DEMOGRAPHIC

AND

HEALTH

RESEARCH

DHS WORKING PAPERS

2010 No. 80

Ushma D. Upadhyay

Deborah Karasek

December 2010

This document was produced for review by the United States Agency for 

International Development.

Women’s Empowerment and 

Achievement of Desired Fertility in 

Sub-Saharan Africa
The DHS Working Papers series is a prepublication series of papers reporting on research in progress that 

is based on Demographic and Health Surveys (DHS) data. This research is carried out with support 

provided by the United States Agency for International Development (USAID) through the MEASURE 

DHS project (#GPO-C-00-08-00008-00). The views expressed are those of the authors and do not 

necessarily reflect the views of USAID or the United States Government. 

MEASURE DHS assists countries worldwide in the collection and use of data to monitor and evaluate 

population, health, and nutrition programs. Additional information about the MEASURE DHS project can 

be obtained by contacting MEASURE DHS, ICF Macro, 11785 Beltsville Drive, Suite 300, Calverton, 

MD 20705 (telephone: 301-572-0200; fax: 301-572-0999; e-mail: reports@measuredhs.com; internet: 

www.measuredhs.com).
Women’s Empowerment and Achievement of Desired Fertility 

in Sub-Saharan Africa 

Ushma D. Upadhyay 

Deborah Karasek 

ICF Macro

Calverton, Maryland, USA 

December 2010 

Corresponding author: Ushma D. Upadhyay, Advancing New Standards in Reproductive Health (ANSIRH), Bixby 

Center for Global Reproductive Health, University of California, San Francisco. 1330 Broadway, Suite 1100, 

Oakland, CA 94612; Phone: (510) 986-8928; Email: upadhyayu@obgyn.ucsf.edu
ACKNOWLEDGMENTS 

We appreciate the guidance and insightful review comments from Dr. Sunita Kishor of 

ICF Macro and Prof. Simona Bignami of the University of Montreal. We thank Bryant Robey for 

his comments and editorial expertise. We also thank Dr. Karen Hardee of Population Action 

International for review comments on an earlier draft that was presented at the 2010 annual 

meeting of the Population Association of America. This study was supported by a fellowship 

from the United States Agency for International Development (USAID) through the MEASURE 

DHS project at ICF Macro. 

Suggested citation: 

Upadhyay, Ushma D. and Deborah Karasek. 2010. Women‘s Empowerment and Achievement of 

Desired Fertility in Sub-Saharan Africa. DHS Working Papers No. 80. Calverton, Maryland, 

USA: ICF Macro.
ABSTRACT 

Previous studies, conducted mainly in Asian countries, have shown that women‘s 

empowerment is associated with contraceptive use, lower fertility, and longer birth intervals. Yet 

little is known about the association of women‘s empowerment with fertility desires in subSaharan African countries where overall fertility levels remain high. This study tries to fill this 

gap, exploring whether women‘s empowerment affects their ideal number of children and their 

ability to have only the number of children they want. This study used couples data from four 

recent Demographic and Health Surveys (DHS) in sub-Saharan Africa: Guinea 2005, Mali 2006, 

Namibia 2006/2007, and Zambia 2007. Women‘s empowerment was measured by women‘s 

participation in household decision-making, and by two indices representing gender-role 

attitudes: attitudes toward wife beating and attitudes toward refusing sex with one‘s husband. 

The results of the multivariable models indicate that, in two of four countries, having egalitarian 

gender-role attitudes was associated with having a smaller ideal number of children, even after 

adjusting for other factors. Greater household decision-making was not as consistently associated 

with a smaller ideal number of children. In all four countries, a husband having a greater ideal 

number of children was associated with the woman having a greater ideal number of children, 

regardless of her level of empowerment. Additionally, in Namibia, empowered women were 

more likely than less empowered women to have more children than they desired. This finding 

likely reflects dissatisfaction felt by more empowered women whose fertility is high, consistent 

with social norms, but who personally value smaller families. Additional research is needed that 

evaluates the validity of the household decision-making index as an indicator of empowerment in 

the context of sub-Saharan communities. 

1

INTRODUCTION

The body of research on women‘s empowerment has conceptualized and defined this 

construct in many ways and used different terms, often interchangeably, including ―autonomy,‖

―status,‖ and ―agency‖ (Lee-Rife and Edmeades 2011; Malhotra et al. 2002; Upadhyay and 

Hindin 2005). A review of the literature also shows different measures for the same 

conceptualization. For example, studies often measure women‘s autonomy with an index that 

assesses their participation in decision-making in various household issues. This index represents 

women‘s degree of control over their environment. Some researchers include both major and 

minor decisions, while others include only major decisions, excluding day-to-day household 

decisions and those that are traditionally within the woman‘s domain. Women‘s empowerment 

encompasses many dimensions, including economic, socio-cultural, familial/interpersonal, legal, 

political, and psychological (Malhotra et al. 2002), which contributes to the wide variation in 

conceptualizations of women‘s empowerment. 

Given this variation in conceptualization, it is difficult to measure women‘s 

empowerment consistently. Kabeer (2001), whose definition is widely accepted, defines 

empowerment as ―the expansion of people‘s ability to make strategic life choices in a context 

where this ability was previously denied to them.‖ Two central components of empowerment are 

agency and resources needed to exercise life choices (Kabeer 2001; Malhotra et al. 2002). Even 

with a clear definition, these constructs are difficult to quantify in a standardized way. 

Additionally, to measure empowerment at an individual level, researchers must translate the 

amorphous constructs into a set of specific questions that population-based surveys can ask of 

individual respondents (Kishor and Subaiya 2008). 

Another challenge is the variation in cultural contexts that affect the measurement of 

women‘s empowerment. It is desirable to use standardized questions that enable cross-cultural 

comparisons of empowerment. Yet a measure that captures empowerment in one context may 

have limited relevance in another, as is the case with measures that assess mobility in a 

community where women‘s free movement is the norm. While many existing measures of 

empowerment were originally conceptualized and developed for the context of Asia, and for 

South Asian countries in particular (Dyson and Moore 1983; Mason 1987), measures that are 
2

universally applicable regardless of the gender equity environment, such as those used in 

Demographic and Health Surveys (DHS), are most useful for cross-national comparisons. 

Using the available standardized measures of women‘s empowerment among several 

population-based samples from sub-Saharan Africa will allow us to make comparisons and better 

understand whether the available measures adequately capture empowerment in these settings. It 

is still unknown whether the same dimensions of empowerment that were developed elsewhere 

are relevant in sub-Saharan Africa, where the gender environment is completely different than in 

other regions. In Africa, empowerment is likely to look different than elsewhere because of such 

differences as more working women who have control over their earnings, more polygamy, more 

nuclear families (as opposed to extended families), and larger ideal family size, and because 

women‘s status is often tied to their fertility. 

Empowerment and Reproductive Health 

A broad body of research exists on women‘s empowerment and reproductive outcomes. 

Substantial research, primarily focused on Asia, demonstrates that women‘s empowerment is 

associated with contraceptive use (Gwako 1997; Morgan and Niraula 1995; Schuler et al. 1997; 

Woldemicael 2009), lower fertility (Balk 1994; Dyson and Moore 1983; Hindin 2000), and 

longer birth intervals (Upadhyay and Hindin 2005). Some researchers have suggested that 

women‘s empowerment is a key pathway through which education influences fertility (Jejeebhoy 

1995; Mason 1987). To operationalize women‘s empowerment, much of the research literature 

uses the previously mentioned index of participation in household decision-making. The standard 

DHS questionnaire includes a set of questions about household decision-making. Other 

approaches include assessing women‘s acceptance of reasons that a husband is justified for 

beating his wife, and also reasons that a wife is justified in refusing sex with her husband 

(Ethiopian Society of Population Studies 2008). The DHS includes questions about these issues. 

