Skip to main content Accessibility help


  • Ndola Prata (a1), Ashley Fraser (a1), Megan J. Huchko (a2), Jessica D. Gipson (a3), Mellissa Withers (a4), Shayna Lewis (a5), Erica J. Ciaraldi (a3) and Ushma D. Upadhyay (a6)...


This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South Asia (n=24). Household decision-making (n=21) and mobility (n=17) were the most commonly examined domains of women’s empowerment. Findings show that the relationship between empowerment and family planning is complex, with mixed positive and null associations. Consistently positive associations between empowerment and family planning outcomes were found for most family planning outcomes but those investigations represented fewer than two-fifths of the analyses. Current use of contraception was the most commonly studied family planning outcome, examined in more than half the analyses, but reviewed articles showed inconsistent findings. This review provides the first critical synthesis of the literature and assesses existing evidence between women’s empowerment and family planning use.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Available formats

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Available formats

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Available formats


Corresponding author

1 Corresponding author. Email:


Hide All

Center of Expertise in Women’s Health & Empowerment, University of California Global Health Institute, San Francisco, USA



Hide All
Abadian, S. (1996) Women’s autonomy and its impact on fertility. World Development 24(12), 17931809.
Ahmed, S., Creanga, A. A., Gillespie, D. G. & Tsui, A. O. (2010) Economic status, education and empowerment: implications for maternal health service utilization in developing countries. PLoS One 5(6), e11190.
Al Riyami, A., Afifi, M. & Mabry, R. M. (2004) Women’s autonomy, education and employment in Oman and their influence on contraceptive use. Reproductive Health Matters 12(23), 144154.
Amin, R., Hill, R. B. & Li, Y. (1995) Poor women’s participation in credit-based self-employment: the impact on their empowerment, fertility, contraceptive use, and fertility desire in rural Bangladesh. Pakistan Development Review 34, 93120.
Amin, R., Li, Y. P. & Ahmed, A. U. (1996) Women’s credit programs and family planning in rural Bangladesh. International Family Planning Perspectives 22(4), 158162.
Bhatt, E. (1989) Toward empowerment. World Development 17(7), 10591065.
Biswas, T. K. & Kabir, M. (2002) Women’s empowerment and current use of contraception in Bangladesh. Asia-Pacific Journal of Rural Development 12(2), 113.
Blanc, A. K. (2001) The effect of power in sexual relationships on sexual and reproductive health: an examination of the evidence. Studies in Family Planning 32(3), 189213.
Bogale, B., Wondafrash, M., Tilahun, T. & Girma, E. (2011) Married women’s decision making power on modern contraceptive use in urban and rural southern Ethiopia. BMC Public Health 11, 342.
Chacko, E. (2001) Women’s use of contraception in rural India: a village-level study. Health & Place 7(3), 197208.
Chapagain, M. & Matrika, C. (2005) Masculine interest behind high prevalence of female contraceptive methods in rural Nepal. Australian Journal of Rural Health 13(1), 3542.
Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., Glasier, A. & Innis, J. (2006) Sexual and reproductive health 3 - Family planning: the unfinished agenda. Lancet 368(9549), 18101827.
Cleland, J., Harbison, S. & Shah, I. H. (2014) Unmet need for contraception: issues and challenges. Studies in Family Planning 45(2), 105122.
Crissman, H. P., Adanu, R. M. & Harlow, S. D. (2012) Women’s sexual empowerment and contraceptive use in Ghana. Studies in Family Planning 43(3), 201212.
DeRose, L. F. & Ezeh, A. C. (2010) Decision-making patterns and contraceptive use: evidence from Uganda. Population Research and Policy Review 29(3), 423439.
Dharmalingam, A. & Morgan, S. P. (1996) Women’s work, autonomy, and birth control: evidence from two South Indian villages. Population Studies 50(2), 187201.
Do, M. & Kurimoto, N. (2012) Women’s empowerment and choice of contraceptive methods in selected African countries. International Perspectives on Sexual and Reproductive Health 38(1), 2333.
Dyson, T. & Moore, M. (1983) On kinship structure, female autonomy, and demographic behavior in India. Population and Development Review 9(1), 3560.
Feldman, B. S., Zaslavsky, A. M., Ezzati, M., Peterson, K. E. & Mitchell, M. (2009) Contraceptive use, birth spacing, and autonomy: an analysis of the Oportunidades program in rural Mexico. Studies in Family Planning 40(1), 5162.
