High Autonomy Research Articles

Identifying Racial Inequities in Respect and Autonomy During Delivery Care [ID: 1378253

INTRODUCTION: Measuring patient experience is core to understanding and addressing inequities in obstetric care quality. METHODS: People who gave birth at one of five hospitals in Massachusetts and identified as non-Hispanic Black (NHB) or non-Hispanic White (NHW) were invited to complete a structured survey 7–16 weeks postpartum, from February to September 2022. The survey included two validated patient experience instruments: the Mothers on Respect index, dichotomized as “very respectful” or not and the Mothers Autonomy in Decision Making scale, dichotomized as “high patient autonomy” or not. We report risk ratios of associations between patient characteristics and respectful or autonomous care, adjusting for hospital cluster using Stata v.17. Institutional review board approval was received from the Social and Behavioral Research IRB at Tufts University. RESULTS: Of 417 respondents (response rate: 25%), 245 (59%) were NHW and 172 (41%) were NHB. Most had a bachelor’s degree (62%). 241 (60%) of births were vaginal. Very respectful treatment was reported by 78% of respondents, whereas high patient autonomy was only reported by 64%. Non-Hispanic White people were 1.2 times as likely to report high respect compared to NHB (95% CI: 1.1, 1.4). Respect was also significantly lower for those with lower education and those with vaginal birth compared to those with cesarean birth. Differences in respect by race remained significant in multivariable models (1.2, 95% CI: 1.0, 1.4). Autonomy did not differ by any of the assessed demographic or delivery characteristics. CONCLUSION: Examining patient experience revealed inequities. To identify opportunities for improvement and monitor change, brief, validated, patient reported experience measures need to be incorporated into routine data collection.

Matters of Gender and Social Disparities Regarding Postnatal Care Use Among Nepalese Women: A Cross-Sectional Study in Morang District.

The study compares the uses of postnatal care (PNC) and women's autonomy gradients across social caste and used intersectionality concepts to estimate odds ratio of women's autonomy and social caste on complete PNC. A community-based cross-sectional study among 600 women aged 15-49 years who had at least one child younger than the age of 2 years in Morang District, Nepal, was conducted from April to July 2019. PNC, women's autonomy (decision-making power, freedom of movement, and control over finances) and social caste were collected by both methods. Multivariable logistic regressions were used to determine associations between women's autonomy, social caste, and complete PNC. Complete PNC totaled 13.5% of respondents. About one-fourth of respondents reported poor overall autonomy; however, non-Dalit demonstrated higher autonomy than Dalit. Non-Dalit exhibited greater odds of complete PNC by four times. Women exhibited high women's autonomy in decision-making power, control over finance, and freedom of movement and have greater odds of complete PNC than low autonomy by 17, 3, and 7 times, respectively. The study raises awareness of intersectionality (gender and social caste), relating to maternal health in caste-based system countries. To improve maternal health outcomes, health care personnel should identify and systematically address barriers that women of lower-caste membership face and offer these women appropriate advice or resources to obtain care. A multilevel change program that involves different actors like husbands and community leaders is needed for improving women's autonomy and lessening stigmatized perceptions, attitudes, or practices toward non-Dalit caste-members.

A Validity and Reliability Study of The Turkish Version of The Mothers’ Autonomy in Decision Making Scale

Objective: The focus of the study is women's experiences of autonomy while making decisions about their care during pregnancy, labour and birth. The aim of this study is to adapt the Mothers Autonomy in Decision Making Scale (MADM), developed by Vedam et al. in 2017, into Turkish health care culture. Methods: The survey, which was created in the Google form, was conducted between May 15th to August 15th 2019 through social media. 344 women participated in the study and 286 women answered the questionnaire in total. The data were evaluated using the SPSS package software. Findings related to construct validity of the scale were made using exploratory factor analysis method. Results: Reliability of the Turkish form of the scale was performed with Cronbach’s Alfa and the internal consistency value of the scale was found to be 0.91. MADM scores were found to be highest for midwives (33.28±10.10) and lowest for family physicians (23.89±11.44). More than half of the midwives who have been cared for have a high autonomy score on the scale of MADM (%54.4). Conclusion: MADM scale was found to be valid and reliable in Turkey to assess decision-making experiences during maternity care.

