Association Between Women’s Empowerment and Unmet Family Planning Needs in Low- and Middle-Income Countries in Southeast Asia: A Cross-Sectional Study

Abstract

This study examined the associations between women’s empowerment and unmet family planning needs in five low- and middle- income countries in Southeast Asia using demographic and health survey data. The sample of ever-married women aged 15 to 49 years across five Southeast Asian countries (Cambodia [n = 10,231], Indonesia [n = 30,965], Myanmar [n = 6,644], the Philippines [n = 13,512], and Timor-Leste [n = 5,750]) were included in this study. We conducted a multiple logistic regression to analyze the associations between the four women’s empowerment indicators and unmet needs. The findings showed positive associations between women’s medium level of agreement to wife-beating, women’s decision-making, level of knowledge, and unmet needs. Both negative and positive associations were reported for labor force participation and unmet needs. Finally, improving women’s decision-making and workplace conditions and encouraging women’s labor force participation can reduce unmet needs for family planning.

Keywords:

• Empowerment
• unmet need
• family planning
• contraception
• Southeast Asia

Acknowledgements

The authors express gratitude to USAID, the DHS program for providing the access to data, and the MEXT scholarship program.

Ethics approval

As this is a secondary data analysis of DHS data, the standard survey procedures and questionnaires of DHS were reviewed and approved by the ICF Institutional Review Board (IRB). Country-specific survey protocols were also reviewed by the IRB of the host country to ensure that they follow the laws and norms of the specific country. The ICF IRB ensured that survey procedures followed informed and voluntary participation as well as protection of participants’ confidentiality and anonymity. Further information can be obtained from the DHS program website listed in the reference (The DHS Program, 2020). A study protocol was registered at the DHS program website for the permission to download the datasets (supplementary document).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are publicly available from the DHS Program. The sources of data are as follows:

Cambodia: https://www.dhsprogram.com/methodology/survey/survey-display-464.cfm

Indonesia: https://www.dhsprogram.com/methodology/survey/survey-display-522.cfm

Myanmar: https://www.dhsprogram.com/methodology/survey/survey-display-454.cfm

The Philippines: https://www.dhsprogram.com/methodology/survey/survey-display-510.cfm

Timor-Leste: https://www.dhsprogram.com/methodology/survey/survey-display-514.cfm