Skip to main content

Advertisement

SpringerLink
Log in

Women’s Sexual Autonomy and Short Birth Interval in Sub-Saharan Africa: A Multilevel Analysis of Demographic and Health Survey Data

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Sexual autonomy is an inalienable human right to protect and maintain an informed decision over one’s body, sexuality, and sexual experience. With the increased attention to women’s empowerment and gender equality all over the world, it is surprising that previous research has overlooked the relationship between women’s sexual autonomy and short birth intervals. This study examined the association between women’s sexual autonomy and short birth intervals in sub-Saharan Africa (SSA). Data were sourced from the Demographic and Health Surveys of 29 sub-Saharan African countries conducted from 2010 to 2019. A total of 222,940 women were included in this study. Multilevel logistic regression analysis was conducted to examine the association between sexual autonomy and short birth interval. The results were presented as adjusted odds ratios (aOR) and significance level was set at p < .05. The overall proportions of sexual autonomy and short birth interval among women in SSA were 75.1% and 13.3%, respectively. Women who reported having sexual autonomy had lower odds of short birth interval [aOR = 0.94; CI = 0.91, 0.96]. The likelihood of short birth interval among women increased with increasing maternal and partner’s age but reduced with increasing level of education and wealth index. Given that short birth intervals could have negative maternal and child health outcomes, public health authorities in sub-Saharan African countries should endeavor to promote health interventions and social programs to empower women with low sexual autonomy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Adu, C., Mohammed, A., Budu, E., Frimpong, J. B., Tetteh, J. K., Ahinkorah, B. O., & Seidu, A. A. (2022). Sexual autonomy and self-reported sexually transmitted infections among women in sexual unions. Archives of Public Health, 80(1). https://doi.org/10.1186/s13690-022-00796-4

  • Ajayi, A. I., & Somefun, O. D. (2020). Patterns and determinants of short and long birth intervals among women in selected sub-Saharan African countries. Medicine, 99(19), e20118. https://doi.org/10.1097/MD.0000000000020118

    Article  PubMed  PubMed Central  Google Scholar 

  • Amadu, I., Seidu, A. A., Duku, E., Okyere, J., Hagan, J. E., Hormenu, T., & Ahinkorah, B. O. (2021). The joint effect of maternal marital status and type of household cooking fuel on child nutritional status in sub-Saharan Africa: Analysis of cross-sectional surveys on children from 31 countries. Nutrients, 13(5), 1541. https://doi.org/10.3390/nu13051541

    Article  PubMed  PubMed Central  Google Scholar 

  • Arthur, E., & Oaikhenan, H. E. (2017). The effects of health expenditure on health outcomes in sub-Saharan Africa (SSA). African Development Review, 29(3), 524–536.

    Article  Google Scholar 

  • Aychiluhm, S. B., Tadesse, A. W., Mare, K. U., Abdu, M., & Ketema, A. (2020). A multilevel analysis of short birth interval and its determinants among reproductive age women in developing regions of Ethiopia. PLoS ONE, 15(8), e0237602. https://doi.org/10.1371/journal.pone.0237602

    Article  PubMed  PubMed Central  Google Scholar 

  • Begna, Z., Assegid, S., Kassahun, W., & Gerbaba, M. (2013). Determinants of inter birth interval among married women living in rural pastoral communities of southern Ethiopia: A case control study. BMC Pregnancy and Childbirth, 13(1). https://doi.org/10.1186/1471-2393-13-116

    Article  Google Scholar 

  • Becker, H. (2019). Women in Namibia. In Oxford research encyclopedia of African history. https://doi.org/10.1093/acrefore/9780190277734.013.525

  • Budu, E., Ahinkorah, B. O., Seidu, A. A., Hagan, J. E., Agbemavi, W., Frimpong, J. B., Adu, C., Dickson, K. S., & Yaya, S. (2021). Child marriage and sexual autonomy among women in sub-Saharan Africa: Evidence from 31 demographic and health surveys. International Journal of Environmental Research and Public Health, 18(7), 3754. https://doi.org/10.3390/ijerph18073754

    Article  PubMed  PubMed Central  Google Scholar 

  • Conde-Agudelo, A., Rosas-Bermudez, A., Castaño, F., & Norton, M. H. (2012). Effects of birth spacing on maternal, perinatal, infant, and child health: A systematic review of causal mechanisms. Studies in Family Planning, 43(2), 93–114.

    Article  PubMed  Google Scholar 

  • Corsi, D. J., Neuman, M., Finlay, J. E., & Subramanian, S. V. (2012). Demographic and health surveys: A profile. International Journal of Epidemiology, 41(6), 1602–1613.