Hierarchical Reinforcement Learning in Multi-Domain Elastic Optical Networks to Realize Joint RMSA

To improve the network scalability, a large elastic optical network is typically segmented into multiple autonomous domains, where each domain possesses high autonomy and privacy. This architecture is referred to as the multi-domain elastic optical network (MDEON). In the MDEON, the routing, modulation, and spectrum allocation (RMSA) for the inter-domain service requests are challenging. As a result, deep reinforcement learning (DRL) has been introduced recently where the RMSA policies are learned during the interaction of the DRL agents with the MDEON environment. Due to the autonomy of each domain in the MDEON, joint RMSA is essential to improve the overall performance. To realize the joint RMSA, we propose a hierarchical reinforcement learning (HRL) framework which consists of a high-level DRL module and multiple low-level DRL modules (one for each domain), with the collaboration of DRL modules. More specifically, for the inter-domain service requests, the high-level module obtains some abstracted information from the low-level DRL modules and generates the inter-domain RMSA decision for the low-level modules. Then the low-level DRL module gives the intra-domain RMSA decision and feeds back to the high-level module. The proposed HRL framework preserves the autonomy of each single domain while delivering effective overall network performance through the cooperation of the high-level and low-level DRL modules. Simulation results demonstrate that our proposed method outperforms previous approaches.

Culture and the way of granting job autonomy: Goal or execution?

AbstractResearchers have assumed that Westerners exercise higher job autonomy than Easterners. However, recent studies have reported mixed and even contradictory findings. The authors distinguish between two types of job autonomy, namely goal and execution autonomy, to examine the relevant cultural differences. The former denotes participation in setting work goals and making plans for meeting those goals, while the latter denotes the ability to complete tasks flexibly. Four studies with a total sample of 1192 participants working in financial or insurance companies were conducted. Study 1a generated items for a new measure of the two types of job autonomy and explored its factor structure. Studies 1b and 1c verified its construct validity and predictive capacity. Study 2 confirmed the structural and metric equivalence of the measure between samples from the United Kingdom and China. The results of Study 2 suggested that the Chinese workers were likely to have high execution autonomy but low goal autonomy, whereas the British workers tended to have high goal autonomy but low execution autonomy. The theoretical and practical implications of job autonomy in cross‐cultural contexts are discussed.

Evaluating higher education (HE) work design to sustain academics' work–life balance

PurposeThis paper aims to examine work design and the linkages of work design with the work–life balance of academics in higher education (HE).Design/methodology/approachA sample of 307 academics was recruited for this study. The result was analysed using SPSS (statistical package of social science) and AMOS (analysis of moment structure) structural equation modelling (SEM).FindingsThis paper discovered that high autonomy, task significance, task identity and feedback were linked to greater work-to-family enrichment (W-FE) levels amongst academics, whilst, low job autonomy, task identity and task significance were linked to high work-to-family conflict (W-FC) levels.Originality/valueThis paper highlights the importance of promoting good academics' work–life balance by evaluating and improvising the academics' work design.

Menstrual Hygiene Practices and its Predictors Among Young Women in India: Findings from the National Family Health Survey-5 (2019–2021)

Introduction India is moving towards menstrual hygienic practices. However, using unhygienic menstrual absorbents is still a reproductive health concern among women in India. Objective This study investigates the prevalence of menstrual hygiene practices by geographical location and socio-economic factors among women in India. Materials and Methods National Family Health Survey-5 (NFHS-5) (2019–2021) data were utilized to fulfill the study objectives. The study participant included 241,180 young women aged 15–24 years. A bivariate chi-square test was applied to present the percentage distribution of menstrual hygienic practices. Multivariate logistic regression analyses were used to examine the predictors linked with hygienic practices related to menstruation. Results About 77% of the women used hygienic absorbents to protect menstrual bloodstains in India. The menstrual hygienic practices are significantly lower in the improvised states of central and eastern India. Multivariable analysis reveals that higher educated women (adjusted odds ratio (AOR): 5.36; 95% confidence interval (CI): 4.18–6.87) residing in the richest quintile households (AOR: 6.17; 95% CI: 4.61–8.26) have a higher probability of hygienic practices related to menstruation. Besides, higher autonomy and mass media exposure are positively associated with hygiene practices. Conclusion The study findings recommend opportunities for reproductive education among women, offering financial incentives, and improving women’s empowerment may increase menstrual hygienic practices. Additionally, interventions should focus on socioeconomically poor women to increase the use of sanitary napkin. Interventions should also focus on marginalized women to increase the use of sanitary napkin.

