Women's Position and Family Planning in Egypt

Author(s): Pavalavalli Govindasamy and Anju Malhotra

Source: Studies in Family Planning, Vol. 27, No. 6 (Nov. - Dec., 1996), pp. 328-340
Published by: Population Council
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 Wiomen's Position and Family Planning
in Egypt

Pavalavalli Govindasamy and Anju Malhotra

In this report, datafrom the 1988 Egypt Demographic and Health Survey are used to address
some of the most frequently raised questions about the relationship between gender inequality and
reproductive behavior. Thefindingsfrom binomial and multinomial logit models show that while
the relationship between women's position andfertility control in Egypt is complex, some clear,
broad patterns exist that have important theoretical and policy implications. First, although
women's status in Egypt is clearly multidimensional, the reproductive aspect of women's position
has a strong connection with the nonreproductive dimensions. Second, the casefor the continued
use of education and employment as proxies of women's position, especially in relationship to
fertility control, is considerably discredited by the results. Finally, thefindings indicate that
Egyptian culture supports gender equality in the form of interaction and negotiation rather than
women's autonomy. (STuEDs IN FAMILY PLANNNmG 27,6: 328-340)

In recent years, it has become increasingly obvious that
demographers need to go beyond theorizing to inves-
tigate empirically the relationship between women's
status and fertility outcomes. The specifics of this rela-
tionship become especially important as programs in
developing countries seek to provide services that are
responsive to and centered around women's reproduc-
tive needs (Basu, 1992; Kritz and Gurak, 1989; Mason,
1984; United Nations, 1994). Traditionally, fertility and
family planning surveys have been an inadequate data
source for examining this relationship, largely because
they have lacked direct measures of women's status,
both within and outside the reproductive sphere (Ma-
son, 1984; Oppong, 1983; Safilios-Rothschild, 1982). At
the same time, small-scale studies that focus on wom-
en's position per se have often lacked the advantages
offered by large-scale demographic surveys: a national
Pavalavalli Govindasamy is Demographic Specialist,
Demographic and Health Surveys, Macro International,
11785 Beltsville Drive, Suite 300, Calverton, MD 20705.
Anju Malhotra is Assistant Professor, Center on Population,
Gender and Social Inequality, University of Maryland.
and international scope; generalizability; a wide vari-
ety of background, household, and socioeconomic in-
dicators; and detailed measures of fertility and contra-
ceptive use.
By incorporating several direct measures of wom-
en's position in the household and in society, the Egypt
Demographic and Health Survey of 1988 served as a pio-
neering effort to make a nationally representative de-
mographic survey more conducive to research on gen-
der issues (Sayed et al., 1989). These data are used here
to address several of the most frequently raised ques-
tions about the relationship between gender inequality
and reproductive behavior: First, if women's status is
multidimensional, are women's autonomy and power
in the nonreproductive aspects of domestic life reflected
in reproductive matters? This report examines the ex-
tent to which those Egyptian women who have a greater
role in household decisionmaking or who have greater
freedom of movement also have a greater role in mak-
ing family planning decisions and are more likely than
others to use contraceptives. Second, how instrumen-
tal are the standard proxies of women's status, particu-
larly education and employment, in defining the above
relationship; that is, to what extent are women em-
powered in domestic and reproductive matters chiefly
because they are educated or employed? Third, how im-

