Role of women's empowerment in determining fertility and reproductive health in Bangladesh: a systematic literature review

INTRODUCTION: Research on fertility and reproductive health has expanded rapidly. However, questions regarding the association between women empowerment and fertility in terms of the reproductive health status in Bangladesh remain unanswered. This study aimed to address these questions through a systematic literature review. METHODS: In this review study, the PubMed, Scopus, Banglajol, and Google Scholar databases were searched systematically and screened in terms of the inclusion and exclusion criteria. Data from 15 articles included in this review were extracted for further assessment. RESULTS: Fifteen studies with a total of 212,271 participants from Bangladesh met our selection criteria. Most of the articles were conducted on ever-married women aged 15 to 49 years using nationally representative Bangladesh Demographic and Health Survey data. The major religions were Islam (86.8%-90.2%) and Hinduism (10%-13%). The age of women at first marriage varied from 14 to 20 years, and the age at first birth ranged from 16 to 22 years. The fertility rate in Bangladesh has reduced remarkably over the period from 1975 to 2022. After controlling for other social and health factors, the study found that empowerment factors such as women's education, working status, involvement in household decision-making, participation in economic decision-making, and freedom in movement influenced the fertility and reproductive health status in Bangladesh. CONCLUSION: As an initial step, this study found a negative relationship between women's empowerment and the control of fertility and reproductive health. Greater policy focus should be directed toward women empowerment factors to improve the fertility situation and reproductive health status in Bangladesh and other countries with similar sociodemographic profiles.