Women's empowerment and remaining within ideal family size in the East African Community.

backgroundOne in every 27 people worldwide belongs to the East African Community, a region with shared cultural traits and free movement. Despite recent declines, the fertility rates in this Community remain high. This study assesses the link between women's empowerment and remaining within the woman's ideal family size, considering the women's perceptions of their husbands' desired family size.

methodsThis study used Demographic and Health Survey datasets of Burundi (2015-2016), The Democratic Republic of the Congo (2013-2014), Kenya (2022), Rwanda (2019), Tanzania (2022), and Uganda (2016). A total of 5855 married or cohabiting women aged 35-49 who perceive that their husband wants more children than they do were included in this study. IBM SPSS Statistics 24 (SPSS: Statistical Package for the Social Sciences) was employed for data analysis. The Survey-based Women's empowerment (SWPER) index, across its three domains (attitude toward violence, social independence, and decision-making) was adopted to evaluate empowerment levels. Binary logistic regression was implemented to examine the association between the domains and the outcome variable, which indicates whether a woman has remained within her ideal number of children. Additionally, the link between potential confounders and the outcome variable was assessed. Univariable and multivariable models including country fixed effects were estimated. Sensitivity analyses excluded women below their ideal number. Variables showing p-values < 0.05 were considered statistically significant.

resultsOverall, 63.3% of women were within their stated ideal number. Most women had medium levels of empowerment across all the index domains. Empowerment in the domains of social independence and decision-making was significantly associated with remaining within the woman's goal (Adjusted Odds Ratios: 1.41 (95% CI 1.28-1.56) and 0.80 (95% CI 0.72-0.89), respectively). From control variables, woman's age, household size, and ability to read a sentence showed significant association with the outcome. Only social independence was positively linked to the outcome. Attitude toward violence showed no significant association with the dependent variable in the univariable model.

conclusionsIn settings where gender power imbalances may persist, strengthening women's autonomy and their reproductive health agency with a focus on factors that promote social independence empowerment is needed in the East African Community.