Is women’s social independence a strong determinant for the reproductive health-related outcomes of the Turkish population?

Abstract

Abstract Background Women's empowerment is increasingly recognized as a crucial factor in achieving reproductive health goals and gaining related rights. This study analyzed the relationship between women’s social independence and various reproductive health-related outcomes. Methods The study used data from the nationally representative 2018 Turkey Demographic and Health Survey. We analyzed data from 5156 married women. The study included eight dependent variables: 1) a total number of births; 2) an ideal number of children; 3) women’s ability to have just the desired number of children; 4) unplanned births; 5) needs for modern family planning methods; 6) contraceptive category (female-only or couple contraceptive methods); 7) induced abortions; and 8) miscarriages. The main predictor of outcome variables was women’s social independence, which was measured using a modified form of the social independence domain of the survey-based women's empowerment (SWPER) index. Principal component analysis was used to estimate the factor loadings of the items and calculate individual standardized scores. Social independence scores were classified into 20% quintiles as lowest, lower, middle, higher, and highest. The relationship between the dependent and independent variables was explored by calculating prevalence ratios and corresponding 95% confidence intervals (PRs, 95% CI) using a robust Poisson regression analysis. PRs were adjusted by age, household wealth quantiles, residence, and region. Results Women with the lowest levels of social independence had higher PRs than those with the highest social independence in the following categories: number of births of four or more [PR = 16.0 (7.2–25.3)], ideal number of children of four or more [PR = 1.9 (1.6–2.2)], more children than the ideal number [PR = 5.7 (3.3–8.1)], having an unplanned birth [PR = 2.3 (1.6–2.9)], the use of female-only contraceptive methods [PR = 1.7 (1.4–1.9)], induced abortions [PR = 1.9 (1.5–2.4)], and miscarriages [PR = 1.7 (CI 1.3-2.0)]. As women's social independence levels decreased, there was a consistent and gradual increase in negative reproductive health outcomes. Conclusion The study indicates that higher social independence levels are strongly associated with better reproductive health outcomes, emphasizing the need for women's empowerment in social independence for reproductive health policies.