision-making among married women in Zambia. This paper utilizes secondary data from the 2013 Zambia Demographic Health Survey (ZDHS). Logistic regression analysis was used to identify various factors associated with factors that affect women’s autonomy in household decision-making among married women in Zambia. The findings of the study show that married women in Zambia are more likely to participate in decision-making that involved purchases of daily household needs (86%) followed by decision making that involved visits to her family or relatives (75%) and decisions about her own health care (74%). About 66per cent of the respondents reported having participated in household major purposes. Some socio-demographic variables only influenced women in some domains and not all. For instance, age only influenced decision-making on household goods and visits to family. Rich wealthy status, living in urban areas, higher levels of education and justification of wife-beating were influential to healthcare decision-making among women. Zambian programmes and policy initiatives should develop a clear policy foundation that should be crucial to empower women to take part in decision-making processes in the household. Moreover, enhancing their access to and control over economic resources and enabling them to establish and realise their rights are also essential means to empower women to be more autonomous in decision-making.

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Moderating Effect of Husband’s Controlling Attitudes on the Relation Between Women’s Household Decision-Making Autonomy and Intimate Partner Violence Experience in Nigeria

Journal of Interpersonal Violence ◽

10.1177/0886260519888534 ◽

2019 ◽

pp. 088626051988853

Author(s):

Adegbenga M. Sunmola ◽

Mohammed N. Sambo ◽

Olusegun A. Mayungbo ◽

Luqman A. Morakinyo

Keyword(s):

Decision Making ◽

Intimate Partner Violence ◽

Partner Violence ◽

Intimate Partner ◽

Cross Sectional ◽

Women’S Autonomy ◽

Women's Autonomy ◽

Household Decision ◽

Household Decision Making ◽

Nationally Representative

Existing studies show a consensus on the importance of women’s household decision-making autonomy. However, the studies also show mixed findings of the association between the variable and intimate partner violence (IPV). In this study, moderating effects of husband’s controlling and domineering attitudes on the association between women’s household decision-making autonomy and husband-perpetrated physical, sexual, and emotional violence were investigated. Data used in the study were drawn from an existing database of a 2013 cross-sectional Demographic and Health Survey (DHS) of nationally representative sample ( N = 19,360) of Nigerian married women. Participants were interviewed on measures of women’s autonomy, husband’s attitudes, and husband-perpetrated violence. Results revealed that women who exercised high household decision-making autonomy significantly experienced more physical ( b = .31, t = 11.78, p < .001), sexual ( b = .05, t = 3.59, p < .01), and emotional ( b = .17, t = 9.76, p < .001) violence if they reported relationship with husbands who endorsed high controlling and domineering attitudes. The results represent an extension over existing research and have implications on how husband’s attitudes could improve women’s autonomy and reduce their IPV experience in various intervention settings.

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Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

10.21203/rs.2.22504/v3 ◽

2020 ◽

Author(s):

Abdul-Aziz Seidu ◽

Joseph Kojo Oduro ◽

Bright Opoku Ahinkorah ◽

Eugene Budu ◽

Francis Appiah ◽

...

Keyword(s):

Decision Making ◽

Hiv Testing ◽

Health Surveys ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Healthcare Decision ◽

Healthcare Decision Making ◽

Decision Making Capacity ◽

Sub Saharan ◽

Ssa Countries

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment, as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios (AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV, compared to those whose healthcare decisions were taken by others, and this persisted after controlling for significant covariates: [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728] respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

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Women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa: a multi-country analysis of demographic and health surveys

10.21203/rs.2.22504/v2 ◽

2020 ◽

Author(s):

Abdul-Aziz Seidu ◽

Joseph Kojo Oduro ◽

Bright Opoku Ahinkorah ◽

Eugene Budu ◽

Francis Appiah ◽

...

Keyword(s):

Decision Making ◽

Hiv Testing ◽

Health Surveys ◽

Sub Saharan Africa ◽

Demographic And Health Surveys ◽

Healthcare Decision ◽

Healthcare Decision Making ◽

Decision Making Capacity ◽

Sub Saharan ◽

Ssa Countries

Abstract Background Global commitment to stop Human Immunodeficiency Virus (HIV) and ensure access to HIV treatment calls for women empowerment as these efforts play major roles in mother-to-child transmission. We explored the association between women’s healthcare decision-making capacity and HIV testing in sub-Saharan Africa (SSA). Methods We used data from the current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 28 countries in SSA. At the descriptive level, we calculated the prevalence of HIV testing in each of the countries. This was followed by the distribution of HIV testing across the socio-demographic characteristics of women. Finally, we used binary logistic regression to explore the likelihood of HIV testing by women’s health care decision-making capacity and socio-demographic characteristics. The results were presented as Crude Odds Ratios (COR) and Adjusted Odds Ratios(AOR) with their corresponding 95% confidence intervals signifying precision. Statistical significance was set at p-value <0.05. Results We found that prevalence of HIV testing in the 28 SSA countries was 64.4%, with Congo DR having the least (20.2%) and the highest occurred in Rwanda (97.4%). Women who took healthcare-decisions alone [COR=3.183, CI=2.880-3.519] or with their partners [COR=2.577, CI=2.335-2.844] were more likely to test for HIV compared to those whose healthcare-decisions were taken by others and this persisted after controlling for significant covariates [AOR=1.507, CI=1.321-1.720] and [AOR=1.518, CI=1.334-1.728], respectively. Conclusion SSA countries intending to improve HIV testing need to incorporate women’s healthcare decision-making capacity strategies. These strategies can include education and counselling. This is essential because our study indicates that the capacity of women to make healthcare decisions has an association with their decision to test for their HIV status.

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