Beyond Individual Choices: Exploring the Social Determinants of Reproductive Autonomy and Gender Based Violence in Rural Niger
- Tomar, Shweta
- Advisor(s): Silverman, Jay;
- Baker, Holly
Abstract
Background: Social context plays a crucial role in shaping individual attitudes and behaviors. This dissertation examines how attitudes, social norms, and social networks influence reproductive autonomy and experiences of gender-based violence (GBV) among adolescent wives (AWs) in rural Niger.Methods: I conducted cross-sectional studies using data from AWs, their husbands, and mothers-in-law. I used multilevel linear regressions to examine fertility-related attitudes and social norms with AWs’ fertility desires. I used generalized estimating equation linear regressions to test the moderating effects of social networks on the relationship between very early child marriage and AWs’ contraceptive self-efficacy (CSE). Finally, I used multilevel logistic regressions to examine the association between AWs’ fertility-related attitudinal discordance from their husbands and peers with reported violence. Results: AW’s social norms (descriptive and injunctive), husbands’ injunctive norms, and community-level descriptive norms were associated with AWs’ fertility desires while individual or collective attitudes were not. (Chapter 2) Early child marriage was associated with lower CSE. AWs’ perception that social network members (alters) use contraceptives or support wives’ involvement in Family Planning (FP) decision-making weakens, and FP-related communication with alters magnifies the negative association between very early child marriage and CSE. (Chapter 3) The relationships between attitudinal discordance between AWs and their husbands/peers and reported violence varied by type of violence. Overall, AWs’ discordant attitudes favoring longer delay before first childbirth were associated with increased odds, while discordant attitudes favoring shorter delay were associated with reduced odds of experiencing violence. (Chapter 4). Conclusion: There is a complex interplay between social norms, interpersonal relationships, reproductive autonomy, and GBV. The association between social norms and fertility desires suggests the need for community-wide interventions that go beyond individual attitudes engaging men and women to foster norms where women can make decisions without social pressure. Our research also highlights the potential for social network-based interventions to mitigate the adverse effects of early child marriage on AWs’ reproductive agency. Interventions must consider how communication with alters can limit AWs' CSE in unsupportive FP contexts. Violence interventions need to be sensitive to the cultural context and address social norms tying women's values to reproduction.