Rural-Urban Women’s Decision-Making Autonomy on Contraceptive Use in Indonesia

This study examined the relationship between women’s decision-making autonomy and contraceptive use in Indonesia, using data from the 2014 Indonesia Family Life Survey (IFLS) on 9,153 married women aged 15–49. Ordered logistic regression was used to assess the relationship between women’s participation in four household decisions and their decision-making autonomy. These decisions include food purchases, household purchases, freedom to visit family and relatives, and contraceptive use. The findings indicate that women in urban areas have higher levels of decision-making autonomy than those in rural areas. The autonomy index generally increases with age, but rural women consistently show lower autonomy levels across all age groups compared to their urban counterparts. A positive relationship between decision-making autonomy and contraceptive use was observed in both rural and urban settings. The marginal effect of autonomy on contraceptive use is more pronounced for short-acting reversible contraception (SARC) than for long-acting reversible contraception (LARC). Behavioral economic factors, such as distorted perceptions of excessive risk information about LARC, upfront costs, potential discomfort, and traditional social norms, influence contraceptive attitudes and behaviors. These findings underscore the importance of addressing gendered power dynamics and societal norms that restrict women’s autonomy.