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The effect of women’s bargaining power within couples on contraceptive use in Cameroon [version 1; peer review: 2 approved with reservations, 1 not approved]
Authors: Dimitri Tchakounte Tchuimi and Benjamin Fomba Kamga
Source: Gates Open Research, 4:20; DOI:
Topic(s): Contraception
Women’s empowerment
Country: Africa
Published: FEB 2020
Abstract: Background: The prevalence of contraception among married women, evaluated at 23%, is low in Cameroon. Maternal death rates, estimated at 782 deaths per 100,000 live births, are very worrying. The National Strategic Plan for Reproductive, Maternal, Newborn and Child Health (2015-2020) focuses on increasing contraceptive prevalence as a means to reduce maternal death. This paper identifies women’s bargaining power as a factor that may stimulate contraceptive use. The objective of this study is to measure the effect of women's bargaining power within couples on contraceptive use. Methods: The data used come from the Demographic and Health Survey and Multiple Indicators (DHS-MICS) conducted in 2011. Women’s bargaining power within couples is measured by a Woman Bargaining Power Composite Index (WBPCI) built through a multiple correspondence analysis. Descriptive statistics (frequency distribution, cross tabulation, chi-square test) and the probit model were used to analyze the relationship between WBPCI and contraceptive use. Additionally, since the target population for this study is couples in which women were not pregnant, a Heckman probit model was also estimated to address the potential selection bias. Results: The results of the descriptive statistics show that women's bargaining power is higher among women who use contraception than for those who do not. The results of the probit model show that women's bargaining power significantly increases the probability of contraceptive use by 3.4%. In addition, the probability of using contraception also increases with the education of women. The estimation of the Heckman probit model illustrates that the effect of women's bargaining power on the probability of contraceptive use remains virtually unchanged. Conclusions: To reduce high maternal death rates in Cameroon, public health policies should not only focus on the health system itself but should also focus on social policies to empower women in the household.