Fikree, F. F., Khan, A., Kadir, M. M., Sajan, F. & Rahbar, M. H. (2001) What influences contraceptive use among young women in urban squatter settlements of Karachi, Pakistan? International Family Planning Perspectives 27(3), 130136.
Gage, A. J. (1995) Women’s socioeconomic position and contraceptive behavior in Togo. Studies in Family Planning 26(5), 264277.
Govindasamy, P. & Malhotra, A. (1996) Women’s position and family planning in Egypt. Studies in Family Planning 27(6), 328340.
Haile, A. & Enqueselassie, F. (2006) Influence of women’s autonomy on couple’s contraception use in Jimma town, Ethiopia. Ethiopian Journal of Health Development 20(3), 145151.
Hakim, A., Salway, S. & Mumtaz, Z. (2003) Women’s autonomy and uptake of contraception in Pakistan. Asia Pacific Population Journal 18(1), 6382.
Hamid, S., Stephenson, R. & Rubenson, B. (2011) Marriage decision making, spousal communication, and reproductive health among married youth in Pakistan. Global Health Action 4, 5079.
Harris, R. P., Helfand, M., Woolf, S. H., Lohr, K. N., Mulrow, C. D., Teutsch, S. M. & Atkins, D. (2001) Current methods of the US Preventive Services Task Force – a review of the process. American Journal of Preventive Medicine 20(3), 2135.
Hindin, M. (2000) Women’s autonomy, women’s status and fertility-related behavior in Zimbabwe. Population Research and Policy Review 19(3), 255282.
Hogan, D. P., Berhanu, B. & Hailemariam, A. (1999) Household organization, women’s autonomy, and contraceptive behavior in southern Ethiopia. Studies in Family Planning 30(4), 302314.
Hoque, M. N. & Murdock, S. H. (1997) Socioeconomic development, status of women, family planning, and fertility in Bangladesh: a district level analysis. Social Biology 44(3–4), 179197.
Ip, W. Y., Sin, L. L. & Chan, D. S. (2009) Contraceptive self-efficacy and contraceptive knowledge of Hong Kong Chinese women with unplanned pregnancy. Journal of Clinical Nursing 18(17), 24162425.
Isiugo-Abanihe, U. C. (1994) The socio-cultural context of high fertility among Igbo women. International Sociology 9(2), 237258.
Kabeer, N. (1999) Resources, agency, achievements: reflections on the measurement of women’s empowerment. Development and change 30(3), 435464.
Kabeer, N. (2001a) Conflicts over credit: re-evaluating the empowerment potential of loans to women in rural Bangladesh. World Development 29(1), 6384.
Kabeer, N. (2001b) Reflections on the Measurement of Women’s Empowerment: Theory and Practice. Discussing women’s empowerment: Theory and Practice. Novum Grafiska, AB, Stockholm. URL:
Kabeer, N. (2005a) Gender equality and women’s empowerment: a critical analysis of the third millennium development goal 1. Gender & Development 13(1), 1324.
Kabeer, N. (2005b) Is microfinance a ‘magic bullet’ for women’s empowerment? Analysis of findings from South Asia. Economic and Political Weekly 40(44/45), 47094718.
Kabir, M. A., Khan, M. M., Kabir, M., Rahman, M. M. & Patwary, F. K. (2005) Impact of woman’s status on fertility and contraceptive use in Bangladesh: evidence from Bangladesh Demographic and Health Survey, 1999–2000. Journal of Family Welfare 51(1), 10.
Khan, H. T. (1997) A hierarchical model of contraceptive use in urban and rural Bangladesh. Contraception 55(2), 9196.
Khan, M. R., Turner, A. N., Pettifor, A., Van Damme, K., Rabenja, N. L., Ravelomanana, N. et al. (2009) Unmet need for contraception among sex workers in Madagascar. Contraception 79(3), 221227.
Kishor, K. (1995) Autonomy and Egyptian Women: Findings from the 1988 Egypt Demographic and Health Survey. Macro International Inc., Calverton, MD.
Kishor, S. & Subaiya, L. (2008) Understanding Women’s Empowerment: A Comparative Analysis of Demographic and Health Surveys (DHS) Data. Comparative Report. Macro International Inc., Calverton, MA.
Klugman, J., Hanmer, L., Twigg, S., Hasan, T., McCleary-Sills, J. & Santamaria, J. (2014) Voice and Agency: Empowering Women and Girls for Shared Prosperity. World Bank, Washington, DC.
Kravdal, O. (2001) Main and interaction effects of women’s education and status on fertility: the case of Tanzania. European Journal of Population 17(2), 107136.
Kritz, M., Makinwa-Adebusoye, P. & Gurak, D. (2000) The role of gender context in shaping reproductive behaviour in Nigeria. In Presser, H. & Sen, G. (eds) Female Empowerment and Demographic Processes: Moving Beyond Cairo. Oxford University Press, London, pp. 239260.
Lee-Rife, S. M. (2010) Women’s empowerment and reproductive experiences over the lifecourse. Social Science & Medicine 71(3), 634642.
Mahmood, N. (2002) Women’s role in domestic decision-making in Pakistan: implications for reproductive behaviour. Pakistan Development Review 41(2), 121148.