328 Studies in Family Planning

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portant is women's autonomy as opposed to their co-
operation or negotiation in family planning decision-
making and contraceptive use: To what degree are de-
mographically desirable outcomes-such as higher
levels of contraceptive use-related to women's behav-
ioral and philosophical preference for independence
rather than equality?
These issues are particularly worth examining in the
Egyptian context because of the contradictory and com-
plex nature of both gender relations and fertility con-
trol in Egypt. The most populous country in the Arab
world (with a population of 57 million in 1993), Egypt
was also the first Arab nation to institute a policy aimed
at limiting population growth. By the early 1990s, this
aim had been achieved to a modest degree, with a total
fertility rate (TFR) of about 4.0 children per woman, as
compared with 7.0 children in the early 1960s (El-Zanaty
et al., 1993; Naguib, 1994). The decline in fertility has
been associated with increasing levels of contraceptive
use. Rates of current use rose especially rapidly in the
1980s, from 24 percent in 1980 to 38 percent in 1988 (Say-
ed et al., 1989). At the same time, however, the TFR of
4.0 children in 1991 considerably exceeded the ideal fam-
ily size of 3.1 children. One-third of the women sur-
veyed who reported that they desired no additional chil-
dren stated that they were not using a family planning
method (Naguib, 1994).
Much has been written about the contributory role
of women's position in limiting the potential for fertil-
ity control in Islamic societies. The argument has often
been advanced that both religious law and cultural prac-
tices severely restrict women's nonreproductive options
and their freedom of movement at the same time that
they encourage and reward motherhood (Caldwell,
1986; Roudi, 1988). In an alternative view, others have
contended that the "'fateful triangle' model that sees a
pernicious association between Islam, women and de-
mographic outcomes" (Obermeyer, 1992: 34) is inappro-
priate because it overlooks the complexity and variabil-
ity of both gender relations and fertility behavior withinEgypt may, indeed, be positively related, although the
and across Islamic societies (Balk, 1994; Hoodfar, 1988;
Moghadam, 1992; Schuler et al., 1996). For example, Is-
lamic doctrine can be interpreted to reinforce a tradi-
tional position giving women little freedom in repro-
ductive matters, or, as advocated by Muslim reformists
and feminists, it can be interpreted to emphasize the
egalitarian elements of sacred texts that would advo-
cate human rights and reproductive choice.
Anthropological research also reveals contradic-
tions between ideologically legitimated authority for
men and the actual power and autonomy women often
have in Islamic cultures despite sexual segregation
(Hoodfar, 1988; Moghadam, 1992; Obermeyer, 1992 and
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1994). In fact, it has been suggested that in Egypt this
very system of segregation and the strict division of gen-
der roles serve to define some clear domains of power
and influence for women. Gender norms emphasize the
importance of the family, and the culture advocates a
complementarity of male and female roles for the fam-
ily's optimal success. Thus, it is argued that instead of
minimal influence on reproductive decisions, women
are actually likely to have substantial control over such
matters, because they fall within the socially prescribed
female domain (Naguib, 1994; Nawar et al., 1994).
These theoretical contradictions, in combination
with the issue of unmet contraceptive need, pose a chal-
lenging situation for policymakers. Despite the official
population policy favoring family, or couples' rights
over individual rights, services at the program level in
Egypt are currently provided primarily to women (Na-
guib, 1994). The appropriateness of this strategy can be
better assessed by understanding the extent to which
women's position in Egypt is a key concern in implement-
ing further declines in fertility, and the exact nature of
this relationship. For example, if, as the traditional view
suggests, men are the dominant force in all aspects of
family life, including reproductive decisions, family plan-
ning programs might be better aimed at gaining male
approval and participation. Alternatively, if comple-
mentarity of roles means that women have considerable
control over reproductive matters, then whether they are
largely autonomous in this regard or whether consul-
tation and involvement of the husbands is an essential
part of the process would be important to determine. The
latter scenario would still require the reformulation of
family planning services and programs to be substan-
tially more inclusive of men, whereas the former would
require only that women's reproductive needs be ser-
viced in a more effective manner.
Evidence from two recent studies using data from
the 1988 Egypt Demographic and Health Survey sug-
gests that gender inequality and fertility outcomes in
nature, complexity, and dynamics of this relationship
are yet to be specified. Kishor (1995) shows a positive
correlation between aspects of female autonomy and
contraceptive use, whereas Nawar and her colleagues
(1994) show a negative correlation between autonomy
and desired as well as achieved family size.' Correla-
tions, however, could reflect the role of other factors
that are important in determining women's position or
that are the primary driving force behind these relation-
ships. This study, therefore, investigates the links be-
tween women's position, family planning decision-
making, and contraceptive use in a multivariate frame-
work. Multinomial logit models are used, controlling
Volume 27 Number 6 November/December 1996 329
for a wide range of background characteristics, to ex-
amine the relationship of Egyptian women's power
and autonomy in the nonreproductive aspects of their
domestic lives and their preferences regarding who
should make family planning decisions in the house-
hold. Logit models are used to examine current con-
traceptive use as a function of family planning decis-
ionmaking preferences and the other measures of
women's domestic position, again controlling for back-
ground factors.
Women's Position and Fertility
The theoretical connection between women's position
and their fertility can be posited in terms of the supplythat the concept of autonomy is associated with the con-
of and demand for children and the costs of fertility cepts
reg- of choice and rights, and, as such, may not be ap-
ulation. The argument is usually stated that higher lev- plicable universally across social settings (Isvan, 1991;
els of gender inequality mean earlier marriages, great-
er incentives for both men and women to desire more
children as a result of the economic and social advan-
tages they provide, and fewer nonreproductive options
for women. Where their position is low, women are also
likely to experience high social, economic, and personal
costs of adopting fertility control as a result of their lim-
ited knowledge of and access to contraceptives, lack of
communication or agreement with their husbands, and
because of familial and social opposition and stigma
that may be attached to such behavior (Caldwell, 1982;
Dharmalingam and Morgan, 1996; Folbre, 1983; Ma-
son, 1984).
At the same time, the evidence for these theoretical
propositions from existing studies is mixed, often point-
ing toward the complexity of the connections between
women's position and their fertility behavior and to-
ward the need to focus on specific mechanisms and
proximate determinants rather than fertility per se. A
major reason for the ambiguity is that often studies have
failed to conceptualize women's status adequately, or
to measure it by means of direct indicators rather than
in terms of proxy variables such as education and em-
ployment (Kritz and Gurak, 1989; Mason, 1984; Sathar
and Mason, 1993). When more direct measures of gen-
der inequality have been employed, the evidence has
more clearly pointed toward a positive relationship of
status with fertility outcomes (Balk, 1994; Schuler et al.,
1996). Increasingly, evidence has come to light that
when broad-based cultural comparisons are made, con-
sistent differences can be found in gender inequality and tion: If, as recent research suggests, the complementarity
fertilty regimes across social settings (Dyson and Moore,
of gender roles within Egyptian households means that
1983; Malhotra et al., 1995). In micro-level comparisons
of individual women, however, the particular social con-
text may be critical in defining the extent to which wom-
en's position is an important determinant of fertility out-
comes (Balk, 1994; Dharmalingam and Morgan, 1996;
Sathar et al., 1988).
The definition and conceptualization of women's
position itself is also a problem (Mason, 1984; Safilios-
Rothschild, 1982). Here, as in most related studies, the
focus is not on the overall position of women, but rather
on their access to and control of social and economic
resources or options relative to men. In recent years, the
term "autonomy" has come to be used frequently to in-
dicate this access and control, but the term is not en-
tirely satisfactory for two reasons. First, gendered ac-
cess and control usually involve the exercise of power
and influence, not just the ability to act independently.
Second, many non-Western analysts have pointed out
Moghadam, 1992; Naguib, 1994; Nawar et al., 1994).
With regard to Egyptian culture, for example, the sug-
gestion has been made that in common with many other
Middle Eastem and Asian societies, autonomy may not
necessarily be valued and sought as a social good, be-
cause interdependence rather than independence often
results in support, status, and power. A tacit recogni-
tion is given, even in these societies, to the idea that the
ability to carry out one's intentions is desirable. Whether
this ability results from acting autonomously, from hav-
ing gained influence through negotiation and interac-
tion, or from both is not clear (Isvan, 1991; Nawar et
al., 1994). Because for Egypt this question is especially
interesting, an important focus of this analysis is the rel-
evance of women's desire and ability to act indepen-
dently as opposed to their ability to act within a coop-
erative conjugal relationship.
Part of the complexity of women's position in any
society lies in its multidimensionality. Empirical re-
search in an increasing number of settings has begun
to document the multiplicity of women's domestic and
public roles and the variety of dimensions in which
women may or may not exercise power, including the
social, economic, and reproductive arenas (Isvan, 1991;
Mason, 1984; Oppong, 1983). As in other societies, ex-
isting evidence in Egypt suggests that power, input, or
freedom for women in one sphere may not correspond
with a similar status in another sphere (Govindasamy
and Malhotra, 1994; Kishor, 1995). For Egypt, this mul-
tidimensionality poses an especially interesting ques-
childbearing and rearing are particularly within wom-
en's domain of influence, whereas household finances
and physical mobility are less likely to be (Kishor, 1995;