    Article  PubMed  Google Scholar 

  • De Jonge, H. C., Azad, K., Seward, N., Kuddus, A., Shaha, S., Beard, J., Costello, A., Houweling, T. A. J., & Fottrell, E. (2014). Determinants and consequences of short birth interval in rural Bangladesh: A cross-sectional study. BMC Pregnancy and Childbirth, 14(1). https://doi.org/10.1186/s12884-014-0427-6

  • Edwards, L. (2005). Women’s control over their sexual lives: Most women in Namibia are not free to make their own decisions about their sexual and reproductive lives. Sister Namibia, 17(3), 12–14.

    Google Scholar 

  • Ejigu, A. G., Yismaw, A. E., & Limenih, M. A. (2019). The effect of sex of last child on short birth interval practice: The case of northern Ethiopian pregnant women. BMC Research Notes, 12(1). https://doi.org/10.1186/s13104-019-4110-x

  • Gebrehiwot, S. W., Abera, G., Tesfay, K., & Tilahun, W. (2019). Short birth interval and associated factors among women of child bearing age in Northern Ethiopia, 2016. BMC Women’s Health, 19(1). https://doi.org/10.1186/s12905-019-0776-4

  • Hailu, D., & Gulte, T. (2016). Determinants of short interbirth interval among reproductive age mothers in Arba Minch district Ethiopia. International Journal of Reproductive Medicine, 2016, 17. https://doi.org/10.1155/2016/6072437

    Article  Google Scholar 

  • Jatrana, S., & Pasupuleti, S. S. R. (2013). Women’s autonomy, education and birth intervals: Visiting the less familiar. Paper presented at the XXVII International Population Conference, Busan, Republic of Korea. Retrieved from https://iussp.org/sites/default/files/event_call_for_papers/Autonomy-IUSSP-16-8-2013_0.pdf.

  • Jatrana, S., & Pasupuleti, S. S. R. (2015). Women’s autonomy, education and birth intervals in India: Visiting the less familiar. Asian Population Studies, 11(2), 172–190.

    Article  Google Scholar 

  • Kozuki, N., & Walker, N. (2013). Exploring the association between short/long preceding birth intervals and child mortality: Using reference birth interval children of the same mother as comparison. BMC Public Health, 13(3). https://doi.org/10.1186/1471-2458-13-S3-S6

  • Memiah, P., Opanga, Y., Bond, T., Cook, C., Mwangi, M., Fried, J., Joseph, M. A., Owuor, K., Mochache, V., & Machira, Y. W. (2019). Is sexual autonomy a protective factor for neonatal, child, and infant mortality? A multi-country analysis. PLoS ONE, 14(2), e0212413. https://doi.org/10.1371/journal.pone.0212413

    Article  PubMed  PubMed Central  Google Scholar 

  • Moyo, F. L. (2004). Religion, spirituality and being a woman in Africa: Gender construction within the African religio-cultural experiences. Agenda, 18(61), 72–78.

    Google Scholar 

  • Mutowo, J., Kasu, C. M., & Mufunda, E. (2014). Women empowerment and practices regarding use of dual protection among family planning clients in urban Zimbabwe. Pan African Medical Journal, 17, 300. https://doi.org/10.11604/pamj.2014.17.300.3282

    Article  PubMed  PubMed Central  Google Scholar 

  • Petroni, S., Steinhaus, M., Fenn, N. S., Stoebenau, K., & Gregowski, A. (2017). New findings on child marriage in sub-Saharan Africa. Annals of Global Health, 83(5–6), 781–790.

    Article  PubMed  Google Scholar 

  • Pimentel, J., Ansari, U., Omer, K., Gidado, Y., Baba, M. C., Andersson, N., & Cockcroft, A. (2020). Factors associated with short birth interval in low-and middle-income countries: A systematic review. BMC Pregnancy and Childbirth, 20(1). https://doi.org/10.1186/s12884-020-2852-z

    Article  Google Scholar 

  • Putra, I. G. N. E., Dendup, T., & Januraga, P. P. (2021). The roles of women empowerment on attitude for safer sex negotiation among Indonesian married women. Women & Health, 61(1), 95–108.

    Article  Google Scholar 

  • Raj, A., Jackson, E., & Dunham, S. (2018). Girl child marriage: A persistent global women’s health and human rights violation. In S. Choudhury, J. Erausquin, & M. Withers (Eds.), Global perspectives on women’s sexual and reproductive health across the lifecourse (pp. 3–19). Springer.

    Chapter  Google Scholar 

  • Rutstein, S. O. (2005). Effects of preceding birth intervals on neonatal, infant and under-five years mortality and nutritional status in developing countries: Evidence from the demographic and health surveys. International Journal of Gynecology & Obstetrics, 89, S7–S24.

    Article  Google Scholar 

  • Sano, Y., Sedziafa, A. P., Vercillo, S., Antabe, R., & Luginaah, I. (2018). Women’s household decision-making autonomy and safer sex negotiation in Nigeria: An analysis of the Nigeria Demographic and Health Survey. AIDS Care, 30(2), 240–245.