Mahmud, S. (1991) Current contraception among programme beneficiaries. Bangladesh Development Studies 19(3), 3561.
Malhotra, A., Schuler, S. & Boender, C (2002) Measuring women’s empowerment as a variable in international development. Background paper prepared for the World Bank Workshop on Poverty and Gender: New Perspectives. World Bank, Washington DC.
Morgan, S. P., Sharon, S., Smith, H. L. & Mason, K. O. (2002) Muslim and non-Muslim differences in female autonomy and fertility: evidence from four Asian countries. Population and Development Review 28(3), 515537.
Moursund, A. & Kravdal, Ø. (2003) Individual and community effects of women’s education and autonomy on contraceptive use in India. Population Studies 57(3), 285301.
Mumtaz, Z. & Salway, S. (2005) ‘I never go anywhere’: extricating the links between women’s mobility and uptake of reproductive health services in Pakistan. Social Science & Medicine 60(8), 17511765.
Mumtaz, Z. & Salway, S. (2009) Understanding gendered influences on women’s reproductive health in Pakistan: moving beyond the autonomy paradigm. Social Science & Medicine 68(7), 13491356.
Pande, R. P., Falle, T. Y., Rathod, S., Edmeades, J. & Krishnan, S. (2011) ‘If your husband calls, you have to go’: understanding sexual agency among young married women in urban South India. Sexual Health 8(1), 102109.
Peyman, N., Hidarnia, A., Ghofranipour, F., Kazemnezhad, A., Oakley, D., Khodaee, G. & Aminshokravi, F. (2009) Self-efficacy: does it predict the effectiveness of contraceptive use in Iranian women? Eastern Mediterranean Health Journal 15(5), 12541262.
Pitt, M. M., Khandker, S. R., McKernan, S. M. & Latif, M. A. (1999) Credit programs for the poor and reproductive behavior in low-income countries: are the reported causal relationships the result of heterogeneity bias? Demography 36(1), 121.
Safilios-Rothschild, C. (1990) Women’s income profile as a key indicator of women’s status for the understanding of changing fertility behaviour in rural Kenya. Genus 46(3–4), 3143.
Saleem, A. & Pasha, G. R. (2008) Women’s reproductive autonomy and barriers to contraceptive use in Pakistan. European Journal of Contraception & Reproductive Health Care 13(1), 8389.
Sathar, Z. A. & Kazi, S. (1997) Women’s Autonomy, Livelihood and Fertility: A Study of Rural Punjab. Chapter 4. Pakistan Institute of Development Economics [PIDE], Islamabad, Pakistan.
Schuler, S. R., Hashemi, S. M. & Riley, A. P. (1997) The influence of women’s changing roles and status in Bangladesh’s fertility transition: evidence from a study of credit programs and contraceptive use. World Development 25(4), 563575.
Sedgh, G., Singh, S. & Hussain, R. (2014) Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning 45(3), 301314.
Steele, F., Amin, S. & Naved, R. T. & Population Council Policy Research Division (1998) The Impact of an Integrated Micro-Credit Program on Women’s Empowerment and Fertility Behavior in Rural Bangladesh. Population Council, Policy Research Division.
UN General Assembly (2000) United Nations Millennium Declaration: Resolution Adopted by the General Assembly. 55/2, 18th September 2000. United Nations New York.
United Nations Population Fund (1994) Programme of Action of the International Conference on Population & Development (ICPD). Part One, Section VII: Reproductive Rights and Reproductive Health, B. Family planning: Actions. UN, New York.
Upadhyay, U. D., Gipson, J. D., Withers, M., Lewis, S., Ciaraldi, E. J., Fraser, A. et al. (2014) Women’s empowerment and fertility: a review of the literature. Social Science & Medicine 115, 111120.
Upadhyay, U. D. & Karasek, D. (2010) Women’s empowerment and achievement of desired fertility in sub-Saharan Africa. DHS Working Papers. ICF Macro, Calverton, MD.
Vlassoff, C. (1982) The status of women in rural India: a village study. Social Action 32(4), 380407.
Wang, R. H. & Chiou, C. J. (2008) Relative contribution of intrapersonal and partner factors to contraceptive behavior among Taiwanese female adolescents. Journal of Nursing Scholarship 40(2), 131136.
Woldemicael, G. (2009) Women’s autonomy and reproductive preferences in Eritrea. Journal of Biosocial Science 41(2), 161181.
Woldemicael, G. & Beaujot, R. (2011) Currently married women with an unmet need for contraception in Eritrea: profile and determinants. Canadian Studies in Population 38(1–2), 6181.
Zafar, M. I. (1996) Husband–wife roles as a correlate of contraceptive and fertility behaviour. Pakistan Development Review 35(2), 145170.


  • Ndola Prata (a1), Ashley Fraser (a1), Megan J. Huchko (a2), Jessica D. Gipson (a3), Mellissa Withers (a4), Shayna Lewis (a5), Erica J. Ciaraldi (a3) and Ushma D. Upadhyay (a6)...


Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed