Characteristics of respondents
Description of respondents by selected background characteristics is presented in Table 1 with weighted frequencies and percentages. Overall, the mean age of the women was 32 years, while urban and rural women were 33 and 31 years, respectively. There were slightly older rural women in the sample than their urban counterparts (43.9% vs. 37.2%). With respect to educational attainment, the largest proportion of women had no formal education, with a huge variation by place of residence. For instance, 56.7% of the rural women had no formal education relative to 61.8% of their urban counterparts with secondary/tertiary education. Over two-thirds of the women reported to be currently working (70.1%), but slightly higher among urban women (75.7%) compared with 67% of women residing in rural areas. Generally, the largest proportion of women was found in the lowest wealth quintile households, with variation across the place of residence. The majority of urban women (67.1%) were found in the highest wealth index households, compared to 61.0% of rural women in the lowest wealth index households. Considering region of residence, the proportions of the women ranged from 28.5% in the North-west and 10.0% in the South-south with variations across the place of residence.
Family structure, decision-making measures and negotiating safe sexual practices
Table 2 presents the results of family structure, decision-making and negotiating safe sexual practices of respondents. The results indicate that about 70% of the women were found in monogamous unions, with slightly more rural women than their urban counterparts in polygamous unions (34.8% and 21.7%, respectively). Concerning decision-making measures, Table 2 shows that frequency of having autonomy in healthcare decision and the large household purchase was low, but lower among rural women compared with women residing in urban areas. On the other hand, women had a notably higher rate of autonomy in making decisions on how to spend their earnings (69.5%). A similar result was observed among urban and rural women with a slight difference (67.7% and 70.9%, respectively). Considering attitudes towards negotiating safe sexual practices, over two-thirds of the women believe that a wife is justified asking the husband to use a condom if he has STI and refusing to have sex with the husband if he had sex with other women.
Bivariate association of women’s attitudes towards negotiating safe sexual practices with all the explanatory variables
Wife justified asking the husband to use a condom if he has STI: The results of unadjusted associations between a wife justified asking husband to use a condom if he has STI and all the explanatory variables using multivariate analysis presented in Table 3 showed significant relationships between decision-making measures and wife justified asking the husband to use a condom if he has STI. For instance, coming from polygamous unions was significantly found not to be a protective factor for believing that a wife is justified asking the husband to use a condom if he has STI among urban and rural women (OR: 0.71; CI: 0.63-0.80 and OR: 0.82; CI: 0.76-0.87, respectively). Our results further revealed that the odds of believing that a wife is justified asking the husband to use a condom if he has STI significantly reduced among urban women who made joint decisions on their healthcare with husbands/partners (OR: 0.67; CI: 0.55-0.80) compared with women who had decision-making autonomy on their healthcare. Similar results were observed among urban and rural women whose husbands/partners made such decisions independently (OR: 0.43; CI: 0.36-0.52 and OR: 0.68; CI: 0.59-0.77, respectively). Women in urban and rural areas who had less autonomy in deciding large household purchases were significantly less likely to believe that a wife is justified asking the husband to use a condom if he has STI. For instance, urban and rural women whose husbands/partners made independent decisions on large household purchase (OR: 0.60; CI: 0.48-0.74 and OR: 0.59; CI: 0.50-0.71, respectively) had lower odds of believing that a wife is justified asking the husband to use a condom if he has STI. Also, the odds significantly reduced for urban and rural women who had less autonomy in deciding how to spend their earnings (OR: 0.36; CI: 0.30-0.45 and OR: 0.28; CI: 0.24-0.32, respectively), compared with those in the reference category.
The results in Table 3 further revealed that all the co-variables were significantly associated with women’s belief that a wife is justified asking the husband to use a condom if he has STI, except women’s age. Concerning educational attainment, the odds of believing that a wife is justified by asking the husband to use a condom if he has STI, significantly increased for both urban and rural women with an increase in educational attainment. Being employed significantly increase the odds of believing that a wife is justified asking the husband to use a condom if he has STI for both urban and rural women (OR: 1.46; CI: 1.30-1.63 and OR: 1.29; CI: 1.20-1.38, respectively). Also, the likelihood of women of believing that a wife is justified asking the husband to use a condom if he has STI significantly increased wealth quintile of both urban and rural women. For instance, urban and rural women found in highest wealth quintile households (OR: 1.94; CI: 1.69-2.23 and OR: 1.71; CI: 1.56-1.88, respectively) were significantly more likely to believe that a wife is justified asking the husband to use a condom if he has STI. In comparison with women in the North-central, our results showed that the likelihood of believing that a wife is justified asking the husband to use a condom if he has STI significantly increased among urban women found in the Southern regions and rural women found in the North-east, North-west and South-east (OR: 1.20; CI: 1.09-1.32; OR: 1.13; CI: 1.03-1.24 and OR: 2.99; CI: 2.47-3.61, respectively).