330 Studies in Family Planning

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Naguib, 1994; Nawar et al., 1994), can women's control
of their fertility be achieved without empowering them
in other critical spheres? Most recent political and femi-
nist rhetoric has argued that women's ability to control
reproduction is necessarily and fundamentally related
to their domestic, financial, and intellectual empower-
ment (United States Department of State, 1995; United
Nations, 1994). While broad-based initiatives for im-
proving women's position are desirable from the point
of view of rectifying gender inequities, how essential
they are for achieving demographic goals is not clear.
Do education and employment lead to fertility con-
trol because they give women greater freedom or equal-
ity within their domestic situations than uneducated, un-
employed women can attain? Education and employ-
ment have long been at the forefront of policy recom-
mendations aimed at improving wormen's status, so
much so that they are the most frequently used proxies
for measuring that status (Mason, 1984; Oppong, 1983;
Safilios-Rothschild, 1982; Vlassoff, 1994). As a result
of the widespread negative relationship between edu-
cation and fertility, the argument is usually stated that
exposure to education promotes an ideology of inde-
pendence and egalitarian marital relationships, result-
ing in women's greater desire for and ability to prac-
tice fertility control (Caldwell, 1982; Goode, 1963). How-
ever, the precise mechanisms by which schooling influ-
ences family formation are not well documented, and the
presumption that educated women are more greatly em-
powered or more independent in their married lives than
uneducated women should be tested rather than as-
sumed (Kritz and Gurak, 1989; Sathar and Mason, 1993).
Education has several sequelae for fertility that may be
largely unrelated to women's status (Mason, 1984; Ober-
meyer, 1992). For example, education raises the cost of
rearing children, which may be an important contribu-
tor to declining fertility levels in many parts of the
world (Caldwell, 1982; Dharmalingam and Morgan,
1996; Folbre, 1983). Similarly, the implications of school-
ing for gender equality may not be relevant if those with
higher educational levels are selected from social classes
was interviewed. The present analysis is limited to 7,857
or ethnic groups that prefer lower fertility for other rea-
sons (Sathar et al., 1988).
The proposed role of employment in empowering
women and lowering fertility levels is even more un-
certain, because existing research has not determined
that a consistently negative relationship exists between
women's participation in the labor force and their re-
productive lives. Theoretically, paid work should in-
crease women's opportunity costs of having children,
as well as women's value and power in the family, giv-
ing them greater incentive and ability to practice fertil-
ity control (Dharmalingam and Morgan, 1996; Oppong,
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1983; Safilios-Rothschild, 1990; Schuler et al., 1996). This
proposition is questionable in settings such as Egypt for
two reasons. First, women's employment is most often
based on need rather than choice, and, as such, may not
be a liberating force. The evidence supporting the con-
tention that poorer women may have a larger decision-
making role in their families because of their economic
contribution is mixed (Hoodfar, 1988; Morgan and Nir-
aula, 1995; Naguib, 1994; Obermeyer, 1992; Youssef,
1982). Second, in settings such as Egypt, where gender
norms support the male provider role, large proportions
of women engaged in unpaid labor tend to understate
their economic contribution to their families, and this
perception alone may undermine the possibility of their
gaining additional power or autonomy within the house-
hold (Naguib, 1994; Nawar et al., 1994).
Existing studies of Egypt show that different aspects
of women's power and autonomy are related to educa-
tion in varying degrees, and that they are related less
consistently to employment status (Govindasamy and
Malhotra, 1994; Hoodfar, 1988; Kishor, 1995; Nawar et
al., 1994). The key question in this analysis is how these
relationships are reflected in women's contraceptive use
and in their preferences regarding family planning de-
cisionmaking. Existing studies also show that beyond
these two factors, the broad context of social class, re-
gion, or rural-versus-urban residence is also important
in defining the various dimensions of women's posi-
tion in Egyptian households (Govindasamy and Mal-
hotra, 1994; Hoodfar, 1988; Kishor, 1995; Nawar et al.,
1994). Therefore, the importance of these factors in shap-
ing reproductive outcomes and preferences, directly
and through their influence on gender relations, is also
examined here.
Data and Measures
For the 1988 Egypt Demographic and Health Survey
(EDHS), a nationally representative sample of 8,911 ever-
married women between the ages of 15 and 49 years
currently married women for whom fertility control as
well as domestic control and autonomy vis-a-vis their
husbands or others is an active issue. For women's pref-
erences regarding family planning decisionmaking, the
responses of all these women are examined, whereas
for current contraceptive use, those women who were
currently pregnant or potentially seeking to become
pregnant soon are excluded from the analysis. This lat-
ter group is defined as women who either wanted a
child within the next 12 months or were unsure about
the timing they preferred for having another child in
Volume 27 Number 6 November/December 1996 331
the near future.2 That part of the analysis is, therefore,
limited to 5,790 women.
Dependent Variables
The multivariate analysis focuses on two dependent
variables: current use of modem contraceptives and the
role women think they should play in making repro-
ductive decisions. On the latter issue, the EDHS asked
women two questions: Who should have the last word
on having another child and who should decide on the
adoption of family planning?3 The responses available
were: (1) primarily the husband; (2) both husband and
wife; (3) primarily the wife; (4) someone else.4 These re-
sponses permit an examination of the extent of norma-
tive preference for egalitarian or autonomous decision-
making on reproductive matters. The responses to the
two questions overlap to such a degree that in order to
avoid redundancy and remain thematically close to the
issue of contraception, only the latter question is used
in the analysis. The overlap suggests, however, that, to
some extent, the analysis reflects the broader nature of
gender and reproductive decisions in Egypt.
Independent Variables
In measuring women's position within Egyptian house-
holds, the purpose here is not to include a comprehen-
sive set of indicators, because the survey instrument
did not (and could not) capture all important dimen-
sions of gender inequality in Egyptian life. Rather, a
limited set of indicators is examined that represents dif-
ferent dimensions of women's autonomy and power
within the Egyptian setting and that could be consid-
ered to have an impact on reproductive outcomes. To
that end, only those questions on women's position in
the EDHS were retained in the analysis that were least
speculative and most directly relevant to women's lives.
They include two behavioral indicators and one attitu-
dinal one:
1 Because seclusion has been considered to deny
women opportunities to participate in income-
generating activities and to limit their access to
resources, services, support systems, ideas, and
information (Youssef, 1982), a measure on free-
dom of movement is included. It is an indica-
tor based on a series of questions on whether
and under what circumstances-how frequent-
ly and accompanied by whom-women are
able to go out of the house to purchase major
household items or clothing and visit friends
and relatives. A continuous index variable was
332 Studies in Family Planning
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constructed ranging from 1 to 12, based on the
combined responses to these questions, allocat-
ing high scores for women's freedom to ven-
ture outside the household often and unescort-
ed. The issue of women's physical mobility is
an important one in Egyptian society, and in
many ways it is the dimension in this analysis
where independence and autonomy are chiefly
at issue.
2 A woman's overall input in household decisions
is a key indicator of her power and importance
within the family. A question in the EDHS that
comes closest to capturing this input pertains to
a woman's own perception regarding the weight
of her point of view within the household. Re-
sponses available are: same as husband's; less
than husband's; or no weight at all.5
3 Household finances are considered a key re-
source, control over which can allow women
the ability to act independently or to influence
household and reproductive decisions. To the
extent that the financial domain is considered
largely a male sphere within Egyptian society,
women with input on economic issues in the
household may be especially empowered. In the
EDHS, two questions were asked to determine
women's preference regarding who should con-
trol the household budget or make decisions re-
garding lending and borrowing. Responses avail-
able were: primarily the husband; both hus-
band and wife; primarily the wife; someone else.
Again, these responses permit an examination
of the normative preference for dependent, as
opposed to egalitarian or autonomous decision-
making. Because responses to the two questions
showed similar distributions, the question on
household budget is used as the indicator for
preferences regarding financial matters.6
In addition to indicators of these specific dimen-
sions of gender inequality, a set of background charac-
teristics that can shape both women's position and fam-
ily planning decisions or contraceptive use is included:
education, cash and noncash employment, childhood
and current urban residence, religion, socioeconomic
status,7 and the cultural and economic differences rep-
resented by the three regions of Egypt (the Govemor-
ates, Upper Egypt, and Lower Egypt). Because these
outcomes are also likely to be influenced by life-course
and family-formation stages, they are controlled for age,
marital duration, and parity.
Results
Figure 1 shows distributions of selected background
characteristics for Egyptian women. Educational levels
among currently married women are low, with about
one-half having no schooling at all. Even more dramati-
cally, the vast majority (80 percent) of women report
not being engaged in any employment activity, and of
the remaining women, a slightly higher percentage (12
percent) are engaged in noncash rather than cash-based
labor activities. These figures almost certainly underre-
port the economic contribution of married Egyptian
women to their families (Hoodfar, 1988; Nawar et al.,
1994). That the women themselves do not consider their
work of economic value is, to some extent, indicative of
the value given it in the family and in the society.
Figure 2 shows the percentage distributions of the
two dependent variables and the three measures of
women's position. Of the women who are not currently
pregnant or potentially seeking to become pregnant
only about half are using a contraceptive method. With
regard to women's preference for who should make re-
productive decisions, the great majority (60 percent)
consider it to be a matter of joint input by husband and
wife. However, a substantial minority (26 percent), con-
sider it to be solely the husband's (or someone else's)
prerogative. Thus, although normative support exists
Figure 1 Percentage distribution of currently married women, by selected background variables, Egypt, 1988
Variables
..... None
Education 31.7 Primary
Pl ~~Secondary
C... ...... . .....................
Employment I Cash
E SNon cash
Current residence - 56 Rural
. .............3, Govemorates
Region 39.6 Upper Egypt
Lower Egypt
Religion 6. Oter _ MusMim
7-- ero
Parity 12.1 One
(living children) ore
Percent
Source: Egypt Demographic and Health Survey, 1988 (Sayed et al., 1989).
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for the argument that childbearing is a domain in which
Egyptian women have substantial input, it is clearly not
a domain of autonomous decisionmaking for them. Only
14 percent of the women surveyed consider it to be a
matter decided primarily by the wife.
The distributions for the nonreproductive dimen-
sions of women's position also bear out the argument
that gender inequality is multidimensional, and that
Egyptian women have varying degrees of power and
autonomy in different spheres. Clearly, substantial vari-
ability exists within this Islamic society with regard to
women's mobility, with almost one-third of those sur-
veyed considering themselves to be substantially inde-
pendent, and an additional 49 percent exercising a mod-
erate range of freedom and mobility. Similarly, contrary
to the impression that Muslim women are completely
dominated and subservient, 41 percent of the women
in the sample report that their point of view has the same
weight as their husband's, and an additional 48 percent
consider their input to have at least some impact: Only a
small minority (11 percent) of the women stated that their
viewpoint does not matter at all. Also, as expected, the
least normative support for a decisionmaking role for
women is found in the financial sphere: A substantial ma-
jority (58 percent) of the women consider that most bud-
getary matters are appropriately within their husbands'
(or others') control.
N o n e
Volume 27 Number 6 November/December 1996 333
Figure 2 Percentage distribution of currently married women, by current contraceptive use, preference for who should make
family planning decisions, and three measures of women's position, Egypt, 1988

