Sexual Frequency, Women’s Decision-Making and Contraceptive Use in Sub-Saharan Africa: A Multi-Country Analysis

Michelle J. Hindin, Johns Hopkins Bloomberg School of Public Health
Carie J. Muntifering, Johns Hopkins Bloomberg School of Public Health

Since the 1994 Cairo ICPD conference, there has been increasing interest in women’s empowerment, particularly for sexual and reproductive health. Women’s ability to negotiate the timing of intercourse with a partner has not been studied extensively in Africa. We explore the relationships between women’s autonomy and time since most recent intercourse in Ghana, Malawi, Mali, Rwanda, Uganda and Zimbabwe using Demographic and Health Surveys. We also examine the association between modern contraceptive use and time since most recent intercourse. We find a strong relationship between greater women’s decision-making autonomy and less recent sexual activity in all settings. These associations warrant further investigation but could be evidence that greater women’s autonomy results in women’s improved ability to negotiate sex. Additionally, we find a consistent association between modern contraceptive use and timing of most recent intercourse suggesting another potential benefit of promoting contraceptive use for couples wanting to space or limit births.