Abstract
IntroductionGlobally, 2.6 million stillbirths occur each year. Empowering women can improve their overall reproductive health and help reduce stillbirths. Women empowerment has been defined as women’s ability to make choices in economic decision-making, household and health care decision-making. In this paper, we aimed to evaluate if women’s empowerment is associated with stillbirths.MethodsData from 2016 Nepal Demographic Health Surveys (NDHS) were analysed to evaluate the association between women’s empowerment and stillbirths. Equiplots were generated to assess the distribution of stillbirths by wealth quintile, place of residence and level of maternal education using data from NHDS 1996, 2001, 2006, 2011 and 2016 data. For the association of women empowerment factors and stillbirths, univariate and multivariate analyses were conducted.ResultsA total of 88 stillbirths were reported during the survey. Univariate analysis showed age of mother, education of mother, age of husband, wealth index, head of household, decision on healthcare and decision on household purchases had significant association with stillbirths (p < 0.05). In multivariate analysis, only maternal age 35 years and above was significant (aOR 2.42; 1.22–4.80). Education of mother (aOR 1.48; 0.94–2.33), age of husband (aOR 1.54; 0.86–2.76), household head (aOR 1.51; 0.88–2.59), poor wealth index (aOR 1.62; 0.98–2.68), middle wealth index (aOR 1.37; 0.76–2.47), decision making for healthcare (aOR 1.36; 0.84–2.21) and household purchases (aOR 1.01; 0.61–1.66) had no any significant association with stillbirths.ConclusionsThere are various factors linked with stillbirths. It is important to track stillbirths to improve health outcomes of mothers and newborn. Further studies are necessary to analyse women empowerment factors to understand the linkages between empowerment and stillbirths.
Highlights
Disparities in stillbirth rates were found between women by level of education, wealth index and place of residence though decreasing over the years
The study describes the socio-demographic and empowerment factors associated with stillbirths based on the Nepal Demographic Health Surveys (NDHS) 2016 data
Better access to education, improving socioeconomic status and more people living in urban areas could be the reason why the disparity is decreasing over the years as reported by the NDHS report (Ministry of Health 2017)
Summary
2.6 million stillbirths occur each year. Empowering women can improve their overall reproductive health and help reduce stillbirths. Methods Data from 2016 Nepal Demographic Health Surveys (NDHS) were analysed to evaluate the association between women’s empowerment and stillbirths. For the association of women empowerment factors and stillbirths, univariate and multivariate analyses were conducted. Univariate analysis showed age of mother, education of mother, age of husband, wealth index, head of household, decision on healthcare and decision on household purchases had significant association with stillbirths (p < 0.05). Education of mother (aOR 1.48; 0.94–2.33), age of husband (aOR 1.54; 0.86–2.76), household head (aOR 1.51; 0.88–2.59), poor wealth index (aOR 1.62; 0.98–2.68), middle wealth index (aOR 1.37; 0.76–2.47), decision making for healthcare (aOR 1.36; 0.84–2.21) and household purchases (aOR 1.01; 0.61–1.66) had no any significant association with stillbirths. Stillbirths cause many women significant distress, potentially resulting in mental health issues (Roberts et al 2012). Additional risk factors for stillbirths include previous stillbirths (Aminu et al 2014) and advanced maternal age, being above 35 years of age (Flenady et al 2011)
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