Variables and measures

RR~f Cur-rently using
Contraceptive use 36.1 Not using
......... Pregnant or potentially seeking to become p

tamlly planmng aeclslonsPrimarily wife

Preference for who should make Husband or others

~~Low
family planning decisions .... 60.4 Both husband and wife

f ~~~~High|
Wife's freedom of movement 48.7 Medium

Wife's assessment of weight of her own Not taken into account

point of view within household 410 S as hus
[ 0;00?!Ni0?0?.+: i 0 4., .......i.....i......... ... aSam

Preference for who should _ Husband or others

make budget decisions 27.0 Both husband and wife
... . ...... Primarily wife

Percent

Source: Egypt Demographic and Health Survey, 1988 (Sayed et al., 1989).

Preferences about Family Planning Decisionmaking
Multinomial logit models are used here for the multi-
variate estimation of the three-category dependent vari-
able for preferences regarding family planning decision-
making. In a multinomial logit model, all three categories
are included in pairwise contrasts, and each pair of out-
comes is compared while controlling for the possibility
of the third outcome. Two such models were estimated,
one where only background factors are considered
while the indicators of women's position are excluded,
and a second where the full set of explanatory variables
is considered. This approach permits a determination
of the extent to which background factors, especially
education and employment, mediate their effect on re-
productive decisionmaking preferences through the
other measures of women's position. However, this
analysis also produces six sets of contrasts, and an equal
number of logit coefficients that can be cumbersome to
examine jointly. Therefore, Table 1 presents the results
in a less complex form, showing the relative size of sig-
nificant coefficients only. Pluses and minuses indicate
the direction of the coefficient as well as its relative
strength: A single plus or minus indicates a relatively
small effect, whereas a group of four pluses or minuses
indicates an extremely strong effect. The strength of the
relationship is not the same as the degree of statistical
significance. In addition, Figure 3 assists in the inter-
pretation of these findings by presenting the predicted
probabilities for the three outcomes in the dependent
variable as a function of some of the independent vari-
ables of central interest.8
The results shown in Table 1 and Figure 3 shed light
on several issues. First, they show conclusively that
even after controlling for background characteristics,
the variables for women's position have a substantial im-
pact on Egyptian women's preferences regarding who
should make family planning decisions in the house-
hold. As Table 1 shows, the pseudo R2 of .093 in Model
1 doubles to .184 in Model 2, indicating the explana-
tory power of these variables.9 In fact, the coefficients
for the variables for women's position show some of
the strongest effects on the dependent variable. This can
be seen more clearly in Figure 3, where the variation in
predicted probabilities regarding who should make re-
productive decisions is greatest across the measures on
wife's point of view and budgetary decisions. Thus, dif-
ferences in women's input in household matters, free-
dom of movement, and views on budgetary matters are
related to important and measurable differences in their
preferences about who should make fertility decisions.
This relationship indicates that Egyptian women's atti-
tudes regarding reproductive decisionmaking are not
independent of their status within the household on
other matters. That is, although women in Egypt pre-
fer to have considerable input on family planning mat-
ters, they are more likely to do so if they have autonomy
and input in other aspects of their domestic lives.