Such gender-role attitudes measure the extent of women‘s acceptance of norms that justify men‘s 

control over women. As expected, they are associated with lower levels of power over household 

decision-making among women (Dhaher et al. 2010; Hindin 2003; Linos et al. 2010). 
3

Few studies on women‘s empowerment and reproductive outcomes have been conducted 

in Africa. A review of 12 studies of women‘s empowerment and fertility and contraceptive use 

(Malhotra et al. 2002) yielded only 2 studies that specifically looked at countries in sub-Saharan 

Africa. The first, using data from the Togo 1988 DHS, found that women who selected their own 

spouses were more likely to communicate about family planning with their spouses and to use 

contraception than women who had an arranged marriage, as were women who worked for cash 

or participated in credit or savings schemes compared to those who did not (Gage 1995). The 

second study, which examined gender equity at the community level and at the individual level 

in five Nigerian states, found that equity at the community level affects reproductive behavior—

specifically, desire for more children and contraceptive use—net of the individual effects. 

Individual measures of women‘s empowerment had the strongest impact on reproductive 

behavior in communities with lower levels of gender equity (Kritz et al. 2000). 

Two other studies that have focused on the relationship between women‘s empowerment 

and reproductive outcomes in Africa both used the household decision-making index as a 

measure of women‘s empowerment. In a study using Zimbabwe 1994 DHS data, Hindin (2000) 

found that women‘s increased household decision-making was not associated with contraceptive 

use but was associated with lower fertility. Hindin demonstrated that the addition of decisionmaking variables provided independent explanatory power beyond that of traditional measures of 

women‘s status, such as educational attainment and labor force participation. A more recent 

study using the Eritrea 2002 DHS examined the effect of women‘s autonomy on reproductive 

preferences (Woldemicael 2009). Women‘s final say in decisions regarding day-to-day 

household purchases was significantly associated with wanting no more children, having a small 

ideal family size, and ever using modern contraception. The authors found that 

sociodemographic factors such as employment and economic status affect women‘s reproductive 

preferences directly, and also indirectly by increasing women‘s autonomy, which in turn 

influences reproductive preferences. 

Our review of the literature found no other studies, in Africa or elsewhere, that have 

specifically examined the role of women‘s empowerment on women‘s ideal number of children 

and whether empowerment impacts their ability to achieve their ideal fertility. 
4

Exploring the relationship between women‘s empowerment and ideal fertility in several 

sub-Saharan African countries with comparable measures will help fill the research gap. 

Understanding this relationship is imperative in sub-Saharan Africa, where fertility remains high 

and where the fertility transition has slowed or stalled in recent years. Fertility rates in subSaharan Africa are the highest in the world, with women averaging five to six children in their 

lifetimes (United Nations Population Division 2008). Yet there is also a substantial unfulfilled 

demand for smaller families among African women. Unmet need for family planning is high in 

sub-Saharan Africa, with 24% of married women age 15-49 reporting that they do not want to 

have another child soon or at all, but nevertheless not using any contraceptive method (Sedgh 

2007). One study determined that, on average, the total fertility rate (the number of children per 

woman) in sub-Saharan Africa would decline considerably if women had just the number of 

births they wanted (Westoff and Bankole 2002). Such statistics led us to ask would improving 

women‘s empowerment help them have just the number of children they want and reduce 

fertility rates in the region? 

Our study aims to answer this question and explores whether women‘s empowerment 

affects their ideal number of children and the achievement of their desired fertility. We also 

examine how husbands‘ fertility desires influence the relationship between women‘s 

empowerment and their ideal number of children. There is wide consensus that men strongly 

influence couples‘ childbearing behavior (Bankole and Singh 1998; Ezeh 1993; Speizer 1999). 

While men‘s ideal number of children in Africa tends to be higher than women‘s (Gebreselassie 

2008; Short and Kiros 2002; Westoff and Bankole 2002), one study in Ghana has suggested that 

husbands‘ declining fertility desires are largely responsible for national-level reductions in 

fertility (DeRose et al. 2002). 
5

Figure 1. Conceptual framework. 

This study seeks to explore the pathways through which women‘s empowerment may 

influence ideal number of children and achievement of that ideal number (see Conceptual 

Framework, Figure 1). There could be two mechanisms through which women‘s empowerment 

affects fertility. One pathway seeks to determine whether a woman‘s level of empowerment 

affects her ideal number of children, independent of her husband‘s ideal number of children or 

her sociodemographic characteristics. Women‘s empowerment may stimulate a desire for 

expanded life opportunities, driving down their ideal number of children. This makes the 

assumption that more empowered women desire additional roles and objectives beyond 

motherhood. Ideal number of children therefore seems to be a plausible outcome of women‘s 

empowerment. However, this pathway does not incorporate women‘s ability to achieve their 

desires. 

The second pathway examines whether a woman‘s level of empowerment affects her 

ability to achieve her ideal number of children. This pathway rests on the assumption that 

empowerment expands a woman‘s agency and resources so that she can control her environment 

in order to achieve her stated ideal number of children. The actual number a woman states as her 

Woman’s 

sociodemographic 

characteristics

Husband’s ideal 

number of children Woman’s empowerment indicators

 Number of decisions in which wife has 

any say

 Attitudes toward wife beating 

 Attitudes towards wife’s right to refuse 

sex 

Other gender-related variables

 Age at first marriage 

 Interspousal age difference

 Interspousal education difference 

 Ability to access health care

Ideal number of 

children

Limiting fertility to ideal 

number of children

Expanding life 

opportunities

Agency and 

resources
6

ideal will affect her likelihood of having more children than she wants; that is, a woman having a 

very small ideal number of children is less likely to be able to limit her actual number of births to 

her ideal, especially in a socio-cultural context of high fertility. This influence is not specifically 

examined in our study, and thus it is represented by a dotted arrow in the conceptual framework. 

This pathway from empowerment to limiting fertility to her ideal necessitates intensive, on-going 

effort to use contraception and to control fertility over her reproductive life. Such efforts may be 

possible with a high degree of agency and resources. 

Thus we hypothesize that more empowered women will have a smaller ideal family size 

than less empowered women because having fewer children will allow them greater freedom to 

pursue other life opportunities. We also hypothesize that more empowered women will be more 

likely to limit fertility to their desired number of children than less empowered women because 

they have the agency and resources to take the actions needed to achieve their desired fertility. 
7

DATA AND METHODS 

Data Sources 

The data for this study are from four nationally-representative Demographic and Health 

Surveys: Guinea 2005, Mali 2006, Namibia 2006/2007, and Zambia 2007—the four most recent 

DHS in sub-Saharan Africa that contain the data required to answer our research questions. The 

surveys collected data on behavioral, social, and demographic indicators, including women‘s 

status, desired number of children, and fertility, as well as many other topics. All surveys were 

approved by the Institutional Review Board of Macro International and approved by the local 

governments and implementing partners. 