Study on the Relationship Between High Commitment Human Resource Management, Job Autonomy and Job Satisfaction

In order to explore the relationship between high commitment human resource management, job autonomy, and job satisfaction, a random questionnaire survey is conducted on 194 teachers in higher education institutions nationwide. SPSS24.0 is used in methods including descriptive statistical analysis, one-way analysis of variance, back testing, correlation analysis, regression analysis, and stepwise regression analysis. The following results are obtained: 1.High commitment human resource management and job autonomy were significantly and positively correlated; 2.High commitment human resource management is significantly and positively correlated with job satisfaction; 3.Job autonomy is significantly and positively correlated with job satisfaction; 4.High commitment human resource management and job autonomy are significantly different in terms of education. Job satisfaction is significantly different in terms of employee status and years of working. High commitment human resource management, job autonomy, and job satisfaction are significantly different in terms of school location (provincial capital, non-provincial capital); 5.Job autonomy plays a partially mediating role in the relationship between high commitment huamn resource management and job satisfaction. In response to the results, it is suggested that Chinese higher education institutions should implement high commitment human resource management model to reasonably expand employees’ job autonomy and improve their job satisfaction according to the actual situation.

Work ability among employees 2-10 years beyond breast cancer diagnosis: Late treatment effects and job resources - A longitudinal study.

The number of workers who have previously undergone a cancer treatment is increasing, and possible late treatment effects (fatigue, physical and cognitive complaints) may affect work ability. The aim of the study was to investigate the impact of late treatment effects and of job resources (autonomy, supportive leadership style, and colleagues' social support) on the future work ability of employees living 2-10 years beyond a breast cancer diagnosis. Data at T1 (baseline questionnaire) and at T2 (9 months later) were collected in 2018 and 2019 (N = 287) among Dutch-speaking workers with a breast cancer diagnosis 2-10 years ago. Longitudinal regression analyses, controlling for years since diagnosis, living with cancer (recurrence or metastasis), other chronic or severe diseases, and work ability at baseline were executed. Higher levels of fatigue and cognitive complaints at baseline predicted lower future work ability. The three job resources did not predict higher future work ability, but did relate cross-sectionally with higher work ability at baseline. Autonomy negatively moderated the association between physical complaints and future work ability. Fatigue and cognitive complaints among employees 2-10 years past breast cancer diagnosis need awareness and interventions to prevent lower future work ability. Among participants with average or high levels of physical complaints, there was no difference in future work ability between medium and high autonomy. However, future work ability was remarkably lower when autonomy was low.

Blockchain-Driven Image Encryption Process with Arithmetic Optimization Algorithm for Security in Emerging Virtual Environments

The real world is bounded by people, hospitals, industries, buildings, businesses, vehicles, cognitive cities, and billions of devices that offer various services and interact with the world. Recent technologies, including AR, VR, XR, and the digital twin concept, provide advanced solutions to create a new virtual world. Due to the ongoing development of information communication technologies and broadcast channels, data security has become a major concern. Blockchain (BC) technology is an open, decentralized, and transparent distributed database that can be maintained by the group. BC’s major features are high credibility, decentralization, transparency, versatility, autonomy, traceability, anonymity, intelligence, reward mechanisms, and irreversibility. This study presents a blockchain-driven image encryption technique using arithmetic optimization with a fractional-order Lorenz system (BDIE-AOFOLS). The BDIE-AOFOLS technique uses the FOLS method, which integrates the Arnold map, tent map, and fractional Lorenz system. Besides this, an arithmetic optimization algorithm (AOA) was carried out for the optimum key generation process to achieve the maximum PSNR value. The design of an AOA-based optimal generation of keys for the FOLS technique determines the novelty of the current work. Moreover, the cryptographical pixel values of the images can be stored securely in the BC, guaranteeing image security. We compared the outcomes of the proposed BDIE-AOFOLS technique against benchmark color images. The comparative analysis demonstrated the improved security efficiency of the BDIE-AOFOLS technique over other approaches, with a mean square error of 0.0430 and a peak signal-to-noise ratio of 61.80 dB.