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Table 1 Strength of significant coefficients in multinomial logit models: Currently married women's preference for who should
make family planning decisions as a function of women's position and background factors, Egypt, 1988
Model 1 Model 2
Both husband Both husband
and wife Wife versus Wife versus and wife versus Wife versus Wife versus
versus husband husband both husband husband or husband both husband
Variables or others or others and wife others or others and wife

Background factors
Education
None (r)
Primary + + ns ns ns ns
Secondary +++ ++ -- ++ + ns
Employment
None (r)
Noncash ns ++ - + ++
Cash ns ns ns - ns ns
Current residence
Rural (r)
Urban + + ns ns ns ns
Region
Govemorates (r)
Upper Egypt -- -- -- --
Lower Egypt ns -- -- ns -- --
Childhood residence
Rural (r)
Town ns ns ns ns ns ns
City ++ ++ ns + + ns
Religion
Muslim (r) - - ns ns ns
Non-Muslim ns ns - ns ns ns
Socioeconomic status
Poor (r)
Middle class + ns ns ns + ns
Upper middle class ++ ++ ns ns + ns
Upper class +++ ns - ++ ns
Age ns ns ns ns ns ns
Martal duration ns ns ns ns ns ns
Parity + ++ - + ++
Women's position
Freedom of movement - - - + - --
Preference for who makes
budget decisions
Husband/others (r) - - -
Both husband and wife - - - +++I+ - -
Primarily wife - - - +++ ++++ +
Wife's assessment of weight of her
own point of view in household
No weight at all (r)
Less than husband's - - +++ + --
Same as husband's - - ++++ ++

Pseudo R2(N) .093 (7,857) .184 (7,857)

(r) = Reference category. -= Not applicable. ns = Not significant.

Note: Pluses and minuses indicate the direction of the coefficient as well as its relative.strength: A single plus or minus indicates a relatively small effect, whereas
group of four pluses or minuses indicates an extremely strong effect.

However, the results show that these three variables
do not affect family planning decisionmaking prefer-
ences in the same manner or to a similar degree, thus
providing support for the idea that women's position
is multidimensional. For example, Figure 3 indicates
that women who feel that their viewpoint has no weight
in their household are likely to run contrary to the gen-
eral norm toward a preference for joint decisionmaking
on reproductive matters: If all else is equal, 46 percent
of these women are likely to think that husbands or oth-
ers should be making such decisions, while only 37 per-
cent support joint input by husband and wife. By con-
trast, if all else remains equal, a majority of the wo.men
with even the lowest level of mobility (55 percent), or
those who prefer their husbands to control family fi-
nances (54 percent), are likely to support joint decision-
making on family planning matters. Furthermore, the ef-
fect of freedom of movement is weaker than that of who

Volume 27 Number 6 November/December 1996 335

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Figure 3 Predicted probabilities: Women's preference for who should make family planning decisions, by selected