Because husband‘s fertility desires are also a key issue of interest, our analysis focused 

on matched couples. The analysis includes 1,997 matched couples in Guinea (weighted sample 

size 1,995), 2,665 matched couples in Mali (weighted sample size 2,668), 867 matched couples 

in Namibia (weighted sample size 849), and 3,129 matched couples in Zambia (weighted sample 

size 3,204). All reported sample sizes are weighted samples. Use of the DHS couples file limits 

the sample to currently married women age 15-49 with husbands who are physically present, 

living in the same household and age 15-59 (except for Namibia where men age 15-49 were 

surveyed). We compared socio-demographic characteristics and empowerment indicators among 

all women in the individual file and the subsample of women in the couples file and found few 

significant differences between the two files (see Appendix Table). Overall, the larger individual 

sample of women was slightly older and wealthier than the couples subsample, with the 

exception of Namibia. Empowerment indicators of decision-making and attitudes toward wife 

beating were similar across both groups. Women in the couples sample reported fewer reasons 

that women are justified in refusing sex than those in the individual sample. 
8

Variable Description and Measures 

Dependent Variables 

The first outcome of interest is wives‘ ideal number of children. The DHS assesses ideal 

family size by asking women with children, ―If you could go back to the time you did not have 

any children and could choose exactly the number of children to have in your whole life, how 

many would that be?‖ For women with no children at the time of the survey, the questionnaire 

asks, ―If you could choose exactly the number of children to have in your whole life, how many 

would that be?‖ Both questions allow non-numeric responses such as ―As God decides.‖ A subanalysis demonstrated that there were few differences in empowerment indicators between 

women who provided numeric responses and those who provided non-numeric responses. Thus, 

non-numeric responses were recoded to the mean numeric value for the rest of the sample, and 

ideal family size was treated as a continuous numeric variable in the analysis. 

The second outcome of interest is the ability of women to have just the number of 

children they want. This outcome was operationalized as a dichotomous measure of whether a 

woman had more living children than her reported desired number of children. It was calculated 

as the woman‘s number of living children minus her ideal number of children. If the total was 

more than zero, she was coded as having more children than her stated ideal. Women who 

provided a non-numeric ideal number of children were coded as not having more children than 

their stated ideal. 

Independent Variables 

In this study, the key explanatory variables of interest are three indicators of women‘s 

empowerment: women‘s role in household decision-making, and two types of attitudes about 

gender roles. These are based on sets of questions included in the standard DHS questionnaire. 

Women’s role in household decision-making: This indicator is designed to assess women ̳s 

degree of control over their environment and is often used as a measure of women‘s autonomy. 

The DHS asks women who in their family usually has the final say in four types of household 
9

decisions: (1) respondent‘s own health care; (2) making major household purchases; (3) making 

household purchases for daily needs; and (4) visits to family or relatives. Women ̳s answers are 

coded into one of the following categories: respondent alone, respondent jointly with her 

husband, respondent ̳s husband alone, respondent jointly with others, or others only. The 

empowerment indicator is constructed by grouping women into two categories: women who 

have any say (alone or jointly) in all four household decisions, indicating a higher level of 

empowerment, and women who do not have any say in one or more decisions. 

Attitudes about gender roles: The next two indicators explore women‘s acceptance of unequal 

gender roles. The surveys ask women, ―Sometimes a husband is annoyed or angered by things 

that his wife does. In your opinion, is a husband justified in hitting or beating his wife in the 

following situations: If she goes out without telling him? If she neglects the children? If she 

argues with him? If she refuses to have sex with him? If she burns the food?‖ This measure is 

dichotomized into two categories: women who report none of the reasons are justified for a 

husband beating his wife, indicating a higher level of empowerment, and women who report one 

or more reasons are justified. 

For the other measure of acceptance of unequal gender roles, the surveys ask women, 

―Husbands and wives do not always agree on everything. Please tell me if you think a wife is 

justified in refusing to have sex with her husband when: She knows her husband has a sexually 

transmitted disease? She knows her husband has sex with other women? She has recently given 

birth? She is tired or not in the mood?‖ This measure is dichotomized into two categories: 

women who report all of the reasons are justified for refusing sex, indicating a higher level of 

empowerment, and women who report one or more are not justified. A missing response for any 

of the items in the indices was considered to be a non-affirmative response, representing a zero 

value for each measure. 

Other gender-related variables: Additional gender-related variables that can serve as a proxy 

for empowerment examined in the study include the wife‘s age at first marriage, interspousal age 

difference (husband‘s reported age minus wife‘s reported age) and interspousal education 

difference (husband‘s reported years of education minus wife‘s reported years of education). 
10

These factors shape the conditions or environment in which a woman can exercise her agency, 

and thus they serve as facilitators or impediments to empowerment. Women‘s empowerment 

researchers often use interspousal age and education differentials to measure the relative status of 

husbands and wives (Abadian 1996; Frankenberg and Thomas 2001; Jejeebhoy 2000). One study 

demonstrated that such measures influence marital decision-making power (Frankenberg and 

Thomas 2001). All three of these measures were included in our analyses as continuous 

measures. Number of years of education was missing for 20 cases in Mali, 3 in Namibia, and 10 

in Zambia. For these cases, the interspousal educational difference was set to the country‘s mean 

education difference. 

Additionally, two novel measures assess empowerment in the health care domain. The 

surveys ask women, ―Many different factors can prevent women from getting medical advice or 

treatment for themselves. When you are sick and want to get medical advice or treatment, is each 

of the following a big problem or not? Getting permission to go? Not wanting to go alone?‖ Each 

of these two measures was dichotomized into two categories, women who report that the factor is 

not a big problem, indicating a higher level of empowerment, and women who report that the 

factor is a big problem. 

Husband’s influence: The analyses controlled for the effects of husbands‘ ideal number of 

children, which was measured using the same questions described above for women. For the 

husband, however, responses are divided into the following four categories: 0 to 2, 3 to 5, 6 or 

more children, and non-numeric responses. For the analysis modeling the probability of a woman 

having more children than her ideal, we controlled for the husband‘s ideal number, relative to his 

wife‘s response. That is, we divided the husband‘s ideal number of children into the following 

categories: husband agrees with wife (including non-numeric responses), husband‘s ideal is more 

than wife‘s, husband‘s ideal is fewer than wife‘s, and husband gave a non-numeric response 

when the wife did not. This measure was not used in the analysis modeling the woman‘s ideal 

number of children because it was too closely tied to the outcome. 
11

Sociodemographic variables: Additionally, the analyses included several sociodemographic 

variables that served as controls: current age, a household wealth index, education, weekly media 

exposure, employment status, number of living children, and urban/rural residence. Weekly 

media exposure was defined as reading a newspaper, listening to the radio, or watching 

television at least once per week. Employment status included anyone who is currently working 

or has worked in the past 12 months. 

Data Analyses 

We conducted the analyses in several steps. First, we described the characteristics of the 

matched couple sample. We estimated means and prevalence rates on fertility desires/behavior, 

women‘s empowerment indicators, other gender-related factors, and sociodemographic 

characteristics. 

Second, we used linear regression to estimate unadjusted and adjusted effects of women‘s 

empowerment, other gender-related factors, and husbands‘ ideal number of children on women‘s 

ideal number of children, controlling for sociodemographic characteristics. This model examines 

the first pathway in our conceptual framework. Beta coefficients and 95% confidence intervals 

are reported. To confirm that the three empowerment indicators were independent, each indicator 

was first included alone in a model with other gender-related factors, husbands‘ ideal number of 

children, and sociodemographic variables. Beta coefficients were similar to those found in 

models that included all three indicators (not shown). The final multivariable models included 

the three empowerment indicators together, along with the other covariates. 