Who Gains Mental Health Benefits from Work Autonomy? The Roles of Gender and Occupational Class

In recent years, improving work autonomy as an important priority in the UK labour market has been shown to enhance employee mental health and well-being. However, previous theories and empirical studies have paid little attention to the intersectional inequalities in the mental health benefits of work autonomy, preventing us from gaining a comprehensive understanding of the mental consequences of work autonomy. By integrating literature from occupational psychology, gender and social class, this study develops theoretical hypotheses regarding whether and how the mental health benefits of work autonomy vary alongside the intersectional axes of gender and occupational class and tests these hypotheses using long-term panel data in the UK (2010–2021). Overall, we find that those from higher occupational class and male employees acquire significantly more mental health benefits from high work autonomy compared with those from lower occupational class and female employees. Moreover, further analyses show significant intersectional inequalities of gender and occupational class. While male employees from all occupational classes gain significant mental health benefits from work autonomy, only female employees from higher (but not lower) occupational classes benefit from work autonomy. These findings contribute to the literature in the sociology of work by demonstrating the intersectional inequalities in mental health consequences of work autonomy, especially for women in the lower occupational class, highlighting the need for a more gender- and occupation-sensitive design in future labour market policies.

Dynamics modeling and optimal control for multi-information diffusion in Social Internet of Things

As an ingenious convergence between the Internet of Things and social networks, the Social Internet of Things (SIoT) can provide effective and intelligent information services and has become one of the main platforms for people to spread and share information. Nevertheless, SIoT is characterized by high openness and autonomy, multiple kinds of information can spread rapidly, freely and cooperatively in SIoT, which makes it challenging to accurately reveal the characteristics of the information diffusion process and effectively control its diffusion. To this end, with the aim of exploring multi-information cooperative diffusion processes in SIoT, we first develop a dynamics model for multi-information cooperative diffusion based on the system dynamics theory in this paper. Subsequently, the characteristics and laws of the dynamical evolution process of multi-information cooperative diffusion are theoretically investigated, and the diffusion trend is predicted. On this basis, to further control the multi-information cooperative diffusion process efficiently, we propose two control strategies for information diffusion with control objectives, develop an optimal control system for the multi-information cooperative diffusion process, and propose the corresponding optimal control method. The optimal solution distribution of the control strategy satisfying the control system constraints and the control budget constraints is solved using the optimal control theory. Finally, extensive simulation experiments based on real dataset from Twitter validate the correctness and effectiveness of the proposed model, strategy and method.

Influence of job autonomy on job crafting of dental hygienists.

Job autonomy focuses on the job performance and tasks of health providers with a national licence in South Korea, which affects job crafting, to develop job competency. This study was conducted to identify the influence of job autonomy on job crafting of dental hygienists. This cross-sectional study included 411 dental hygienists extracted through convenience sampling from a pool of 35,000 clinical dental hygienists in South Korea. Measuring tool are Korean version of the Job Crafting Questionnaire (JCQ-K) and job autonomy questionnaire (JAQ). To investigate the level of job autonomy and crafting of dental hygienists based on their general characteristics, t-tests and one-way ANOVAs were performed. Pearson correlation was performed to determine the linear correlation between autonomy and crafting. To determine whether job autonomy affects job crafting, an adjusted regression analysis was conducted using general characteristics as control variables. High job autonomy and job crafting were associated with increases in participant age with job experience as a senior staff, education level, and work environment, such as dental office or hospital. A significant positive correlation was observed (r=0.64) between job autonomy and job crafting. Job autonomy (β=0.58) and dental/medical hospital in university (β=0.13) had a significant relationship with dental hygienists' job crafting. Job autonomy could positively influence the job crafting of dental hygienists in South Korea. Our findings suggest that job latitude should be redesigned to promote task competency and social responsibility with a health outcome perspective for the population as well as the dental hygiene profession.