characteristics, Egypt

DoWife

~ ~1 41 EliBoth
~~~~ ~~~~~ ~~~~~~<~~~~~~> ~~~~husband
and wife
80

Gn ~~~~~~~~~~~~~~~~~~~~~~~~lHsad
others
0.37

60 0.59 ~0580.54
0.60 0.60 0.6202 0.65 0.55 0.61 0.66 0.60
0.68 0.80 0.70
w40~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~......
0.62~~~~~~~~~~

046.....

40 .......0 _ '0
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ 0~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~......

a) '~~~~~~~~~~~~~~~~~~~~~~~~~~~ ou,~~~~~~~~~~~~~~~~~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~~~~~~ ~~~~~~.....

~ ~~~ ~~~ ~~~~~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~. . . . . .

.....

"~~~~~~~~~~~~~~~~~~~~~~~~~~~ 'g~ ~ ~ ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~.....

Characteristics~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~......

makes budget decisions or that of the perceived weight en's position contribute toward an explanation of varia-
of women's point of view.'0 tions in attitudes about family planning above and be-
In general, regardless of the variations in women's yond the explanation based on education and employ-
position, and indeed for any of the other variables, ment. Second, although taking women's position directly
equality rather than autonomy seems to be Egyptian into account reduces the effect of education, it does not
women's preference with regard to reproductive de- completely eliminate it. The results indicate that primary
cisionmaking. Although it varies to some degree, the schooling in Egypt may be influencing women's atti-
middle bar showing joint decisionmaking is the most tudes regarding family planning decisionmaking almost
prominent across the categories of almost every vari- entirely through its effect on their domestic power and
able in the figure. For freedom of movement and weight freedom. However, a substantial portion of the effect
of wife's point of view, the two categories where women of secondary schooling seems to operate through other
rank highest are actually the ones most supportive of channels: Even after accounting for the women's posi-
joint rather than independent decisionmaking. Simi- tion variables in Model 2, secondary education contin-
larly, women who prefer joint decisionmaking on finan- ues to have a strong and independent influence on atti-
cial matters also overwhelmingly prefer joint decision- tudes regarding reproductive decisionmaking.
making on reproductive matters. However, possibly With employment, the story is even more complex.
because a woman's having sole control of household The results show that the effects of cash employment
finances is unusual in Egypt, women who express this are actually more modest than the effects of noncash
preference are also the ones who are most likely to pre- employment. Furthermore, taking women's position
fer having sole control of family planning decisions. into account actually enhances these effects. Moreover,
With regard to schooling and employment, the re- employment for cash tends slightly to increase wom-
sults show that while women's position does mediate the en's preference for their husbands to make family plan-
effect of these variables for attitudes regarding fertility ning decisions (29 percent as opposed to 24 percent for
control, they cannot be considered proxies for direct mea- women who are not employed). Because this effect is
sures of women's status. First, as can be seen by the dif- apparent only in Model 2, it appears that cash employ-
ferences in R2 for the two models, the variables on wom- ment does improve women's position within the house-

336 Studies in Family Planning

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hold, and that this improvement serves to counteract Table 2 Odds ratios of current contraceptive use as a
women's tendency to defer family planning decisions function of women's preference for who should make family
planning decisions, women's position, and selected
to their husbands. A similar, but less pronounced pat-
background factors, among currently married women who are
tern among those who are not paid cash for their labor
not pregnant or potentially seeking to become pregnant soon,
suggests that possibly the mere fact of their working Egypt, 1988
poses a threat to the man's status as a provider, and these Variable Model 1 Model 2
women may be especially conscious of expressing def- Background factors
erence to their husbands. This pattern, however, is not Education
None (r) 1.00 1.00
universal among working women. Remarkably, the re-
Primary 1.45*** 1.44*
sults also indicate that the women employed in noncash Secondary 1.39** 1.34U
activities are more likely than those who are paid to sup- Employment

port wives' exclusive control over family planning de- None (r) 1.00 1.00
Noncash 1.25* 1.27*
cisions (predicted probability of 21 percent as opposed
Cash 1.00 1.03
to 13 percent). If the noncash work is largely in family Current residence
or farm activities, some women engaged in such work Rural (r) 1.00 1.00
Urban 2.06*** 2.02*
may be frustrated by the constraints it imposes and by
Region
their lack of recognition as contributors to the house- Governorates (r) 1.00 1.00
hold's well-being. In such cases, reproductive decision- Upper Egypt 0.59*** 0.61
Lower Egypt 1.64*** 1.66m
making may be a desirable form of independence.
Childhood residence
Rural (r) 1.00 1.00

Current Contraceptive Use Town 1.51* 1.48*

city 1.04 1.03
Religion
Logit models are employed to predict the current use
Muslim (r) 1.00 1.00
of contraceptives as a function of background factors, Non-Muslim 1.87 1.20
measures of women's position, and respondents' pref- Socioeconomic status

erences regarding family planning decisionmaking.11 Poor (r) 1.00 1.00

Middle class 1.62*** 1.61
Table 2 shows the odds ratios of using a contraceptive
Upper middle class 2.34*** 2.30*
method for each unit increase in a continuous indepen- Upper class 2.92*** 2.88*
dent variable, or in comparison with the omitted cat- Age 0.98* 0.97*
Marital duration 0.72*** 0.97*
egory of the discrete variables. An odds ratio above 1.00
Parity 1.25*** 1.26*
indicates greater likelihood of practicing contraception, Women's position
whereas an odds ratio below 1.00 indicates the oppo- Freedom of movement 1.08*** 1.08*
Preference for who makes budget decisions
site. The measure of women's preferences for who
Husband/others (r) 1.00 1.00
makes family planning decisions is excluded in Model Both husband & wife 1.21* 1.09
1 so that the extent to which it mediates the effect of Primarily wife 1.13 1.02

the nonreproductive dimensions of women's position Wife's assessment of weight of her own
point of view in household
can be seen by comparing the coefficients of women's
No weight at all (r) 1.00 1.00
position variables in Models 1 and 2. Less than husband's 1.34** 1.18

The results in Table 2 indicate that regardless of Same as husband's 1.29* 1.11
Preference for who makes family planning decisions
other background characteristics, Egyptian women
Husband/other (r) - 1.00
with egalitarian and independent attitudes regarding Both husband and wife - 1.67*
family planning decisionmaking are actually more Primarily wife - 1.69*

likely to be using contraceptives than are women who Model chi square 1215.2 (21df) 1256.8 (23df)
(N) (5,790) (5,790)
consider this matter to be primarily within the hus-
Significant at * p < 0 .05; **
band's (or others') domain. However, an independent
-= Excluded.
attitude regarding family planning decisionmaking
does not result in a greater likelihood of using contra-
ceptives when it is compared with a preference for joint The findings indicate that a woman's greater free-
decisionmaking. For a woman who prefers independent dom of mobility and her greater influence in the non-
or joint decisionmaking in family planning matters, the reproductive sphere also result in a higher likelihood
odds of using a method are about 1.7 in comparison of her using a contraceptive method. However, a wom-
with a woman who prefers to leave family planning de- an's influence on her household and her attitudes re-
cisions to her husband or others. garding financial matters affect her contraceptive use

Volume 27 Number 6 November/December 1996 337

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largely as a result of her attitudes regarding who should
make reproductive decisions. Freedom of movement,
