Use of Female Sterilization and associated Factors among Women of Reproductive Age in Malawi

Malawi has witnessed an increase in the uptake of female sterilization, making it one of the few countries having a high prevalence of female sterilization on the continent. The factors responsible for the high uptake of female sterilization are not known.

The main objective of this study was to establish the factors associated with the use of female sterilization in Malawi.

In the study, the 2015-16 Malawi Demographic and Health Survey has been used. The chi-square test and multivariate binary logistic regression were used to explore the factors influencing the uptake of female sterilization in the country.

Results showed the prevalence of female sterilization to be 18.1% as a method of contraception. Women residing in the Northern Region (OR=1.587, 95% CI=1.276-1.972; p=0.000) and the Central Region (OR=2.387, 95% CI=2.084-2.734; p=0.000), with no education (OR=2.102, 95% CI=1.634-2.703; p=0.000) and primary education (OR=1.488, 95% CI=1.206-1.835; p=0.000), who had not been visited by a field worker in the last twelve months (OR=2.252, 95% CI=1829-2.774; p=0.000) or had not visited a health centre in the last twelve months (OR=1.860, 95% CI=1.634-2.117; p=0.000), had higher odds of being sterilized. While women who were not working (OR=0.771, 95% CI=0.664-0.894; p=0.000), aged 30 years or less (OR=0.104, 95% CI=0.0.79-0.136; p=0.000), poor (OR=0.599, 95% CI=0.510-0.704; p=0.000), having middle wealth status (OR=0.744, 95% CI=0.626-0.883; p=0.000), having no child (OR=0.163, 95% CI=0.119-0.223; p=0.000) or 1-2 children (OR=0.408, 95% CI=0.352-0.473; p=0.000), and not being aware or having heard regarding family planning from television (OR=0.769, 95% CI=0.603-0.981; p=0.000), had lower odds of using female sterilization.

According to African standards, the use of female sterilization in Malawi is high. The factors associated with the use of female sterilization include a high level of education, residing in the Central or Northern Region, aging 30 years and above, having been visited by a field worker in the past 12 months, having visited a health facility in the past 12 months, having heard regarding family planning on TV in the past few months, work status, wealth, and children ever born. These factors should be considered when planning future contraceptive strategies to improve the uptake of female sterilization. Family planning programs should also aim at economic empowerment for women.