Abstract

BackgroundWomen's autonomy in health care decision-making is very crucial for the well-being of women themselves, their children, and the entire family members. Although studying the issue is significant to take proper interventions, the issue is not studied at a nationwide level in Ethiopia. Accordingly, this population-based nationwide study was aimed at assessing the trends of women’s autonomy in health care decision-making and its associated factors in Ethiopia.MethodThe sample was limited to married women of 2005 (n = 8617), 2011 (n = 10,168), and 2016 (n = 9824) Ethiopian Demographic and Health Survey (EDHS) data. Women's autonomy in health care decision-making was measured based on their response to the question ‘person who usually decides on respondent's health care. To examine associated factors, socio-demographic variables were computed using multinomial logistic regression.ResultThe finding revealed that the trend of women’s autonomy in health care decision-making had declined from 18.7% in 2005 to 17.2% in 2011 albeit it had risen to 19.1% in 2016. The autonomy of women who resides in urban areas was 98.7% higher than rural residents, and those who live in the Tigray region, Somali region, and Addis Ababa are 76.6%, 79.7%, and 95.7% higher than who live in Dire Dawa respectively. Unemployed women, women aged from 15 to 24 years, and uneducated women were 45.1%, 32.4%, and 32.2% less likely autonomous in health care decision making respectively.ConclusionThe autonomy of women in health care decision-making had declined from 2005 to 2011. Therefore, the role of stakeholders in taking possible interventions like empowering women shall be strengthened. This is to protect women from certain health problems as well as for the well-being of women themselves, their children, and the entire family members.

Highlights

  • Since women’s participation in the decision-making process is very crucial to achieve the multifaceted development of communities and countries [1], the global community is working to empower women in enhancing their decision-making ability including at the household level

  • The status of employed women in health care decisionmaking had risen from 31.64% in 2005 to 43.9% in 2011 albeit it fails into 41.8% in 2016

  • Among the two Federal Cities Administrations and nine Regional States, the autonomy of women in health care decision making in three Regional States including in Amhara, Oromia, and Harari had shown significant decrements from 2005 to 2011 and 2016

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Summary

Introduction

Since women’s participation in the decision-making process is very crucial to achieve the multifaceted development of communities and countries [1], the global community is working to empower women in enhancing their decision-making ability including at the household level. There is no doubt on the importance of assessing the position of women in decision-making to address the problem of gender inequality via devising policies and taking immediate intervention measures to empower women [3,4,5,6]. This can be possible when the present position of women’s autonomy including in health care decision making is known. This population-based nationwide study was aimed at assessing the trends of women’s autonomy in health care decision-making and its associated factors in Ethiopia

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