Third, to examine the second pathway in our conceptual framework, we used multiple 

logistic regression to model the probability of having more children than desired. Young women, 

in the midst of their reproductive years, are unlikely to have completed childbearing. Therefore, 

this analysis included only women age 35 and older. This model incorporated all of the variables 

used in the previous analyses as independent variables: the women‘s empowerment indicators, 

other gender-related factors, husbands‘ ideal number of children (relative to their wives‘), and 

sociodemgraphic variables. Additionally, it controls for whether the woman ever experienced a 

pregnancy loss, stillborn, or death of a child, because women who have experienced such events 
12

may be less likely to have more children than their stated ideal. While a woman‘s ideal number 

of children is likely causally related to whether she can achieve that ideal, we did not include it 

in the model due to potential endogeneity, given that ideal number of children was used to 

calculate the outcome. 

All analyses were performed using STATA 11 (STATA Corporation, 2009). We used 

STATA‘s svy (survey) commands to take into account the complex survey design of the DHS by 

incorporating women‘s sampling weights and adjusting the standard errors for the cluster 

sampling of primary sampling units. Thus, population-based estimates take into account the 

differential probability of selection into the survey. 
13

RESULTS 

Table 1 presents the characteristics of the sample. Substantial variability was found 

among the four countries in the women‘s empowerment indicators. Namibia had the most 

empowered women, with the most reporting any say in all four household decisions (67.7%), the 

most reporting that none of the five reasons justified wife beating (68.5%), and the most 

reporting that all three reasons were justification for refusing sex (74.5%). Mali had the fewest 

women reporting any say in all four household decisions (10.6%) and the fewest reporting that 

all three reasons justified refusing sex (9.5%). Guinea had the fewest women reporting none of 

the five reasons justified wife beating (11.8%). 

The other gender-related independent variables also varied substantially. Mean 

interspousal age difference among the matched couples ranged from 3.7 years in Namibia to 11.7 

years in Guinea, and the interspousal education difference ranged from -0.6 years in Namibia to 

1.7 years in Zambia. Mean age at first marriage was 16.3 in Guinea and Mali, 17.8 in Zambia, 

and 22.4 in Namibia. Getting permission to go for health care or not wanting to go alone was not 

a problem for most women, with 86.1% of women in Guinea and Mali, 89.5% of women in 

Namibia, and 95.4% of women in Zambia reporting that getting permission was not a big 

problem. Not wanting to go for health care alone was not a big problem for 77.7% of women in 

Namibia, 78.2% in Guinea, 82.3% in Mali, and 95.4% in Zambia. 
14

Table 1. Characteristics of women in matched couples (frequency or mean).

Guinea Mali Namibia Zambia

2005

(n=1,997)

2006 

(n=2,665)

2006/2007 

(n=867)

2007

(n=3,129)

n=1,995 n=2,668 n=849 n=3,204

Fertility Desires/Behavior

Woman's ideal number of children (%)

0-2 2.1 1.8 38.3 6.7

3-5 38.0 29.8 47.7 53.0

6+ 48.5 50.1 12.4 33.5

Non-numeric response 11.4 18.3 1.7 6.8

Woman's ideal number of children (mean)16.0 6.6 3.4 5.1

Husband’s ideal number of children (%)

0-2 1.4 1.6 28.7 7.5

3-5 18.8 18.5 44.3 46.4

6+ 67.7 58.7 25.0 41.9

Non-numeric response 12.1 21.2 2.0 4.2

Husbands’ ideal number of children (mean) 9.9 9.3 4.8 5.7

Couple agrees on ideal number of children (%)213.0 13.7 23.3 25.4

Woman had more children than her ideal (%) 7.0 6.2 18.4 12.0

Woman had more children than her ideal (%) (age 35+ only) 15.3 12.0 26.3 27.7

Women’s Empowerment Indicators

Decision-making

Woman has any say in all 4 decisions (%) 33.8 10.6 67.7 36.2

Number of household decisions in which woman has any say3

(0-4) (mean) 2.0 1.0 3.2 2.6

Attitudes toward wife beating

Belief that none of the 5 reasons for wife beating are justified 

(%) 11.8 24.7 68.5 36.4

Number of reasons for which wife beating is justified3(0-5) 

(mean) 3.2 2.4 0.8 2.1

Attitudes toward refusing sex

Belief that women have a right to refuse sex for all 3 reasons 

(%) 29.2 9.5 74.5 38.4

Number of reasons given for refusing to have sex with husband4

(mean) 1.7 1.1 2.6 2.0

Gender-related Variables

Interspousal age difference (mean years) 11.7 11.2 3.7 5.8

Interspousal education difference (mean years) 1.6 0.8 -0.6 1.7

Age at first marriage 16.3 16.3 22.4 17.8

Getting permission to go for health care treatment is not a big problem 

(%) 86.1 86.1 89.5 95.4

Not wanting to go alone for health care is not a big problem (%) 78.2 82.3 77.7 95.4

1 Non-numeric responses are entered as the mean ideal number of children

2 Does not include non-numeric responses 

3 Women reporting they have final say alone or jointly with their husbands/partners in the following decisions: respondent’s own 

health care; making major household purchases; making household purchases for daily needs; and visits to family or relatives.

4 Women reporting a husband is justified in beating his wife for none of the following reasons: if the wife goes out without telling 

him, neglects the children, argues with him, refuses to have sex with him, or burns the food. 

5 Women reporting that a woman is justified in refusing sexual intercourse with her husband or partner for the following reasons: if 

her husband has a sexually transmitted infection, her husband has sex with other women, and when she is tired or not in the mood.
15

Results of the linear regression model of women‘s ideal number of children produced 

different results by country, but there were some overall trends (Table 2). In general, most of the 

coefficients of the empowerment indicators were in the expected direction; that is they were 

inversely associated with ideal number of children, even though they were not all significant. 

Among the empowerment indicators, gender-role attitudes were more consistently associated 

with wives having a smaller ideal number of children than was participation in household 

decision-making. The decision-making index was significant in only one country (Guinea). 

Reporting that none of the five reasons justified wife beating was associated with having a 

smaller ideal number of children in Guinea and Zambia after controlling for other factors. In 

Mali, contrary to expectations, reporting that none of the five reasons justified wife beating was 

associated with having a larger ideal number of children. Reporting that a wife has the right to 

refuse sex for all three reasons was associated with having a smaller ideal number of children in 

Guinea and Zambia in the unadjusted models, and in only Guinea after controlling for other 

factors. 

Several of the other gender-related factors also were significantly associated with women 

having a smaller ideal number of children in the adjusted models. In Guinea, for every year in 

age that the husband was older than his wife, the wife‘s ideal number of children increased. 

Older age at first marriage was associated with a smaller ideal number of children in Guinea and 

Namibia. None of the other gender-related factors, interspousal education difference, not 

requiring permission to go for health care, and not wanting to go for health care alone, was 

significant in any of the four countries. 

Husband‘s ideal number of children was significantly associated with women‘s ideal 

number of children in all countries. When a husband‘s ideal number of children was 0-2 or 3-5, 

women had a smaller ideal number of children compared to when the husband‘s ideal number of 

children was 6 or more. 
Table 2. Unadjusted and adjusted beta coefficients from linear regression of women’s empowerment and husband’s ideal number of 

children on women’s ideal number of children (matched couples only).