Safer Sex Negotiation Among Ghanaian Women in Sexual Unions: Does Women's Household Decision-Making Capacity Matter?

Women's ability to negotiate for safer sex has been found to be dependent on their household decision making power. However, there is paucity of studies investigating the association between women's household decision making power and safer sex negotiation in Ghana. Thus, we examined the association between women's household decision making autonomy and safer sex negotiation among Ghanaian women in sexual unions using the 2014 Ghana's Demographic and Health Survey. Descriptive statistics, Chi-square test, and multivariable logistic regression models were performed. Statistical significance was set at p < .05at 95% confidence interval.The results showed high prevalence of safer sex negotiation among women with high household decision-making capacity (91.6%). Compared to women with low household decision making autonomy, those with high autonomy in household decision making were more likely to negotiate for safer sex (aOR = 2.06; CI = 1.32-3.21). Women aged 25-34 were more likely to negotiate for safer sex compared to those aged 15-24 (aOR = 1.50; CI = 1.07-2.11). Higher odds of safer sex negotiation were found among women with comprehensive HIV and AIDS knowledge (aOR = 1.49; CI = 1.09-2.05), women who had tested for HIV (aOR = 1.57; CI = 1.27-1.95) and those exposed to newspaper (aOR = 1.80; CI = 1.17-2.78) compared to those who had no comprehensive knowledge on HIV and AIDS, those who had never tested for HIV and those who were not exposed to newspaper, respectively. However, women who belonged to other ethnic groups and the Islamic religion had lower odds of safer sex negotiation compared to Akans (aOR = 0.68; CI = 0.48-0.96) and Christian women (aOR = 0.63; CI = 0.46-0.85). Women empowerment programmes need to be intensified to enable Ghanaian women with low household decision making autonomy to negotiate for safer sex with their partners. Ghana could achieve the Sustainable Development Goals (SDGs), particularly, SDG 3.7 (universal access to sexual and reproductive health services), and SDG 5 (achieve gender equality and empower all women and girls) when household decision-making capacity among women is further strengthened.

Negative effects of time autonomy in digital collaboration

This article in the journal Group. Interaction. Organization (GIO) focuses on the effects of time autonomy on job-to-home spillover and emotional exhaustion when employees face high time pressure in digital collaboration. We assume time autonomy to strengthen rather than to buffer the detrimental indirect effects of high time pressure on emotional exhaustion via job-to-home spillover, and that high digital collaboration amplifies this effect even further. In a sample of N = 111 employees, we investigated this research question using conditional process analysis. Results support our assumptions as for high digital collaboration high time autonomy amplified the detrimental indirect effect of time pressure on emotional exhaustion via job-to-home spillover, whereas for low digital collaboration high time autonomy buffered this indirect effect. Thus, employees’ risk for emotional exhaustion is higher when time pressure, time autonomy and digital collaboration are high. Therefore, employees and leaders should carefully consider their choices concerning the use of time in the context of digital collaboration.

Can autonomy level and anthropomorphic characteristics affect public acceptance and trust towards shared autonomous vehicles?

Shared autonomous vehicles (SAVs) are revolutionizing the future of urban mobility. This study aims to investigate the effects of artificial intelligence (i.e., autonomy level and anthropomorphic characteristics), human-related, environmental, and societal factors on public trust and acceptance. Structural equation modelling is used to analyze a valid survey sample of 451 participants. Results show that autonomy level can both directly and indirectly (via trust) increase public acceptance; Whereas, anthropomorphic characteristics cannot directly affect public acceptance, but can indirectly increase their acceptance via trust. The other human-related, environmental, and societal factors also positively contribute to public acceptance. Additionally, moderators, including age, gender, income, housing size, COVID-19 history, shared mobility experience, vehicle ownership, and driving experience are also examined. In theory, this study contextualizes the trust-in-automation three-factor model, UTAUT model, and trust theory and includes two domain-specific constructs (i.e., SAV anthropomorphism and SAV autonomy) to study public trust and acceptance towards SAVs. In practice, this study suggests the incorporation of some anthropomorphic features and relatively high autonomy level in SAVs to build public trust and acceptance.

