Association between Gender-Based Violence, Women's Empowerment, and Institutional Delivery among Currently Married Young Women in Sub-Saharan Africa

Abstract

Background
The age group designated as young people—that is from 10–24 years of age is a transition period during which young people experience a variety of changes that influence their needs, identities, and behaviour. Gender-based violence (GBV) is an important public health problem. When combined with a lack of empowerment in women, it could severely constrain decision-making on critical issues such as health care seeking among women. This study examined the influence of GBV and women's empowerment on institutional delivery among currently married young women in sub-Saharan Africa.

Methods
Secondary data from the latest (2017–date) Demographic and Health Surveys from 11 Sub-Saharan African countries was used. Currently married young women from age 15–24 years were selected, giving a sample size of 22,247. However, only 8,621 respondents were interviewed for violence.

Results
The results showed the prevalence of GBV to be 35.4%. Less than one fifth of the women were empowered. About 41.9% delivered in a health institution. Binary logistic regression was used to determine how GBV and women's empowerment predict institutional delivery. A statistically significant relationship was seen between emotional and physical GBV (p = 0.002, OR = 0.854, 95% CI: 0.774–0.942) and (p < .001, OR = 0.724, 95% CI: 0.638–0.820) respectively. There was no significant association between sexual GBV and institutional delivery (p = 0.127, OR = 1.198, 95% CI: 0.950–1.510). Total GBV was inversely related to institutional delivery (p < .001, OR = 0.788, 95% CI: 0.719–0.865). The odds of delivering in an institution were twice higher among empowered women (p < 0.001, OR = 2.029, 95% CI: 1.751–2.350).

Conclusion
The prevalence of GBV is still high in sub-Saharan Africa, and the proportion of empowered young women is alarmingly low, putting them more at risk of gender-based violence. These two parameters have a significant influence on institutional delivery, which has been proven to be an essential tool for improving maternal and child health outcomes.