Refusing to have sex with the husband if he had sex with other women: The unadjusted multivariate analysis association results between women’s attitudes towards refusing to have sex with the husband if he had sex with other women are presented in Table 3. Our results showed that both urban and rural women found in polygamous unions (OR: 0.73; CI: 0.66-0.81 and OR: 0.86; CI: 0.80-0.91, respectively) significantly had lower odds of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women. Surprisingly, the results further revealed that rural women having autonomy in deciding their healthcare and large household purchase significantly were less likely to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women. On the other hand, women having less decision-making autonomy on how to spend their earnings reduced the odds of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women. For instance, urban and rural women whose husbands/partners made independent decisions on how to spend their earnings (OR: 0.70; CI: 0.57-0.85 and OR: 0.41; CI: 0.36-0.46, respectively) significantly had lower odds, compared with those in the reference category.
Table 3 further revealed that the likelihood of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women significantly reduced among older women in rural areas, relative to those aged 15-24. An increase in educational attainment increased women’s odds of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women. For instance, urban and rural women with secondary/tertiary education were 30% (OR: 1.51; CI: 1.36-1.68) and 6% (OR: 1.20; CI: 1.12-1.30), respectively more likely than those with primary education to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women. Also, urban and rural women found in highest wealth quintile households (OR: 1.21; CI: 1.07-1.37 and OR: 1.09; CI: 1.00-1.18, respectively) were significantly more likely to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women. A similar result was observed among urban women found in middle wealth quintile households (OR: 1.31; CI: 1.12-1.52). Regarding the region of residence, our results showed that the likelihood of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women increased among urban and rural women found in the North-east, North-west, South-east, South-south and South-west, compared with those in the reference category.
Multivariate association of women’s attitudes towards negotiating safe sexual practices with family structure and decision-making measures
Wife justified asking the husband to use a condom if he has STI: The results of adjusted associations between wife justified asking the husband to use a condom if he has STI and decision-making measures using multivariate analysis are presented in Table 4. Our results showed that urban and rural women found in polygamous unions (aOR: 0.71; CI: 0.61-0.83 and aOR: 0.74; CI: 0.67-0.81, respectively) were less likely to believe that a wife is justified in asking the husband to use a condom if he has STI, compared with those in monogamous unions. Similar results were observed for urban and rural women who had less autonomy in deciding on their healthcare. For instance, the odds of believing that a wife is justified in asking the husband to use a condom if he has STI significantly reduced for urban and rural women whose husbands/partners made independent decisions on their healthcare (aOR: 0.60; CI: 0.47-0.76 and aOR: 0.80; CI: 0.67-0.97, respectively). Also, urban and rural women whose husbands/partners made independent decisions on how to spend their earnings (aOR: 0.38; CI: 0.31-0.47 and aOR: 0.28; CI: 0.24-0.31, respectively) significantly had lower odds of believing that a wife is justified in asking the husband to use a condom if he has STI, relative to those with decision-making autonomy.
Refusing to have sex with the husband if he had sex with other women: The results of adjusted multivariate analysis association between women’s attitudes towards refusing to have sex with the husband if he had sex with other women are presented in Table 4. Urban and rural women found in polygamous unions (aOR: 0.65; CI: 0.57-0.74 and aOR: 0.75; CI: 0.68-0.82, respectively) were less likely to have the belief that a woman is justified in refusing to have sex with the husband if he had sex with other women than those in monogamous unions. Surprisingly, our results further revealed that both urban and rural women who had less autonomy in deciding their healthcare (aOR: 1.24; CI: 1.03-1.24 and aOR: 2.12; CI: 1.81-2.49, respectively) significantly had higher odds of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women, relative to those in the reference category. Our results further showed that urban and rural women whose husbands/partners made independent decisions on how to spend their earnings (aOR: 0.70; CI: 0.57-0.85 and aOR: 0.41; CI: 0.36-0.46, respectively) were significantly less likely to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women, compared with those who had decision-making autonomy.
