Abstract
<jats:p>Introduction The current study examined the association between husbands' and wives' perceptions of women's empowerment, focusing on household decision-making, attitudes toward IPV, and fertility desires in Pakistan. Methods Data from currently married couples participating in the Pakistan DHS (2017-18) were included in the analysis (n=3,027). The level of concordance on fertility desires was assessed using Kappa Coefficient. Principal component analysis (PCA) was applied to assess the internal consistency and dimensionality of household decision-making and IPV attitude items; items within each construct were subsequently summed to generate categorical empowerment scores used in the regression analyses. Relative risk ratios were estimated for perceived empowerment on spousal concordance on fertility desires using multinomial logistic regressions. Results The study found a moderate level of spousal agreement on fertility desires (Kappa=0.51). Among significant findings: wife's perception of her own high decision-making authority was associated with more than a two-fold increase in wife-only discordance (wife wanting more children, husband wanting no more), compared to both spouses wanting more children. Conclusion The study contributes to the understanding of couple's gendered dynamics and how they may influence fertility desires. Such knowledge informs efforts to increase both spouses' involvement in reproductive decision-making and behaviors.</jats:p>