Guinea Mali Namibia Zambia

n=1,995 n=2,668 n=849 n=3,204

2005 2006 2006/2007 2007

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI)

Women’s empowerment indicators

Decision-making

Any say in all 4 decisionsa-0.20 

(-0.42,0.03)

-0.28* 

(-0.49,-0.06)

-0.22 

(-0.81,0.36)

-0.31 

(-0.71,0.08)

-0.26 

(-0.60,0.09)

-0.00 

(-0.30,0.30)

-0.11 

(-0.29,0.07)

0.13 

(-0.03,0.28)

Any say in fewer than 4 decisions 

or no say in any decisions (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Attitudes toward wife beating

None of the 5 reasons for wife 

beating are justifiedb

-0.66*** 

(-0.96,-0.36)

-0.56*** 

(-0.88,-0.24)

0.51*** 

(0.23,0.79)

0.43*** 

(0.18,0.68)

-0.60*** 

(-0.91,-0.29)

-0.03 

(-0.34,0.27)

-0.46*** 

(-0.63,-0.29)

-0.23** 

(-0.38,-0.09)

One or more of the 5 reasons for 

wife beating justified (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Attitudes toward refusing sex

Wife has the right to refuse sex 

for all 3 reasonsc

-0.32** 

(-0.54,-0.09)

-0.36** 

(-0.57,-0.14)

-0.06 

(-0.47,0.35)

-0.08 

(-0.46,0.29)

-0.26 

(-0.62,0.09)

0.08 

(-0.21,0.38)

-0.16* 

(-0.32,-0.00)

-0.04 

(-0.17,0.10)

Wife does not have the right to 

refuse sex for one or more 

reasons (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Other gender-related variables

Interspousal age difference 0.01 

(-0.00,0.03)

0.02* 

(0.00,0.03)

-0.02* 

(-0.04,-0.00)

-0.01 

(-0.03,0.01)

-0.01 

(-0.04,0.02)

-0.00 

(-0.03,0.02)

0.00 

(-0.01,0.02)

0.00 

(-0.01,0.02)

Interspousal education difference -0.04** 

(-0.07,-0.02)

-0.02 

(-0.05,0.00)

-0.03 

(-0.07,0.00)

-0.03 

(-0.08,0.01)

-0.00 

(-0.04,0.04)

-0.01 

(-0.05,0.02)

0.05*** 

(0.03,0.08)

0.01 

(-0.01,0.03)

Age at first marriage -0.08***

(-0.12,-0.05)

-0.05** 

(-0.09,-0.02)

-0.04 

(-0.08,0.00)

-0.02 

(-0.06,0.02)

-0.01 

(-0.04,0.01)

-0.04** 

(-0.06,-0.01)

-0.10*** 

(-0.13,-0.07)

-0.03 

(-0.05,0.00)

Cont’d..

16
Table 2. Cont’d

Guinea Mali Namibia Zambia

n=1,995 n=2,668 n=849 n=3,204

2005 2006 2006/2007 2007

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI)

Permission for health care

Getting permission to go for 

health care treatment is not a 

big problem

-0.14 

(-0.45,0.16)

0.05 

(-0.29,0.38)

0.11 

(-0.21,0.44)

0.14 

(-0.14,0.43)

-0.02 

(-0.38,0.34)

-0.06 

(-0.42,0.31)

-0.17 

(-0.62,0.28)

-0.05 

(-0.42,0.32)

Getting permission to go for 

health care treatment is a big 

problem (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Going alone for health care

Not wanting to go alone for 

health care is not a big 

problem

-0.29 

(-0.62,0.04)

-0.16 

(-0.50,0.18)

0.04 

(-0.25,0.34)

0.03 

(-0.24,0.30)

-0.35* 

(-0.69,-0.01)

-0.03 

(-0.37,0.30)

-0.32*** 

(-0.50,-0.14)

0.04 

(-0.13,0.21)

Not wanting to go alone for 

health care is a big problem (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Husband’s influence

Husband’s ideal number of 

children

0-2 -1.20** 

(-2.05,-0.34)

-0.48 

(-1.30,0.34)

-0.51 

(-1.12,0.10)

-0.46 

(-1.05,0.14)

-1.46*** 

(-1.86,-1.05)

-0.88*** 

(-1.29,-0.47)

-1.82*** 

(-2.12,-1.51)

-0.81*** 

(-1.08,-0.53)

3-5 -0.97*** 

(-1.23,-0.72)

-0.56*** 

(-0.80,-0.32)

-0.70*** 

(-0.98,-0.41)

-0.34* 

(-0.61,-0.08)

-0.70*** 

(-1.08,-0.31)

-0.29 

(-0.64,0.06)

-1.06*** 

(-1.23,-0.89)

-0.39*** 

(-0.57,-0.22)

6+ (ref) (ref) (ref) (ref) (ref) (ref)

Non-numeric response -0.04 

(-0.31,0.23)

-0.17 

(-0.45,0.11)

0.37 

(-0.01,0.74)

0.33 

(-0.02,0.68)

0.69 

(-0.89,2.26)

0.48 

(-1.08,2.04)

-0.16 

(-0.57,0.26)

-0.17 

(-0.55,0.21)

Sociodemographic and health 

variables

Current age 0.03*** 

(0.02,0.05)

0.03** 

(0.01,0.04)

0.04*** 

(0.03,0.06)

0.02 

(-0.00,0.04)

0.06*** 

(0.04,0.07)

0.05*** 

(0.03,0.07)

0.07*** 

(0.06,0.08)

0.04*** 

(0.02,0.05)

Urban residence -0.60***

(-0.86,-0.34)

0.00 

(-0.36,0.36)

-0.58* 

(-1.06,-0.10)

-0.04 

(-0.33,0.26)

-0.76*** 

(-1.05,-0.47)

0.25 

(-0.11,0.62)

-1.01*** 

(-1.20,-0.82)

-0.15 

(-0.41,0.10)

Rural residence (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Cont’d..

17
Table 2. Cont’d

Guinea Mali Namibia Zambia

n=1,995 n=2,668 n=849 n=3,204

2005 2006 2006/2007 2007

Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted Unadjusted Adjusted

β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI) β (95% CI)

Household wealth index

Poorest (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Poorer 0.06 

(-0.31,0.43)

0.10 

(-0.25,0.46)

-0.09 

(-0.45,0.27)

-0.06 

(-0.43,0.30)

-0.60 

(-1.28,0.09)

-0.48 

(-1.14,0.17)

-0.02 

(-0.27,0.22)

0.04 

(-0.18,0.27)

Middle -0.14 

(-0.45,0.18)

-0.01 

(-0.30,0.29)

-0.37* 

(-0.74,-0.01)

-0.27 

(-0.63,0.09)

-1.17*** 

(-1.76,-0.59)

-0.93** 

(-1.49,-0.36)

-0.17 

(-0.38,0.04)

0.02 

(-0.17,0.21)

Richer -0.20

(-0.54,0.15)

-0.02 

(-0.36,0.32)

-0.48* 

(-0.88,-0.08)

-0.31 

(-0.73,0.10)

-1.54*** 

(-2.07,-1.00)

-1.25*** 

(-1.81,-0.69)

-0.76*** 

(-1.00,-0.52)

-0.22 

(-0.53,0.10)

Richest -0.83***

(-1.21,-0.46)

-0.28 

(-0.76,0.21)

-1.01** 

(-1.67,-0.35)

-0.45 

(-1.12,0.23)

-1.67*** 

(-2.21,-1.13)

-1.28*** 

(-1.93,-0.64)

-1.47*** 

(-1.73,-1.21)

-0.55** 

(-0.90,-0.21)

Education

No education (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Primary -0.77*** 

(-1.14,-0.41)

-0.39* 

(-0.78,-0.01)

-0.44* 

(-0.82,-0.07)

-0.34 

(-0.75,0.07)

-0.02 

(-0.56,0.52)

0.24 

(-0.29,0.77)

-0.62*** 

(-0.89,-0.35)

-0.37** 

(-0.63,-0.11)