Multivariate association of women’s attitudes towards negotiating safe sexual practices with family structure, decision-making measures and selected co-variables
Wife justified in asking the husband to use a condom if he has STI: The results of adjusted associations between a wife being justified in asking the husband to use a condom if he has an STI and decision-making measures, as well as co-variables using multivariate analysis, are presented in Table 5. Our results showed that the likelihood of believing that a wife is justified in asking the husband to use a condom if he has STI reduced among women found in polygamous unions, though the result was significant among rural women (OR: 0.81; CI: 0.73-0.90). Also, women who had less autonomy in deciding on their healthcare and how to spend their earnings had lower odds of believing that a wife is justified in asking the husband to use a condom if he has an STI. For instance, the odds of believing that a wife is justified in asking the husband to use a condom if he has an STI significantly reduced for urban and rural women whose husbands/partners made independent their healthcare (OR: 0.59; CI: 0.46-0.76 and OR: 0.83; CI: 0.68-1.00, respectively). Also, women who made joint decisions and whose husbands/partners made independent decisions on how to spend their earnings were less likely to believe that a wife is justified in asking the husband to use a condom if he has STI.
The results in Table 5 further revealed that the odds of believing that a wife is justified in asking the husband to use a condom if he has an STI, significantly increased with additional educational attainment for both urban and rural women. For employment status, being employed was significantly found not to be a protective factor for believing that a wife is justified in asking the husband to use a condom if he has an STI among urban and rural women (OR: 0.49; CI: 0.30-0.79 and OR: 0.08; CI: 0.53-0.84, respectively). Our results showed that an increase in wealth quintiles of both urban and rural women increased the likelihood to believe that a wife is justified in asking the husband to use a condom if he has an STI. For instance, urban and rural women found in the highest wealth quintile households (OR: 1.24; CI: 1.01-1.52 and OR: 1.74; CI: 1.49-2.03, respectively) significantly had lower odds of believing that a wife is justified in asking the husband to use a condom if he has an STI, compared with those in the reference category. Considering region of residence, the results showed that the likelihood of believing that a wife is justified in asking the husband to use a condom if he has an STI significantly increased among urban and rural women found in the North-east (OR: 1.94; CI: 1.42-2.64 and OR: 1.77; CI: 1.49-2.09, respectively) and South-east (OR: 1.40; CI: 1.10-1.78 and OR: 1.42; CI: 1.11-1.82, respectively), but significantly reduced among urban and rural women found in South-west (OR: 0.66; CI: 0.54-0.81 and OR: 0.62; CI: 0.51-0.75, respectively). Besides, the likelihood of believing that a wife is justified in asking the husband to use a condom if he has an STI significantly increased among rural women found in the North-west (OR: 1.26; CI: 1.08-1.47), but reduced for those found in South-south (OR: 0.63; CI: 0.53-0.76).
Refusing to have sex with the husband if he had sex with other women: The results of adjusted multivariate analysis association between women’s attitudes towards refusing to have sex with the husband if he had sex with other women as presented in Table 5, showed that urban and rural women found in polygamous unions (OR: 0.63; CI: 0.55-0.79 and OR: 0.73; CI: 0.66-0.81, respectively) were less likely to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women, compared with their counterparts in the reference category. The likelihood of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women increased among women with less decision-making autonomy on their healthcare. Though, the result was significant among rural women. Our results further showed that urban and rural women whose husbands/partners made independent decisions on large household purchase (OR: 0.71; CI: 0.57-0.87 and OR: 0.40; CI: 0.35-0.46, respectively) were significantly less likely to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women, compared with those in the reference category.
Concerning educational attainment, an increase in urban and rural women’s educational attainment increased the odds of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women. Being employed significantly reduced the odds of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women among urban and rural women (OR: 0.85; CI: 0.62-1.17 and OR: 0.56; CI: 0.45-0.71, respectively). Rural women found in highest wealth quintile households (OR: 1.21; CI: 1.07-1.37) were significantly more likely to believe that a woman is justified in refusing to have sex with the husband if he had sex with other women, compared with those in the lowest wealth quintile households. Our results on the region of residence showed that the likelihood of believing that a woman is justified in refusing to have sex with the husband if he had sex with other women increased among urban and rural women found in the North-east, North-west and South-west regions, relative to those from North-central.