Women's Autonomy and Intimate Partner Violence in Ghana.

CONTEXT Previous studies have established women's autonomy as an important determinant of several demographic outcomes in Sub-Saharan Africa, yet very few have considered intimate partner violence as one of these outcomes. METHODS Data collected in 2017 from 2,289 women residing in 40 communities in Ghana were used to examine associations between three types of autonomy-economic decision making, family planning decision making and sexual autonomy-and women's experiences with physical, sexual, emotional and economic violence. Multilevel logistic regression was used to identify associations. RESULTS All three types of autonomy were associated with having experienced intimate partner violence, although in different ways, at the individual level or community level. At the individual level, after adjustment for theoretically relevant variables, family planning decision-making autonomy was negatively associated with all four types of violence (odds ratios, 0.7-0.8), while economic decision-making autonomy was positively associated with emotional and economic violence (1.2 for each). At the community level, living in a community where women had higher levels of sexual autonomy was associated with reduced odds of having experienced physical and economic violence (0.5 and 0.4, respectively). CONCLUSIONS The findings underscore the relevance of women's empowerment programs as potential mechanisms for reducing intimate partner violence in Ghana. They also point to the need to move beyond individual-level interventions and consider community-level programs that empower women to be autonomous.