Secondary or higher -1.13***

(-1.59,-0.66)

-0.49 

(-0.99,0.00)

-1.74*** 

(-2.10,-1.38)

-1.39*** 

(-2.00,-0.78)

-0.92*** 

(-1.42,-0.41)

0.11 

(-0.47,0.68)

-1.85*** 

(-2.14,-1.57)

-0.81*** 

(-1.11,-0.51)

Weekly media exposure -0.28* 

(-0.51,-0.04)

-0.12 

(-0.35,0.10)

-0.22 

(-0.55,0.12)

-0.02 

(-0.31,0.27)

-1.27*** 

(-1.84,-0.70)

-0.40 

(-0.96,0.16)

-0.58*** 

(-0.75,-0.40)

-0.17* 

(-0.34,-0.01)

Currently employed 0.30 

(-0.02,0.63)

0.01 

(-0.28,0.30)

-0.40* 

(-0.77,-0.03)

-0.39* 

(-0.70,-0.07)

-0.19 

(-0.49,0.11)

-0.05 

(-0.33,0.23)

0.34*** 

(0.18,0.49)

0.12 

(-0.02,0.26)

Polygamous union 0.28** 

(0.08,0.48)

-0.18 

(-0.38,0.03)

-0.06 

(-0.28,0.16)

-0.30* 

(-0.54,-0.06)

0.07 

(-0.31,0.46)

0.08 

(-0.28,0.44)

0.26* 

(0.01,0.50)

-0.23 

(-0.48,0.01)

Number of living children

0 -1.01*** 

(-1.41,-0.61)

-0.50* 

(-0.98,-0.03)

-0.89*** 

(-1.33,-0.45)

-0.45 

(-0.99,0.10)

-2.19*** 

(-2.70,-1.68)

-1.01** 

(-1.64,-0.38)

-2.00*** 

(-2.32,-1.69)

-1.06*** 

(-1.41,-0.71)

1-2 -0.88*** 

(-1.13,-0.63)

-0.54*** 

(-0.82,-0.26)

-1.16*** 

(-1.56,-0.76)

-0.81*** 

(-1.20,-0.43)

-1.70*** 

(-2.16,-1.25)

-0.71** 

(-1.24,-0.18)

-1.71*** 

(-1.90,-1.52)

-0.82*** 

(-1.08,-0.56)

3-4 -0.49*** 

(-0.77,-0.22)

-0.32* 

(-0.59,-0.05)

-0.82*** 

(-1.15,-0.49)

-0.59*** 

(-0.90,-0.29)

-0.99*** 

(-1.48,-0.49)

-0.44 

(-0.97,0.08)

-0.90*** 

(-1.09,-0.71)

-0.48*** 

(-0.69,-0.26)

5+ (ref) (ref) (ref) (ref) (ref) (ref) (ref) (ref)

Cont’d..

18
Table 2. Cont’d

a Women reporting they have final say alone or jointly with their husbands/partners in all 4 of the following decisions: respondent’s own health care; making major 

household purchases; making household purchases for daily needs; and visits to family or relatives. 

b Women reporting a husband is justified in beating his wife for none of the following reasons: if the wife goes out without telling him, neglects the children, argues 

with him, refuses to have sex with him, or burns the food. 

c Women reporting that a woman is justified in refusing sexual intercourse with her husband or partner for all of the following reasons: if her husband has a sexually 

transmitted infection, her husband has sex with other women, and when she is tired or not in the mood.

***p<0.001, **p<0.01, *p<0.05 

19
20

The results of the logistic regression models among the subsample of women age 35 and 

older show that, while few of the odds ratios for the empowerment indicators reached statistical 

significance, most of the odds ratios were greater than one (Table 3). This indicates that 

women‘s empowerment may be positively associated with having more children than ideal. 

Empowerment indicators were significant in only two countries. In Namibia, women who had 

any say in all four household decisions were more likely to have more children than their ideal 

(AOR=2.72 CI=1.19-6.24). In Mali, women reporting that none of the five reasons justified 

wife-beating were less likely to have more children than their ideal (AOR=0.35 CI=0.18-0.71). 

Additionally, the variable representing the difference between a husband‘s ideal number 

of children and his wife‘s ideal number was significant in all countries. When a husband‘s ideal 

number of children was larger than his wife‘s, she was more likely to have more children than 

her ideal—as much as 16 times more likely in Mali. In two countries (Guinea and Mali) this risk 

also increased when a woman‘s husband gave a non-numeric response. 
21

Table 3. Adjusted odds ratios from multivariable logistic regression of women’s empowerment 

and husband’s ideal number of children on having more children than desired (matched couples 

with women >=35 only).

Guinea Mali Namibia Zambia

2005 2006 2006/2007 2007

n=726 n=786 n=303 n=945

OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)

Women’s empowerment indicators

Decision-making

Any say in all 4 decisionsa 1.43 

(0.88,2.31) 

1.27 

(0.63,2.56) 

2.72* 

(1.19,6.24) 

0.81 

(0.56,1.19) 

Any say in fewer than 4 decisions or no 

say in any decisions (ref) (ref) (ref) (ref)

Attitudes toward wife beating

None of the 5 reasons for wife beating 

are justifiedb

0.81 

(0.39,1.66) 

0.35** 

(0.18,0.71) 

1.20 

(0.50,2.91) 

1.19 

(0.85,1.68) 

One or more of the 5 reasons for wife 

beating justified (ref) (ref) (ref) (ref)

Attitudes toward refusing sex

Wife has the right to refuse sex for all 3 

reasonsc

1.34 

(0.87,2.08) 

1.05 

(0.46,2.41) 

1.45 

(0.67,3.16) 

1.34 

(0.95,1.89) 

Wife does not have the right to refuse 

sex for one or more reasons (ref) (ref) (ref) (ref)

Other gender-related variables

Interspousal age difference 0.95* 

(0.91,1.00)

1.02 

(0.96,1.09)

0.99 

(0.92,1.06) 

1.01 

(0.98,1.04) 

Interspousal education difference 1.04 

(0.98,1.11)

0.97 

(0.87,1.07) 

1.08 

(0.98,1.19) 

1.00 

(0.95,1.05) 

Age at marriage 0.98 

(0.92,1.05)

1.00 

(0.94,1.06) 

0.96 

(0.91,1.02) 

0.91*** 

(0.86,0.96) 

Permission for health care

Getting permission to go for health care 

treatment is not a big problem

0.66 

(0.33,1.32)

1.00 

(0.44,2.31) 

2.62 

(0.70,9.77) 

1.25 

(0.51,3.04)

Getting permission to go for health care 

treatment is a big problem (ref) (ref) (ref) (ref)

Going alone for health care

Not wanting to go alone for health care 

is not a big problem

1.78* 

(1.03,3.08) 

1.08 

(0.41,2.82) 

0.29* 

(0.11,0.77)

1.09 

(0.74,1.59) 

Not wanting to go alone for health care 

is a big problem (ref) (ref) (ref) (ref)

Husband’s influence

Husband’s ideal number of children

Husband agrees with wife (ref) (ref) (ref) (ref)

Husband's ideal is more than wife 3.84** 

(1.52,9.66) 

16.11** 

(2.83,91.86) 

4.48** 

(1.52,13.23) 

3.16*** 

(1.90,5.25) 

Husband's ideal is fewer than wife 0.67 

(0.20,2.27) 

1.14 

(0.16,8.27) 

0.39 

(0.12,1.24) 

0.55* 

(0.33,0.91) 

Husband gave non-numeric response 

but wife did not

3.97* 

(1.38,11.48) 

