Contraception Use and Tolerant Attitudes toward Violence against Women: How Media Use and Collective Norms are Jointly Associated with Attitudes and Behaviors among Ethiopian and Tanzanian Women

Abstract

Background: 68% of Ethiopian and 58% of Tanzanian women believe a husband is justified in beating his wife in at least one of five specified circumstances (e.g., overcooking the food). 29% of currently married women in Ethiopia and 38% in Tanzania are using contraception. Use of any method of contraception decreases with the increase in the number of reasons that a woman thinks wife beating is justified. Objective: Our objective is to test the following hypotheses. Hypothesis1: Collective norms are associated with individual attitudes about violence against women and use of contraception. Hypothesis 2: Media use will attenuate the relationship between collective norms and individual attitudes and behaviors. Methods: Data come from the 2011 Ethiopian DHS (N=15, 913) and from the 2016 Tanzanian DHS (N= 13,208), nationally representative surveys of women. Each enumeration area (similar to a zip code) was taken as a separate community (total Ethiopian communities=650 & total Tanzanian communities = 608). Collective norms were classified as low, medium, or high on contraception use and tolerance for violence (CU-TFV) measures based on values at the community level. Regressions were run to predict individual level CU-TFV from collective norms for CU-TFV, media use, and their interaction, controlling for age, wealth, education and urban versus rural. Findings: Collective CU-TFV norms were significant predictors of individual-level CU-TFV, respectively (all Ps\u3c.001). Media use was significant for CU (all Ps \u3c.05) but only significant for TFV among Ethiopian women (P= \u3c0.01). Significant interactions between collective CU-TFV norms and media (all Ps\u3c.05 except TFV in Tanzania) showed that when collective norms were high, media use did not differentially predict CU-TFV. But when CU-TFV was low, media use was positively associated with higher individual CU-TFV in all regressions except TFV in Tanzanian women. Conclusion: Media’s influences appear to be a function of community characteristics. Findings suggest that collective norms are powerful and impact individual CU-TFV but that media can attenuate this relationship in most cases. External media are more consequential among communities with low CU-TFV. For communities that are already engaged in higher contraception use and low tolerance for violence, media use is not as consequential