on the other hand, has a strong and independent posi-
tive effect on contraceptive use above and beyond a
woman's philosophy regarding family planning deci-
sions. This is an important finding in the context of the
general preference for jointly made decisions in Egypt.
Possibly because they allow women greater access to
contraceptive services, independence and freedom of
movement for women make a material difference in the
practice of family planning even within a cultural con-
text where joint input by husband and wife is advocated
on many fronts.
The effects of education and employment, as well
as of many other background characteristics, are not at
all mediated by women's preferences regarding repro-
ductive decisionmaking. The odds ratios for these vari-
ables are almost identical in Models 1 and 2. Further-
more, many background variables exert a strong and
independent influence over contraceptive use regardless
of a woman's position in the household, her freedom of
movement, or her attitudes regarding the control of fi-
nances. In their relationship to contraceptive use, there-
fore, education and employment cannot be considered
effective proxies of women's position on reproductive
or nonreproductive dimensions in Egypt; clearly, a sub-
stantial part of their effect is channeled through some
other mechanism.
Along with rural-urban residence, region, and -so-
cioeconomic status, education is an important predic-
tor of contraceptive use in Egypt. Interestingly, the level
of education is not very important: The odds of wom-
en with primary as well as secondary schooling using
contraceptive methods are about 1.4 times higher than
those for women without schooling. As a result of the
overlap in educational and socioeconomic status, part of
the effect of higher education on contraceptive use may
be apparent in the positive impact of middle and upper-
class status. The effect of employment status is not as
strong, although the findings that cash rather than non-
cash activities increase the likelihood of contraceptive
use are closer to expectations, as compared with the
findings regarding reproductive decisionmaking. Re-
gardless of their domestic position and their expressed
attitudes, women working for cash may be financially
better able and more highly motivated to practice con-
traception than are women who do not work for cash
remuneration.
Conclusions
The analysis of findings provides important insights
338 Studies in Family Planning
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into the relationship between women's position and fer-
tility control in Egypt. Although the relationship is natu-
rally complex, some broad patterns are clearly seen that
have important theoretical and policy implications.
First, despite the multidimensionality of women's
status, the reproductive aspect of women's position in
Egypt has a strong connection with nonreproductive
dimensions. In a combination of attitudes and behav-
iors, women who are supportive of power and auto-
nomy for wives in household matters and finances and
who enjoy freedom of movement are also more likely to
be supportive of wives' having an equal or sole input in
reproductive decisionmaking. This finding means that
efforts at improving Egyptian women's status are not
just worthy goals in terms of gender equality, but that
they can have important repercussions for fertility out-
comes. Preference for influencing reproductive deci-
sions is strongly related to higher levels of contracep-
tive use among these women.
Second, the case for the continued use of educa-
tion and employment as proxies of women's position,
especially in their relationship to fertility control, is se-
riously discredited by these results. Education and em-
ployment only partially mediate the relationship be-
tween the reproductive and nonreproductive dimen-
sions of women's position; a substantial part of their
effect on contraceptive use is channeled through other
mechanisms. Furthermore, the findings indicate that
the three-way relationship between employment, wom-
en's position, and fertility control is a complex one, and
not easily captured in proxy form.
Finally, to a large extent, the results confirm the ar-
gument that in its manifestations of higher status for
women, Egyptian culture supports interaction and ne-
gotiation rather than autonomy. Within this Islamic so-
ciety, despite the considerable variability across mea-
sures of women's position, higher status in the nonre-
productive spheres is found to promote women's pref-
erence for joint rather than sole decisionmaking in fam-
ily planning matters. Furthermore, women with a phil-
osophy of autonomy on this issue are only as likely to
practice contraception as are women who are support-
ive of a more egalitarian approach.
Autonomy is not irrelevant or negative in shaping
Egyptian women's attitudes and behavior regarding
fertility control. In general, it plays a role similar to
egalitarianism, and, in some cases, it has an important
independent effect most evident in the strong and posi-
tive relationship between freedom of movement and
contraceptive use. Although policymakers must in-
creasingly consider and incorporate Egyptian men in
family planning program objectives, they must also fo-
cus on women's special needs and constraints, espe-
cially those of access and availability to contraceptive
methods.
Acknowledgment
This research was made possible in part by support from the
Hewlett Foundation and the United States Agency for Inter-
national Development (USAID) through its DHS program.
The authors thank Mark Mather and Qiang Li for assistance
with data analysis.
Notes
1 Kishor's study uses only the 1988 Egypt Demographic and Health
Survey, whereas Nawar et al. use it in conjunction with a 1991
Central Agency for Public Mobilization and Statistics (CAPMAS)
survey on "The Characteristics of the Household and the Role
of Egyptian Women in the Family"; their correlation of autonomy
and family size is based on the latter data source.
2 This group of women is excluded because, almost by definition,
they are not using contraceptives. In most of their behaviors,
women who stated that they wanted a child within the next 12
months and those who were unsure about their preferred tim-
ing for their next birth resembled each other. They also differed
substantially from women who stated a confirmed later pref-
erence for the next birth or who did not desire an additional
child.
3 The EDHS measured only preferences rather than actual input
on this issue. Although these attitudinal measures are not the
preferred option as dependent variables, in reflecting a combi-
nation of normative and personal perspectives, they represent
an important dimension of gender inequality in reproductive
processes in Egypt.
4 On this and other questions with similar response categories, cat-
egories 1 and 4 are combined because of the small number of
cases in the "others" category.
5 Other questions of this nature concerned women's attitudes
about voicing disagreement with their husbands and on a wom-
an's role in the home versus her role in the workplace. The re-
sponses to the behavioral question are preferred for analysis here
because the question represents women's actual situation rather
than their personal or normative viewpoint.
6 As in the case of reproductive decisions, the questions about
financial decisions measure normative and personal prefer-
ences; the present analysis is limited to these questions rather
than actual decisionmaking input because of the structure of
the EDHS.
7 The measure of socioeconomic status is based on ownership of
relevant consumer durables in Egyptian society. In ascending
order, these are: a black-and-white television, an electric or gas
stove, a color television, or a car. Those in a higher social class
could own any or all of the items used to classify those in the
socioeconomic groups below them.
8 Based on the multinomial logit coefficients, the predicted prob-
abilities show the likelihood of each given outcome of the depen-
dent variable conditional for a given characteristic among inde-
pendent variables, and holding all other characteristics constant.
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9 The R2 statistic that is typically used to measure goodness of fit in
the context of ordinary least squares regression models is not ap-