8.73* 

(1.46,52.37)

3.00 

(0.44,20.65) 

1.19 

(0.53,2.66)

Cont’d..
22

Table 3. Cont’d

Guinea Mali Namibia Zambia

2005 2006 2006/2007 2007

n=726 n=786 n=303 n=945

OR (95% CI) OR (95% CI) OR (95% CI) OR (95% CI)

Sociodemographic and health 

variables

Current age 1.06* 

(1.01,1.12)

1.00 

(0.95,1.06) 

0.99 

(0.90,1.09) 

1.04* 

(1.00,1.08)

Urban residence 1.49 

(0.58,3.82) 

1.28 

(0.61,2.72) 

0.78 

(0.32,1.90) 

1.00 

(0.59,1.68) 

Rural residence (ref) (ref) (ref) (ref)

Household wealth index

Poorest (ref) (ref) (ref) (ref)

Poorer 0.65 

(0.34,1.27) 

1.19 

(0.61,2.34) 

2.61 

(0.65,10.43) 

0.96 

(0.57,1.63) 

Middle 0.83 

(0.44,1.56) 

0.96 

(0.39,2.34) 

2.17 

(0.63,7.42) 

1.30 

(0.79,2.13) 

Richer 0.67 

(0.33,1.35) 

1.20 

(0.50,2.88) 

0.68 

(0.18,2.64) 

0.96 

(0.52,1.80)

Richest 0.59 

(0.18,1.88) 

0.64 

(0.21,1.98) 

0.92 

(0.17,5.00) 

1.58 

(0.68,3.69) 

Years of education

No education (ref) (ref) (ref) (ref) (ref)

Primary 1.30 

(0.41,4.13)

1.08 

(0.42,2.82) 

0.88 

(0.31,2.55) 

1.44 

(0.86,2.39) 

Secondary or higher 1.41 

(0.53,3.78) 

1.79 

(0.60,5.31) 

0.77 

(0.22,2.71) 

1.08 

(0.48,2.40) 

Weekly media exposure 0.72 

(0.44,1.18) 

1.55 

(0.74,3.24)

2.14 

(0.83,5.50)

0.92 

(0.66,1.28) 

Currently employed 1.40 

(0.54,3.65) 

2.29* 

(1.18,4.46) 

1.45 

(0.63,3.31) 

1.22 

(0.88,1.68) 

Polygamous union 0.65 

(0.40,1.06) 

1.09 

(0.64,1.85)

0.81 

(0.31,2.13) 

1.01 

(0.65,1.57) 

Ever had a miscarriage, stillborn, or child

death

1.39 

(0.81,2.40) 

1.31 

(0.66,2.61)

0.46 

(0.20,1.06) 

1.82*** 

(1.29,2.59) 

a Women reporting they have final say alone or jointly with their husbands/partners in all 4 of the following 

decisions: respondent’s own health care; making major household purchases; making household purchases for 

daily needs; and visits to family or relatives. 

b Women reporting a husband is justified in beating his wife for none of the following reasons: if the wife goes out 

without telling him, neglects the children, argues with him, refuses to have sex with him, or burns the food. 

c Women reporting that a woman is justified in refusing sexual intercourse with her husband or partner for all of the 

following reasons: if her husband has a sexually transmitted infection, her husband has sex with other women, and 

when she is tired or not in the mood.

***p<0.001, **p<0.01, *p<0.05 
23

DISCUSSION 

This study demonstrates that several dimensions of women‘s empowerment and genderrelated factors are associated with a desire for fewer children in sub-Saharan African countries. 

In two of the four countries examined (Guinea and Zambia), women‘s egalitarian gender-role 

attitudes are important in predicting a smaller ideal number of children. In one country (Mali), 

women‘s egalitarian gender-role attitudes are associated with both a larger ideal number of 

children and with limiting fertility to their desired number of children. In Namibia, 

empowerment appears to be strongly associated with having more children than desired—a 

finding that was contrary to our hypothesis. This finding likely reflects a dissatisfaction felt by 

more empowered women whose fertility is high, consistent with social norms, but who 

personally value smaller families. 

By comparing actual fertility and ideal fertility, we develop a proxy measure for 

unwanted fertility. This measure may be better than the conventional measure of unintended 

pregnancies, which requires women to say whether a particular child was wanted or not. In the 

countries in this study, 12% to 28% of women age 35 and over reported having more children 

than their ideal. Substantial reductions in the high total fertility rate could occur if women could 

avoid undesired fertility and have only the number of children they consider ideal. 

Women‘s autonomy, as measured by household decision-making, is associated with 

women‘s ideal number of children in this analysis in only one country. We used a standardized 

household decision-making index that has also been used in other studies to measure women‘s 

empowerment and/or autonomy. The decision-making variable was not significant for the other 

countries even after recoding it as a continuous variable, and testing other permutations of 

individual or joint decision-making. In contrast, previous studies have found that higher 

autonomy is associated with lower fertility (Balk 1994; Dyson and Moore 1983; Hindin 2000). 

Most of the previous studies using this measure have been done in Asia. This discrepancy in 

findings may be a result of the differences in cultural context between Africa and Asia. Decisionmaking may not be as relevant an indicator for empowerment in the sub-Saharan African 

context; gender-role attitudes may be better at capturing variation in empowerment among these 

populations. Qualitative research that explores what empowerment means in this region is 

needed to develop more contextually appropriate indicators of women‘s empowerment. 
24

Other researchers have posited that the well established effect of women‘s education on 

fertility may be explained by education‘s effect of empowering women (Jejeebhoy 1995; Mason 

1987). Our study suggests, however, that women‘s empowerment does not sufficiently account 

for the association. In all countries examined except Namibia, higher levels of education are 

mostly still significantly associated with a smaller ideal number of children, even after 

controlling for women‘s empowerment. Thus, education probably affects women‘s fertility in 

other ways than increasing their empowerment. Similarly, women‘s empowerment affects 

fertility beyond what is explained by education. In future studies it will be important to separate 

and examine the individual contributions of education and empowerment. 

This study demonstrates that husbands have a strong role in influencing women‘s 

preferences as well as women‘s ability to achieve their reproductive preferences. As expected, 

having a husband with a smaller ideal number of children is associated with a woman having a 

smaller ideal number of children, regardless of her level of empowerment. There are two 

explanations that contribute to this finding. First, women may marry like-minded men, and thus 

their ideal family sizes agree. Second, after marriage, spouses may conform to each other‘s 

ideals. In a sub-analysis none of the women‘s empowerment indices predict husband-wife 

agreement on ideal family size, confirming that couple agreement is not limited to empowered 

women. The finding that empowerment as measured by household decision-making and gender 

role attitudes was less influential in predicting achievement of ideal fertility than husband‘s 

desires suggests that even empowered women are sometimes powerless in their reproductive 

behavior when their husbands have different fertility goals. Perhaps a measure that captures 

empowerment specifically in family planning and fertility domains needs to be considered and 

developed. 

One limitation of this study is the presence and treatment of non-numeric responses to the 

DHS question on ideal number of children. We also explored this subsample and determined that 

they were similar to the rest of the sample on most of the women‘s empowerment indicators. 

Thus, we were comfortable with setting non-numeric responses to the mean ideal number of 

children, with the rationale that this group is likely to have a variation in preferences similar to 

the rest of the sample. 

