Empowering Women’s Choices: A Comparative Study on Sexual Autonomy and Modern Contraceptive Utilization in Pakistan and Bangladesh

Background: The low contraceptive rates in countries like Pakistan and Bangladesh require that more concepts be explored which are specially relevant or unique to this region. This article explores sexual autonomy along with socio-demographic and cultural factors that greatly influence women's autonomy and contraceptive behavior. Objectives: This study aims to examine the relationship between modern contraceptive use and sexual autonomy among currently married women in Pakistan and Bangladesh, and to identify key demographic factors influencing this relationship. Methodology: The most recent Demographic and Health Surveys (DHS) Pakistan (2017-2018) and Bangladesh (2017-2018) were used. Descriptive and bivariate analyses were used to examine variation in sexual autonomy and contraceptive use across countries, as well as association with major socio-demographic variables including education and place of residence. Results: The difference in reported sexual autonomy was highly significant, with 78.2% of the Bangladeshi women reporting sexual autonomy and only 38.6% among Pakistani women. Increasing sexual autonomy is associated with higher odds of modern contraception use. Multivariable and mediation analyses estimated regional, educational disparities, and the justification of abuse. Conclusion: There is substantial variation in the prevalence of sexual autonomy between Pakistan and Bangladesh. Interventions to improve contraceptive use could give precedence to increasing women's autonomy, including their education and empowerment, while also responding to the sociocultural barriers of country specificity.