Observational studyBMC women's health2025
Education, economic autonomy and digitalization as factors associated with married women's ability to make sexual and reproductive health decisions in sub-Saharan Africa: a multi-level analysis of 16 countries.
Observational study in BMC women's health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Cleanliness Grades as Clinical Indicators of Vaginal Infection Burden in Women from Northern Madagascar: A Cross-Sectional Study.Journal of clinical medicine · 2026Article
- Prevalence and determinants of ability to refuse sex among women of reproductive age in Tanzania: evidence from national representative surveys.BMC women's health · 2026Article
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Authors and funding
2 authors.
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Abstract
backgroundDespite progress in various aspects of women's rights and health, a significant gap persists in the area of reproductive health decisions among women in Sub-Saharan Africa. This study seeks to address this gap by investigating the interplay between educational access, economic autonomy, and digital systems on the sexual and reproductive health (SRH) outcomes of married women in the Sub-Saharan African context.
methodsLeveraging cross-sectional data obtained from the latest demographic and health surveys conducted across 16 Sub-Saharan African nations between January 2015 and December 2021, the study's focus centred on 67,437 married women. Through the utilization of binary logistic regression, model-adjusted odds ratios accompanied by a 95% confidence interval were calculated.
resultsCompared to their counterparts in Benin, married women in Madagascar (aOR = 4.95, 95% CI = 4.29-5.71) and Uganda (aOR = 3.42, 95% CI = 2.99-3.90) exhibited the highest levels of agency in making SRH decisions among the 16 countries studied. Factors like higher education (aOR = 2.37, 95% CI = 2.13-2.64), familiarity with modern contraception (aOR = 3.19, 95% CI = 1.99-5.13), utilization of mobile phones for financial transactions (aOR = 1.21, 95% CI = 1.14-1.28), possession of a bank account (aOR = 1.17, 95% CI = 1.10-1.25), current employment (aOR = 1.19, 95% CI = 1.08-1.32), and engagement with the internet (aOR = 1.16, 95% CI = 1.08-1.24) were found to significantly influence SRH decisions-making across all countries.
conclusionsEnhancing the sexual and reproductive health outcomes of married women in Sub-Saharan Africa necessitates targeted efforts, particularly among those without higher education, limited contraceptive knowledge, reliance on mobile phones for financial transactions, without bank accounts, lacking internet access, and currently unemployed. By addressing these specific areas, interventions can be more effective in bridging the existing gaps in SRH decision-making among married women in this region.
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