The study is unique in that it examined men‘s influence on women‘s wanted and actual 
25

fertility—an influence that is rarely included in other studies. We used men‘s actual reports of 

their own ideal family size in our models. While doing so required the use of a subsample of 

matched couple dyads, thereby compromising our sample size, we believe examining their 

influence greatly adds to the richness of the findings. In all four countries, we found that men‘s 

ideals about family size strongly influence women‘s ideals. Husband‘s ideals also have a strong 

effect on whether wives achieve their desired family size, especially if the husbands want more 

children than their wives. These findings suggest that addressing men‘s needs for information 

and resources for spacing and limiting their children is useful and a good investment for policies 

and programs. 

As countries around the world work to promote gender equality and empower women as 

part of achieving the Millennium Development Goals, it can be expected that demand for smaller 

families will follow. Additionally, family planning programs can address women‘s 

empowerment as part of their mission to help women and couples have only the number of 

children they want. Such programs are likely to generate interest in family planning services, 

create demand for smaller families, and also reduce unwanted fertility. 
26

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Appendix Table. Characteristics of all currently married/cohabiting women age 20-44 (all women sample) and the subsample of women 

whose husbands/partners were also interviewed (couple subsample) by selected characteristics, DHS surveys 2005-2007

Guinea Mali Namibia Zambia

2005 2006 2006/2007 2007

All 

women Couples

F stat p-value

All 

women Couples

p-value

All 

women Couples

p-value

All 

women Couples

n=1,995 n=7,954 n=2,668 n=14,583 n=849 n=9,804 n= 3,204 n=4,402 p-value

Women’s 

Sociodemographic 

Characteristics

Age (%)

15-24 23.5 23.4 0.01 0.9354 30.5 32.1 0.1807 18.2 14.9 0.0050 27.5 26.5 0.0436

25-34 40.1 35.5 24.96 0.0000 39.3 35.6 0.0013 46.1 39.9 0.0011 43.0 42.7 0.6282

35-49 36.4 41.0 19.66 0.0000 30.2 32.4 0.0469 35.7 45.1 0.0000 29.5 30.8 0.0155

Urban residence (%) 21.7 26.1 23.15 0.0000 26.2 30.7 0.0000 56.5 50.2 0.0001 33.1 35.0 0.0001

Household wealth 

index (%)

Poorest 24.8 22.6 4.00 0.0474 21.3 19.0 0.0327 14.8 17.1 0.0631 24.3 20.7 0.0000

Poorer 20.7 20.7 0.00 0.9878 21.0 20.1 0.2524 11.9 15.5 0.0084 18.8 19.6 0.0507

Middle 22.7 20.4 6.03 0.0152 19.1 20.0 0.3770 18.9 20.3 0.2226 19.5 20.2 0.0380

Richer 16.5 18.2 3.56 0.0612 21.3 19.9 0.1807 24.8 23.1 0.2402 19.7 20.7 0.0436

Richest 15.3 18.0 10.77 0.0013 17.3 21.0 0.0012 29.7 25.0 0.0027 17.8 18.7 0.0549

Education (%)

No education 87.8 85.3 12.60 0.0005 84.9 82.1 0.0005 12.2 11.8 0.7184 12.9 13.0 0.6590

Primary 7.0 8.0 3.07 0.0819 10.5 10.3 0.7828 25.3 30.3 0.0002 62.1 60.8 0.0090

Secondary or higher 5.2 6.6 7.37 0.0074 4.6 7.5 0.0000 62.5 57.9 0.0031 25.0 26.2 0.0081

Weekly media 

exposure (%) 45.0 46.0 0.90 0.3434 74.3 74.4 0.9289 88.1 86.2 0.1217 66.7 65.4 0.0222

Currently employed (%) 87.6 86.9 0.99 0.3210 63.2 64.0 0.4406 60.9 60.6 60.9 60.0 0.8895

Age at marriage (mean) 16.2 16.3 1.22 0.2719 16.3 16.4 0.1423 22.4 22.8 0.0298 17.8 17.8 0.3539

Polygamous union (%) 50.7 53.1 3.30 0.0712 41.8 40.3 0.3466 15.3 19.0 0.0063 11.4 15.2 0.0000

Cont’d..

30
Appendix Table. Cont’d

Guinea Mali Namibia Zambia

2005 2006 2006/2007 2007

All 

women Couples

F stat p-value

All 

women Couples

p-value

All 

women Couples

p-value

All 

women Couples

n=1,995 n=7,954 n=2,668 n=14,583 n=849 n=9,804 n= 3,204 n=4,402 p-value

Number of living 

children (%)

0 9.4 10.1 1.80 0.1817 10.0 12.8 0.0002 8.6 7.8 0.3779 7.6 7.2 0.0925

1-2 34.7 32.9 3.47 0.0643 31.9 32.7 0.4347 45.9 42.0 0.0772 32.3 33.1 0.0636

3-4 31.0 30.3 0.66 0.4196 27.8 37.1 0.6053 31.2 30.8 0.8223 31.5 30.7 0.0795

5+ 24.9 26.7 3.86 0.0513 30.3 37.4 0.0009 14.3 19.4 0.0001 28.6 29.0 0.4535

Ever had a 

miscarriage, stillborn, 

or child death (%) 56.4 53.5 6.82 0.0099 58.5 54.6 0.0004 22.4 27.3 0.0016 48.0 47.4 0.2099

Women’s 

Empowerment 

Indicators

Decision-making

Woman has any say 

in all 4 decisions (%) 33.8 34.6 0.79 0.3761 10.6 11.1 0.7501 67.7 64.3 0.0502 36.2 37.0 0.1391

Number of 

household decisions 

in which woman has 

any say3(0-4) 

(mean) 2.0 2.0 1.93 0.1665 1.0 1.0 0.3143 3.2 3.2 0.5648 2.6 2.7 0.0084

Attitudes toward wife 

beating

Belief that none of 

the 5 reasons for 

wife beating are 

justified (%) 11.8 12.2 0.37 0.5458 24.7 23.3 0.2462 68.5 65.3 0.0479 36.4 36.1 0.4923

Number of reasons 

for which wife 

beating is justified3

(0-5) (mean) 3.2 3.1 4.56 0.0344 2.4 2.5 0.0549 0.8 0.9 0.2116 2.1 2.1 0.2173

Cont’d..

31
Appendix Table. Cont’d

Guinea Mali Namibia Zambia

2005 2006 2006/2007 2007

All 

women Couples

F stat p-value

All 

women Couples

p-value

All 

women Couples

p-value

All 

women Couples

n=1,995 n=7,954 n=2,668 n=14,583 n=849 n=9,804 n= 3,204 n=4,402 p-value

Attitudes toward 

refusing sex

Belief that women 

have a right to 

refuse sex for all 3 

reasons (%) 29.2 28.8 0.10 0.7519 9.5 18.7 0.0000 74.5 75.2 0.6429 38.4 38.0 0.2953

Number of reasons 

given for refusing to 

have sex with 

husband4(mean) 1.7 2.4 936.30 0.0000 1.1 1.7 0.0000 2.6 2.6 0.5913 2.0 2.0 0.1712

1 Non-numeric responses are entered as the mean ideal number of children

2 Does not include non-numeric responses 

3 Women reporting they have final say alone or jointly with their husbands/partners in the following decisions: respondent’s own health care; making major 

household purchases; making household purchases for daily needs; and visits to family or relatives. 

4 Women reporting a husband is justified in beating his wife for none of the following reasons: if the wife goes out without telling him, neglects the children, argues 

with him, refuses to have sex with him, or burns the food. 

5 Women reporting that a woman is justified in refusing sexual intercourse with her husband or partner for the following reasons: if her husband has a sexually 

transmitted infection, her husband has sex with other women, and when she is tired or not in the mood.

32