The Role of Women's Autonomy and Experience of Intimate Partner Violence as a Predictor of Maternal Healthcare Service Utilization in Nepal.

Sujan Gautam,Hyoung-Sun Jeong

doi:10.3390/ijerph16050895

Abstract

This study aims to identify the relationship of women’s autonomy and intimate partner violence (IPV) with maternal healthcare service utilization among married women of reproductive age in Nepal. This study used data from the 2016 Nepal Demographic and Health Survey (NDHS), which is a nationally representative sample survey. The association between outcome variables with selected factors were examined by using the Chi-square test (χ2), followed by multiple logistic regression. The sample was adjusted for multi-stage sampling design, cluster weight, and sample weight. Of the total sample, 68.4% reported attending sufficient Antenatal care (ANC) visits throughout their pregnancy, while 59.9% reported having a health facility delivery. The factors associated with both, sufficient ANC visits and institutional delivery includes ethnicity, place of residence, household wealth status, and the number of living children. Women who have access to media, and who have intended pregnancy were more likely to have sufficient ANC visits. Exposure to some forms of violence was found to be the barrier for maternal health service utilization. Attending ANC visits enables mothers to make the decision regarding skilled attendance or health facility delivery. Preventing any forms of violence need to be considered as a vital element in interventions aimed at increasing maternal health service utilization.

Highlights

Approximately 830 women die each day from preventable causes related to pregnancy or childbirth
As far as women’s autonomy related factors are concerned, most of the women’s were relatively unemployed (37.5%); more than half (55.7%) were exposed to any type of media at least once a week; about one third (32.7%) had high autonomy in household decision making; about 29% had an attitude of accepting violence by their husbands for any single or several reasons; and only 9%
It is the basic assumption that if women have autonomy in household decision making, if women are employed, have control over financial resources, have access to media, and have an attitude opposing towards partner violence, they are more likely to utilize maternal healthcare service, whereas women who are exposed to any form of intimate partner violence (IPV) are less likely to utilize maternal healthcare service

Summary

Introduction

Approximately 830 women die each day from preventable causes related to pregnancy or childbirth. Almost 99% of deaths occur in developing countries. This shows that the lifetime risk of death due to pregnancy—or childbirth-related complications—is higher in developing countries as compared to developed countries (for example, the lifetime risk of death of 1-year-old women from a maternal cause is; 1 in 180 in developing countries vs 1 in 4900 in developed countries) [1]. Maternal health refers to the health of the women during pregnancy, childbirth and the postpartum period, maternal health service includes antenatal care (ANC), delivery care and postnatal care (PNC). The lives of millions of women of reproductive age can be saved through proper utilization of maternal health care services

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