Women's empowerment and its association with intimate partner violence in sub-Saharan Africa: a study using recent demographic and health surveys.

BACKGROUND

Intimate partner violence (IPV) remains a major public health and human rights concern in sub-Saharan Africa (SSA). This study examined the association between multidimensional empowerment and IPV among married or cohabiting women using the Survey-based Women's Empowerment (SWPER) Global Index.

METHODOLOGY: We conducted a cross-sectional analysis of the most recent Demographic and Health Survey data collected between 2010 and 2023 in 21 Sub-Saharan African countries. The study included 90,807 married or cohabiting women aged 15-49 years. Women's empowerment was measured using the three SWPER Global domains. Survey-weighted bivariate analyses and multivariable logistic regression were used to examine associations with IPV, with adjusted odds ratios and 95% confidence intervals reported.

RESULTS

Pooled IPV prevalence was 12.4% (2.0% in Mauritania to 30.8% in Sierra Leone). High empowerment in the attitudes-towards-violence domain (aOR = 0.59; 95% CI: 0.55-0.63) and social-independence domain (aOR = 0.84; 95% CI: 0.77-0.92) was associated with lower odds of IPV. Decision-making empowerment was not independently associated with IPV (high vs. low: aOR = 1.05; 95% CI: 0.98-1.13). Primary education was associated with slightly higher odds of IPV (aOR = 1.08; 95% CI: 1.00-1.16), and higher education was associated with lower odds (aOR = 0.75; 95% CI: 0.61-0.93). Older age (aORs = 1.37-1.96), cohabitation (aOR = 1.11; 95% CI: 1.04-1.19), primary education (aOR = 1.08; 95% CI: 1.00-1.16), parity of two or more (aORs = 1.39-1.52), several occupational groups (aORs = 1.17-1.45), and partner's secondary education (aOR = 1.23; 95% CI: 1.13-1.34) were associated with higher odds of IPV. In contrast, Islamic affiliation (aOR = 0.88; 95% CI: 0.82-0.96), richer or richest wealth status (aORs = 0.91 and 0.81) were associated with lower odds.

CONCLUSION

Women's empowerment is associated with IPV in a multidimensional manner. Prevention efforts should support women's agency while also addressing unequal power within relationships, norms that tolerate violence, and barriers to survivor-centered services.