propriate for logit models because it assumes a linear estimation
procedure. Nonetheless, several "pseudo R2" statistics have been
proposed for logit models, and the one used here is calculated as
[1- L(Q)/L(w)], where L(QI) is the value of the estimated log-like-
lihood function and L(X) is the value of the log-likelihood func-
tion according to the null hypothesis.
10 To some degree, the strength of these coefficients is deceptive
because freedom of movement is a continuous variable, while
the other two measures of women's position show effects of dis-
crete categories. However, the predicted probabilities in Figure
3 show clearly that differences in attitudes regarding family plan-
ning decisionmaking across various levels of freedom of move-
ment are much smaller than across the three categories for the
other two variables.
11 In this analysis, the exclusion of women who are currently preg-
nant or who potentially are seeking to become pregnant soon
gives a truer contrast between users and nonusers of contracep-
tives, because the latter group omits women who have little rea-
son for practicing contraception. However, it does raise the issue
of selection bias: Women who are pregnant or who potentially are
seeking to become pregnant soon could have been selected for the
very characteristics that we are theoretically interested in. For
example, women who are pregnant may have less decision-
making power or autonomy than others, which may be the rea-
son that they are pregnant. This potential problem of selection
bias is dealt with here by constructing a multinomial logit model
for the entire sample of currently married women using a three-
category dependent variable: (1) pregnant or potentially seek-
ing to become pregnant soon; (2) currently using a contracep-
tive method; and (3) not using a method. This analysis showed
that although the women in the first category are a select group
(having less education and lower position), when compared with
women who are using contraceptives, they show a pattern simi-
lar to that of women who are not using a method. Furthermore,
the contrast of central interest-that between users and nonus-
ers-shows essentially the same picture in the logit models that
are presented in the analysis. The results in the logit models,
therefore, are not biased as a result of the exclusion of this group
of women.
References
Balk, Deborah. 1994. "Individual and community aspects of women's
status and fertility in rural Bangladesh." Population Studies 48,1:
21-45.
Basu, Alaka. 1992. Culture, the Status of Women, and Demographic Be-
havior. Oxford: Clarendon Press.
Caldwell, John. 1982. Theory of Fertility Decline. London: Academic
Press.
. 1986. "Routes to low mortality in poor countries." Popula-
tion and Development Review 12,2: 171-220.
Dharmalingam, A. and S. Philip Morgan. 1996. "Women's work, au-
tonomy, and birth control: Evidence from two South Indian vil-
lages." Population Studies 50,2: 187-202.
Dyson, Tim and Mick Moore. 1983. "On kinship structure, female
autonomy and demographic behavior." Population and Develop-
ment Review 9,1: 35-60.
Volume 27 Number 6 November/December 1996 339
El-Zanaty, Fatima, Hussein Sayed, Hassan Zaky, and Ann Way. 1993.
Egypt Demographic and Health Survey 1992. Cairo and Calverton,
MD: National Population Council and Macro Intemational.
Folbre, Nancy. 1983. "Of patriarchy born: The political economy of
fertility decisions." Feminist Studies 9,36: 159-175.
Goode, William J. 1963. World Revolution and Family Patterns. New
York: Free Press of Glencoe.
Govindasamy, Pavalavalli and Anju Malhotra. 1994. "Aspects of fe-
male autonomy in Egypt: What can we learn from DHS data?"
Paper presented at the 1994 annual meeting of the Population
Association of America, Miami, 5-7 May.
Hoodfar, Homa. 1988. "Household budgeting and financial manage-
ment in a lower income Cairo neighborhood." In A Home Divided:
Women and Income in the Third World. Eds. Daisy Dwyer and
Judith Bruce. Stanford, CA: Stanford University Press.
Isvan, Nilufer A. 1991. "Productive and reproductive decisions in
Turkey: The role of domestic bargaining." Journal of Marriage and
the Family 53,4: 1,057-1,070.
Kishor, Sunita. 1995. "Autonomy and Egyptian women: Findings
from the 1988 Egypt Demographic and Health Survey." Demo-
graphic and Health Surveys Occasional Papers 2. Calverton, MD:
Macro International.
Kritz, Mary M. and Douglas T. Gurak. 1989. "Women's status, edu-
cation and family formation in sub-Saharan Africa." International
Family Planning Perspectives 15,3: 100-105.
Malhotra, Anju, Reeve Vanneman, and Sunita Kishor. 1995. "Fertil-
ity, dimensions of patriarchy, and development in India." Popu-
lation and Development Review 21,2: 281-305.
Mason, Karen Oppenheim. 1984. The Status of Women: A Review of its
Relationships to Fertility and Mortality. New York: The Rockefeller
Foundation.
Moghadam, Valentine M. 1992. Modernizing Women: Gender and So-
cial Change in the Middle East. Boulder, CO: Lynne Reiner Pub-
lishers.
Morgan, S. Philip and Bhanu Niraula. 1995. "Gender inequality in two
Nepali villages." Population and Development Review 21,4: 745-782.
Naguib, Nora Guhl. 1994. "Gender inequalities and demographic
behavior: The case of Egypt." Paper presented at the Popula-
tion Council Symposium on Family, Gender, and Population Pol-
icy: International Debates and Middle Eastern Realities, Cairo,
7-9 February.
Nawar, Laila, Cynthia B. Lloyd, and Barbara Ibrahim. 1994. "Wom-
en's autonomy and gender roles in Egyptian families." Paper pre-
sented at the Population Council Symposium on Family, Gen-
der and Population Policy: International Debates and Middle
Eastern Realities, Cairo, 7-9 February.
Obermeyer, Carla Makhlouf. 1992. "Islam, women, and politics: The
340 Studies in Family Planning
This content downloaded from 159.91.93.138 on Fri, 03 Nov 2017 20:09:27 UTC
All use subject to http://about.jstor.org/terms
demography of Arab countries." Population and Development Re-
view 18,1: 33-60.
.1994. "Reproductive choice in Islam: Gender and state in Iran
and Tunisia." Studies in Family Planning 25,1: 41-51.
Oppong, Christine. 1983. "Women's roles, opportunity costs, and fer-
tility." In Determinants of Fertility in Developing Countries. Eds.
Rodolfo A. Bulatao and R.D. Lee et al. New York: Academic
Press.
Roudi, Nazy. 1988. "The demography of Islam." Population Today 16,3:
6-9.
Safilios-Rothschild, Constantina. 1982. "Female power, autonomy
and demographic change in the third world." In Women's Roles
and Population Trends in the Third World. Eds. Richard Anker et
al. London: Croom Helm.
.1990. "Women's income profile as a key indicator of women's
status for the understanding of changing fertility behavior in ru-
ral Kenya." Genus 46,3-4: 31-43.
Sathar, Zeba, Nigel Crook, Christine Callum, and Shahnaz Kazi. 1988.
"Women's status and fertility change in Pakistan." Population and
Development Review 14,3: 415-433.
Sathar, Zeba A. and Karen Oppenheim Mason. 1993. "How female
education affects reproductive behavior in urban Pakistan." Asian
and Pacific Population Forum 6,4:93-103.
Sayed, Hussein Abdel-Aziz, Magued I. Omran, Fatma El-Zanaty, and
Ann A. Way. 1989. Egypt Demographic and Health Survey 1988.
Cairo and Calverton, MD: National Population Council and
Macro International.
Schuler, Sidney, S.M. Hashemi, and Ann P. Riley. 1996. "The effects
of two credit programs and women's empowerment on contra-
ceptive use in Bangladesh." Paper presented at the annual meet-
ing of the Population Association of America, New Orleans, 9-
11 May.
United Nations. 1994. Programme of Action of the United Nations Inter-
national Conference on Population and Development. New York:
United Nations. Chapter 4.
United States Department of State. 1995. Report to the Presidentfrom
the United States Delegation to the United Nations Fourth World Con-
ference on Women. Washington, DC: United States Department
of State.
Vlassoff, Carol. 1994. "From rags to riches: The impact of rural de-
velopment on women's status in an Indian village." World De-
velopment 22: 707-719.
Youssef, Nadia H. 1982. "The interrelationship between the division
of labor in the household, women's roles and their impact on
fertility." In Women's Roles and Population Trends in the Third
World. Eds. R. Anker, Mayra Buvinic, and Nadia H. Youssef. Lon-
don: Croom Helm.