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Does gender equality and availability of contraception influence maternal and child mortality? A systematic review
  1. Tanmay Bagade, 1,
  2. Catherine Chojenta, 1,
  3. Melissa L Harris,
  4. Smriti Nepal,
  5. Deborah Loxton
  1. School of Medicine and Public Health, Faculty of Health and Medicine, The University of Newcastle, Callaghan, New South Wales, Australia
  1. Correspondence to Dr Tanmay Bagade, School of Medicine and Public Health, University of Newcastle, Callaghan, NSW 2308, Australia; Tanmay.Bagade{at}


Background Current global maternal and child health policies rarely value gender equality or women’s rights and are restricted to policies addressing clinical interventions and family planning. Gender equality influences the knowledge, autonomy and utilisation of contraception and healthcare, thereby affecting maternal and child health. This systematic review aims to analyse the concurrent effect of gender equality and contraception on maternal and under-5 child mortality.

Methods A systematic review was conducted to investigate the current evidence. Studies were eligible if three themes—namely, indicators of gender equality (such as female education, labour force participation, gender-based violence), contraception, and maternal or child mortality—were present together in a single article analysing the same sample at the same time.

Results Even though extensive literature on this topic exists, only three studies managed to fit the selection criteria. Findings of two studies indicated an association between intimate partner violence (IPV) and infant mortality, and also reported that women’s contraceptive use increased the risk of IPV. The third study found that the mother’s secondary education attainment significantly reduced child mortality, while the mother’s working status increased the odds of child mortality. The researchers of all included studies specified that contraceptive use significantly reduced the risk of child mortality.

Conclusion Improvement in gender equality and contraception concurrently affect the reduction in child mortality. These findings provide strong support to address the research gaps and to include a gender equality approach towards maternal and child health policies.

  • gender equality
  • maternal mortality
  • child mortality
  • contraception
  • intimate partner violence
  • gender development
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  • Contributors TB was the principal reviewer and SN was a secondary reviewer, and both carried out the data extraction and risk of bias independently. CC was the adjudicator. TB prepared the first draft. TB, CC, MH and DL were involved in discussing the key concepts, designing the study protocol, methodology, interpreting the findings, and providing inputs to the subsequent drafts. CC, MH and DL supervised all the steps in the review process. The corresponding author had full access to information used in this study and had the final responsibility for the decision to submit for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The authors’ views expressed in this publication do not necessarily reflect the views of the University of Newcastle or any other associated agency.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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