Abstract：
Power inequality within the household and sexual relationships is linked to poor reproductive health. Malawi Government through National Sexual and Reproductive Health and Rights policy is committed to women empowerment as well fertility reduction. However, there is limited evidence in Malawi regarding whether women\'s autonomy in the household is an independent determinant of fertility. With this background, the aim of this study is to investigate whether women\'s autonomy in the household is a determinant of fertility in a poor socioeconomic and cultural setting.
This study used Malawi Demographic and Health Survey, 2015-2016. A multivariable Poisson regression model was used to investigate if women\'s autonomy in the household in Malawi determines fertility. The outcome measure, children ever born, was used as a measure of fertility. Women\'s autonomy was measured with two dimensions, such as women\'s household related decision makings and women\'s sexual autonomy. The individual recode and household recode were merged for the analysis. The final study sample was 15,952 women who were cohabiting or married at the time of the survey.
The level of autonomy among women in the household related decisions and sexual autonomy was 49.1% and 64.0% respectively. Controlling for covariates, the study found no significant association between women\'s autonomy dimensions in the household and number of children ever born. On the other hand, living in urban area (IRR = 0.91, CI 0.88-0.93); having less than tertiary education thus, no education (IRR = 1.83, CI 1.67-1.99) or primary education (IRR = 1.55, CI 1.42-1.69) or secondary education (IRR = 1.23, CI 1.13-1.33); poor households (IRR = 1.05, CI 1.01-1.09), starting cohabiting at the age of 19 years or less (AIRR = 1.15, CI 1.13-1.18) and not using modern contraceptive methods (AIRR = 1.17, CI 1.15-1.19) were significantly associated with fertility.
Though women\'s autonomy does not have independent effect on fertility, it may be interacting with other sociocultural norms prevailing in the society. The study recommends that the Government of Malawi should come up with economic hardship emancipation policy for poor households. The government should also come up with a girl-child secondary school completion policy. Furthermore, the government should accelerate the implementation, monitoring and evaluation of National Gender Policy to ensure the women empowerment/autonomy is having positive effect at all level including the household.
This study used Malawi Demographic and Health Survey, 2015-2016. A multivariable Poisson regression model was used to investigate if women\'s autonomy in the household in Malawi determines fertility. The outcome measure, children ever born, was used as a measure of fertility. Women\'s autonomy was measured with two dimensions, such as women\'s household related decision makings and women\'s sexual autonomy. The individual recode and household recode were merged for the analysis. The final study sample was 15,952 women who were cohabiting or married at the time of the survey.
The level of autonomy among women in the household related decisions and sexual autonomy was 49.1% and 64.0% respectively. Controlling for covariates, the study found no significant association between women\'s autonomy dimensions in the household and number of children ever born. On the other hand, living in urban area (IRR = 0.91, CI 0.88-0.93); having less than tertiary education thus, no education (IRR = 1.83, CI 1.67-1.99) or primary education (IRR = 1.55, CI 1.42-1.69) or secondary education (IRR = 1.23, CI 1.13-1.33); poor households (IRR = 1.05, CI 1.01-1.09), starting cohabiting at the age of 19 years or less (AIRR = 1.15, CI 1.13-1.18) and not using modern contraceptive methods (AIRR = 1.17, CI 1.15-1.19) were significantly associated with fertility.
Though women\'s autonomy does not have independent effect on fertility, it may be interacting with other sociocultural norms prevailing in the society. The study recommends that the Government of Malawi should come up with economic hardship emancipation policy for poor households. The government should also come up with a girl-child secondary school completion policy. Furthermore, the government should accelerate the implementation, monitoring and evaluation of National Gender Policy to ensure the women empowerment/autonomy is having positive effect at all level including the household.
摘要：
家庭内部的权力不平等和性关系与不良的生殖健康有关。马拉维政府通过国家性健康和生殖健康与权利政策致力于增强妇女权能以及减少生育率。然而,马拉维关于妇女在家庭中的自主权是否是生育率的独立决定因素的证据有限。在这样的背景下,这项研究的目的是调查在一个贫穷的社会经济和文化背景下，妇女在家庭中的自主权是否是生育的决定因素。
这项研究使用了马拉维人口和健康调查，2015-2016。使用多变量Poisson回归模型来调查马拉维家庭中妇女的自主权是否决定生育率。结果衡量，曾经出生的孩子，被用来衡量生育能力。女性的自主性是用两个维度来衡量的，如妇女的家庭相关决策要素和妇女的性自主权。合并个人重编码和家庭重编码以进行分析。最终的研究样本是调查时同居或已婚的15,952名妇女。
妇女在与家庭有关的决定和性自主权方面的自主权水平分别为49.1%和64.0%。控制协变量，该研究发现，家庭中女性的自主性维度与出生子女数量之间没有显著关联。另一方面,生活在城市地区(IRR=0.91，CI0.88-0.93)；因此，高等教育程度低于高等教育，没有教育（IRR=1.83，CI1.67-1.99）或初等教育（IRR=1.55，CI1.42-1.69）或中等教育（IRR=1.23，CI1.13-1.33）；贫困家庭（IRR=1.05，CI1.01-1.09），从19岁以下开始同居(AIRR=1.15,CI1.13-1.18)和不使用现代避孕方法(AIRR=1.17,CI1.15-1.19)与生育率显著相关.
虽然女性的自主权对生育没有独立的影响，它可能与社会上流行的其他社会文化规范相互作用。该研究建议马拉维政府为贫困家庭提出经济困难的解放政策。政府还应提出一项女童中学毕业政策。此外，政府应该加快实施，监测和评估国家性别政策，以确保妇女赋权/自主在包括家庭在内的所有层面产生积极影响。
这项研究使用了马拉维人口和健康调查，2015-2016。使用多变量Poisson回归模型来调查马拉维家庭中妇女的自主权是否决定生育率。结果衡量，曾经出生的孩子，被用来衡量生育能力。女性的自主性是用两个维度来衡量的，如妇女的家庭相关决策要素和妇女的性自主权。合并个人重编码和家庭重编码以进行分析。最终的研究样本是调查时同居或已婚的15,952名妇女。
妇女在与家庭有关的决定和性自主权方面的自主权水平分别为49.1%和64.0%。控制协变量，该研究发现，家庭中女性的自主性维度与出生子女数量之间没有显著关联。另一方面,生活在城市地区(IRR=0.91，CI0.88-0.93)；因此，高等教育程度低于高等教育，没有教育（IRR=1.83，CI1.67-1.99）或初等教育（IRR=1.55，CI1.42-1.69）或中等教育（IRR=1.23，CI1.13-1.33）；贫困家庭（IRR=1.05，CI1.01-1.09），从19岁以下开始同居(AIRR=1.15,CI1.13-1.18)和不使用现代避孕方法(AIRR=1.17,CI1.15-1.19)与生育率显著相关.
虽然女性的自主权对生育没有独立的影响，它可能与社会上流行的其他社会文化规范相互作用。该研究建议马拉维政府为贫困家庭提出经济困难的解放政策。政府还应提出一项女童中学毕业政策。此外，政府应该加快实施，监测和评估国家性别政策，以确保妇女赋权/自主在包括家庭在内的所有层面产生积极影响。
