Abstract
BackgroundMost previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women’s autonomy. We assessed whether women’s autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia.MethodsWe analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women’s decision-making power and permissive gender norms associated with wife beating. We used Spearman’s correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women’s autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics.ResultsOur multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics.ConclusionsOur study shows that women’s autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution.
Highlights
Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women’s autonomy
According to the 2015 World Health Organization (WHO) report, 303,000 women worldwide died during pregnancy or after childbirth, and most of these deaths occurred in sub-Saharan Africa [2]
Our analysis focused on married women or women living with a male partner of reproductive age (15–49 years) who had a live birth within 5 years before the survey (6058 and 7043 women in the 2005 and 2011 Ethiopia Demographic and Health Surveys (EDHS), respectively)
Summary
Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women’s autonomy. We assessed whether women’s autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. According to the 2015 World Health Organization (WHO) report, 303,000 women worldwide died during pregnancy or after childbirth, and most of these deaths occurred in sub-Saharan Africa [2]. Significantly reducing maternal mortality in subSaharan African countries appears difficult, skilled care before, during, and after childbirth is highly crucial for saving the lives of women and newborn infants [4,5,6]. Maternal healthcare service utilization is strongly recommended as the most critical strategy for reducing maternal mortality rates in low-income countries [7, 8]. 19% of women made four or more antenatal care (ANC) visits during their pregnancy, only 11% of pregnant women had health facility delivery (HFD), and only 9.7% of women received postnatal care (PNC) in the first
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
