Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022

Objectives To assess how education and the use of family planning methods intersect to influence women’s empowerment among currently married women of reproductive age in Nepal.Design, setting and participants The study analysed a combined weighted sample of 21 023 currently married women in the age...

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Main Authors: Yogendra B Gurung, Kamala Lamichhane, Bidhya Shrestha, Tara Lal Shrestha, Rita Karki, Sharadha Hamal
Format: Article
Language:English
Published: BMJ Publishing Group 2025-08-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/3/2/e002576.full
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author Yogendra B Gurung
Kamala Lamichhane
Bidhya Shrestha
Tara Lal Shrestha
Rita Karki
Sharadha Hamal
author_facet Yogendra B Gurung
Kamala Lamichhane
Bidhya Shrestha
Tara Lal Shrestha
Rita Karki
Sharadha Hamal
author_sort Yogendra B Gurung
collection DOAJ
description Objectives To assess how education and the use of family planning methods intersect to influence women’s empowerment among currently married women of reproductive age in Nepal.Design, setting and participants The study analysed a combined weighted sample of 21 023 currently married women in the age group (15–49 years) using data sets of two cross-sectional Nepal Demographic and Health Survey (NDHS). A weighted analysis of the samples was carried out, accounting for the complex survey design. In NDHS 2016, the sample size was 9,868, and in NDHS 2022, it was 11, 155. Thirteen indicators that have been used in previous studies were employed to measure women’s empowerment. To examine the relationship between education, family planning use and women’s empowerment, a multivariate binary logistic regression analysis was conducted, taking into account cluster and survey weights.Outcome measures Women’s empowerment is the primary outcome measure, which was assessed using a composite index of 13 indicators based on previous studies. The indicators encompassed sexual and reproductive autonomy, participation in household decision-making, control over financial decisions and attitudes towards wife-beating.Results The results indicate that women with higher education and those who use family planning methods are significantly more empowered, with adjusted ORs of 3.764 (95% CI 2.894 to 4.895) in 2016 and 4.541 (95% CI 2.914 to 7.079) in 2022 compared with women without education and family planning use. This consistent pattern across both surveys highlights a significant association between education, family planning use and women’s empowerment.Conclusion The study suggests the importance of advocating for education and family planning use as interlinked pathways to empower women. To fulfil Sustainable Development Goal 5—achieving gender equality and empowering all women and girls—government must ensure intersectional strategies that remove barriers to education and reproductive autonomy.
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spelling doaj-art-241003fc8cc2465f9d9ffd4587f8be6c2025-08-20T03:44:04ZengBMJ Publishing GroupBMJ Public Health2753-42942025-08-013210.1136/bmjph-2025-002576Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022Yogendra B Gurung0Kamala Lamichhane1Bidhya Shrestha2Tara Lal Shrestha3Rita Karki4Sharadha Hamal51Tribhuvan University, Central Department of Population Studies1Tribhuvan University, Central Department of Population StudiesCentral Department of Population Studies, Tribhuvan University, Kirtipur, Bagmati Province, NepalCentral Department of English, Tribhuvan University, Kirtipur, Bagmati Province, NepalDepartment of Population Studies, Ratna Rajyalaxmi Campus, Tribhuvan University, Kathmandu, Bagmati Province, NepalDepartment of Community Medicine, Gandaki Medical College Teaching Hospital and Research Center Pvt Ltd, Pokhara, Gandaki Province, NepalObjectives To assess how education and the use of family planning methods intersect to influence women’s empowerment among currently married women of reproductive age in Nepal.Design, setting and participants The study analysed a combined weighted sample of 21 023 currently married women in the age group (15–49 years) using data sets of two cross-sectional Nepal Demographic and Health Survey (NDHS). A weighted analysis of the samples was carried out, accounting for the complex survey design. In NDHS 2016, the sample size was 9,868, and in NDHS 2022, it was 11, 155. Thirteen indicators that have been used in previous studies were employed to measure women’s empowerment. To examine the relationship between education, family planning use and women’s empowerment, a multivariate binary logistic regression analysis was conducted, taking into account cluster and survey weights.Outcome measures Women’s empowerment is the primary outcome measure, which was assessed using a composite index of 13 indicators based on previous studies. The indicators encompassed sexual and reproductive autonomy, participation in household decision-making, control over financial decisions and attitudes towards wife-beating.Results The results indicate that women with higher education and those who use family planning methods are significantly more empowered, with adjusted ORs of 3.764 (95% CI 2.894 to 4.895) in 2016 and 4.541 (95% CI 2.914 to 7.079) in 2022 compared with women without education and family planning use. This consistent pattern across both surveys highlights a significant association between education, family planning use and women’s empowerment.Conclusion The study suggests the importance of advocating for education and family planning use as interlinked pathways to empower women. To fulfil Sustainable Development Goal 5—achieving gender equality and empowering all women and girls—government must ensure intersectional strategies that remove barriers to education and reproductive autonomy.https://bmjpublichealth.bmj.com/content/3/2/e002576.full
spellingShingle Yogendra B Gurung
Kamala Lamichhane
Bidhya Shrestha
Tara Lal Shrestha
Rita Karki
Sharadha Hamal
Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022
BMJ Public Health
title Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022
title_full Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022
title_fullStr Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022
title_full_unstemmed Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022
title_short Do education and use of family planning methods empower women? Evidence from the Nepal Demographic Health Survey (NDHS) 2016 and 2022
title_sort do education and use of family planning methods empower women evidence from the nepal demographic health survey ndhs 2016 and 2022
url https://bmjpublichealth.bmj.com/content/3/2/e002576.full
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