Unintended pregnancies in the Global South: The role of gender equality and economic empowerment
Year: 2025
Type: article
Abstract: • This study provides the most comprehensive, regional analysis on the intersecting determinants of unintended pregnancies in the Global South, offering novel insights that challenge existing assumptions and demand tailored policy responses. • Core Findings and Scientific Novelty: Firstly, our study confirms that synergistic empowerment is key where by economic independence and gender equality act synergistically to reduce unintended pregnancies across the Global South. This intersectionality is a cornerstone finding, validating social ecological models, economic empowerment and feminist theories and arguing against vertical, single-issue reproductive health interventions. • Secondly, the study challenges the “one size-fits all model” by powerfully demonstrating that the empowerment-reproductive health link is not universal, revealing critical regional anomalies. For example: • African Region Paradox: The study found that economic independence was statistically insignificant in reducing unintended pregnancies, and surprisingly, reproductive health autonomy was associated with higher odds of unintended pregnancies. This highlights powerful, uncaptured socio-cultural or programmatic barriers that override economic gains. • Latin America, Caribbean & Oceania (LACO)Anomaly: Revealed a counterintuitive link between greater household autonomy and higher odds of unintended pregnancy, suggesting barriers to effective contraceptive access despite having decision-making power. • Beyond Poverty: The research definitively challenges the simplistic notion that poverty is the sole driver, finding that women in poor and middle-class households are at higher risk of unintended pregnancies, particularly in South/Southeast Asia and LACO. This calls for interventions targeting a broader socioeconomic spectrum. • Policy Significance & Impact: The strong regional disparities necessitate a move away from generalized strategies. Policies must be regionally tailored to address the unique socio-cultural barriers, especially in the African Region where empowerment is not translating into reduced unintended pregnancies. • The findings underscore the critical role of early sexual debut in driving unintended pregnancies. This mandates immediate and expanded investment in CSE and life skills for in- and out-of-school adolescents and unmarried youth, focusing on family planning, not just abstinence. • Need for targeted post-abortion care. Our finding that women with a history of pregnancy termination are at higher risk of future unintended pregnancies is a critical policy lever, demanding that healthcare systems provide enhanced, targeted post-abortion family planning counselling and services to break the cycle. • Conclusion: This study moves the needle in the reproductive health discourse by proving that the battle against unintended pregnancies in the Global South can only be won with the intersection of empowerment and complex regional understanding. Importantly, its robust, multi-regional analysis and identification of critical anomalies provide the essential evidence base for designing more effective, non-vertical policies and interventions. Millions of women in the Global South face unintended pregnancies, undermining their reproductive health, rights, and well-being, and increasing maternal health risks. These challenges perpetuate poverty and inequality. Although economic empowerment and gender equality are recognised as key predictors, their individual and combined effects on unintended pregnancies in this region remain insufficiently explored. The study analysed pooled, weighted normalised Demographic and Health Survey (DHS) data from 2015 to 2022 across 51 Global South countries, encompassing 432,130 currently pregnant women aged (15–49 years). Descriptive and bivariate analyses were conducted. Exploratory factor analysis was used to identify latent constructs of economic empowerment and gender equality, and binary logistic regression was used to assess their association with unintended pregnancy. Nearly a quarter of pregnancies (22.4 %) are unintended in the Global South. Latin America and the Caribbean have the highest rates (47.3 %), followed by Africa (29.0 %), and South/Southeast Asia with the lowest (10.3 %). Women’s economic empowerment and gender equality emerged as significant factors in reducing unintended pregnancies. Specifically, economic independence, reproductive health autonomy, and household autonomy were associated with lower odds of unintended pregnancies (AOR = 0.76; AOR = 0.83, and AOR = 0.95; p < 0.001), remaining strong predictors even after accounting for other socioeconomic and bio-demographic variables. To reduce unintended pregnancies, policies should enhance women’s access to microcredit, promote shared household decision-making, and integrate gender empowerment into reproductive health programmes. However, the effectiveness of these interventions varies by region. For improved outcomes, policies must also address broader societal and structural factors.
Source: Sexual & Reproductive Healthcare
Institutions: University of the Witwatersrand, Mulungushi University
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,850
OpenAlex ID: W4417526801