    Article  PubMed  Google Scholar 

  • Seidu, A. A., Aboagye, R. G., Okyere, J., Agbemavi, W., Akpeke, M., Budu, E., Saah, F. I., Tackie, V., & Ahinkorah, B. O. (2021). 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. SSM-Population Health, 14, 100773. https://doi.org/10.1016/j.ssmph.2021.100773

    Article  PubMed  PubMed Central  Google Scholar 

  • Shifti, D. M., Chojenta, C., Holliday, E. G., & Loxton, D. (2020). Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis. PLoS ONE, 15(1), e0227798. https://doi.org/10.1371/journal.pone.0227798

    Article  PubMed  PubMed Central  Google Scholar 

  • Tenkorang, E. Y. (2012). Negotiating safer sex among married women in Ghana. Archives of Sexual Behavior, 41(6), 1353–1362.

    Article  PubMed  Google Scholar 

  • Tenkorang, E. Y. (2018). Women’s autonomy and intimate partner violence in Ghana. International Perspectives on Sexual and Reproductive Health, 44(2), 51–61.

    Article  PubMed  Google Scholar 

  • Tsegaye, D., Shuremu, M., & Bidira, K. (2017). Practice of child spacing and its associated factors among women of child bearing age (15 to 49 years) in Illubabor zone, South West Ethiopia. International Journal of Nursing and Midwifery, 9(7), 102–108.

    Article  Google Scholar 

  • Upadhyay, U. D., & Hindin, M. J. (2005). Do higher status and more autonomous women have longer birth intervals?: Results from Cebu, Philippines. Social Science & Medicine, 60(11), 2641–2655.

    Article  Google Scholar 

  • Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gøtzsche, P. C., Vandenbroucke, J. P., & Initiative, S. (2014). The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495–1499.

    Article  Google Scholar 

  • World Health Organization. (2005). Report of a WHO technical consultation on birth spacing. Geneva: Switzerland. Available at: www.who.int/maternal_child_adolescent/.../birth_spacing05/en/.

Download references

Acknowledgements

The authors are grateful to MEASURE DHS for giving them access to the data for this study.

Funding

There is no funding for this study.

Author information

Authors and Affiliations

  1. Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana

    Joshua Okyere, Louis Kobina Dadzie & Abdul-Aziz Seidu

  2. Department of English and Communication, The Hong Kong Polytechnic University, Hung Hom, Hong Kong

    Ebenezer Agbaglo

  3. Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong

    Francis Arthur-Holmes

  4. Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana

    Richard Gyan Aboagye

  5. College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia

    Abdul-Aziz Seidu

  6. School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia

    Bright Opoku Ahinkorah

  7. REMS Consultancy Services, Sekondi-Takoradi, Western region, Ghana

    Bright Opoku Ahinkorah

Authors
  1. Joshua Okyere
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Louis Kobina Dadzie
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ebenezer Agbaglo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francis Arthur-Holmes
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Richard Gyan Aboagye
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Abdul-Aziz Seidu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bright Opoku Ahinkorah
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JO, LKD, EA, FHA, RGA, AS, and BOA contributed to conceptualization. JO, RAG, and BOA contributed to methodology. AS, LKD, RAG, and BOA contributed to software. AS, LKD, EA, FAH, RAG, and BOA contributed to data curation. LKD, RGA, AS, and BOA contributed to formal analysis. JO, LKD, EA, FHA, RGA, AS, and BOA contributed to writing—original draft preparation. JO, LKD, EA, FHA, RGA, AS, and BOA contributed to validation.JO, LKD, EA, FHA, RGA, AS, and BOA contributed to writing—reviewing and editing.

Corresponding author

Correspondence to Joshua Okyere.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

Ethical clearance for DHS reports is sought from the Ethics Committee of ORC Macro Inc. as well as Ethics Boards of partner institutions (e.g., Ministries of Health) of the respective studied countries. The survey followed strict ethical standards and protocols by protecting the privacy and confidentiality of all the respondents. Inner City Fund International also ensures that the survey adheres to the United States Department of Health and Human Services’ regulations for the respect of human subjects. Given that this study was based on secondary data, no further approval was needed. The datasets used in this study are freely available for download in the public domain. However, more information and materials about the DHS data usage and ethical standards can be found at http://goo.gl/ny8T6X.

Informed Consent

The DHS ensured that all respondents provided written informed consent before the study initiation.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okyere, J., Dadzie, L.K., Agbaglo, E. et al. Women’s Sexual Autonomy and Short Birth Interval in Sub-Saharan Africa: A Multilevel Analysis of Demographic and Health Survey Data. Arch Sex Behav 53, 413–422 (2024). https://doi.org/10.1007/s10508-023-02713-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-023-02713-4

Keywords

Search

Navigation