Firm investment and financial autonomy: A transaction cost economics and firm lifecycle approach

AbstractThis study examines how firm's investments relate to financial autonomy across different stages of lifecycle. With 1367 Chinese listed companies from 1990 to 2018, the results indicate that firms with high (low) financial autonomy tend to over‐invest (under‐invest). Accordingly, financially autonomous firms have lower valuation. While corporate governance mitigates both over‐ and under‐investment over time in China, such an effect becomes statistically insignificant after considering different magnitudes of financial autonomy. The Chinese policy makers should consider designing more solid corporate governance to control the opportunism of managers who are more financially independent.

Examining the Role of Autonomy Support, Goal Setting, and Care Coordination Quality on HIV PrEP Adherence in Black Men Who Have Sex with Men: HPTN 073.

Autonomy support is a concept that is derived from self-determination theory. Autonomy refers to the freedom to act as one chooses. The current study aimed to examine if autonomy support was associated with dried blood spot validated pre-exposure prophylaxis (PrEP) adherence, and whether the association was mediated by PrEP adherence goal setting and progress toward PrEP adherence goals. Our sample was drawn from Black men who have sex with men (MSM) from across three cities (Chapel Hill, NC; Los Angeles, CA; and Washington, DC) in the United States between February 2013 and September 2014. We used logistic regression to evaluate associations between study variables and path analysis to test mediation effects. Participants were, on average, 28 [standard deviation (SD) = 1.12] years old and 25% were unemployed. We found that MSM who experienced high autonomy support were more likely to adhere to PrEP [odds ratio (OR) = 1.17; 95% confidence interval: 1.00-1.38]. MSM who set PrEP adherence goals were more likely to adhere to PrEP. Moreover, MSM who reported making progress toward their goals were also more likely to adhere to PrEP. Finally, client perception of coordination quality enhanced the magnitude of the association between goal setting and goal progress and the effect size of goal progress on PrEP adherence. Autonomy support, goal setting, goal monitoring/evaluation, and care coordination quality influenced PrEP adherence among Black MSM. Our findings indicate that while it is important to set goals for PrEP adherence, goal setting may need to be accompanied by progress monitoring to achieve the maximal effect.

Women’s autonomy and its effect on antenatal care visits among Tharu women of reproductive age (15-49) of Khairahani Municipality, Nepal

Women's autonomy in health care decision-making is enormously essential for improved maternal and child health outcomes and women's empowerment. This study examines women's autonomy and its effect on antenatal care (ANC) visits among the women of the Tharu community of Khairahani municipality, Chitwan. The probability proportional to size (PPS) sampling technique was adapted for sample estimation in each selected ward. A list of all the Tharu households in the community was prepared from which 294 women were selected using systematic random sampling techniques. Univariate, bivariate (Chisquare test), and multivariate analyses (binary logistic regression) were performed. One-fifth of women were youths aged 15-24 (mean 27.8 years). One out of ten women was illiterate, and about two-thirds (65%) were involved in agriculture. More than two in five women (42%) did not have autonomy. Women's autonomy, age group, educational status, occupational status, and husband's occupational status were significantly associated with antenatal care visits. A significantly high number of women (p&lt;0.001) who had high autonomy (89%), compared with those who had no autonomy (65%), used ANC services for their last birth. Women with low autonomy and high autonomy were three times (OR=3.05; 95% CI=1.01-8.5) and 4.5 times (OR=4.5; 95% CI 2.3-8.6) more likely to utilize ANC visits than those who had no autonomy. Women's autonomy in healthcare decision-making, household purchases, and money expenditure were significantly associated with the use of antenatal care visits. Women's participation in the decision-making process regarding health care and household matters should be focused on and increased for better utilization of antenatal care services.

ACHIEVING THE SDGs TARGETS: WOMEN’S AUTONOMY AND THE CONTINUUM OF MATERNAL AND CHILD HEALTH SERVICES UTILIZATION IN INDONESIA USING IDHS 2017

A reduction of child and maternal mortality is among the targets of the Sustainable Development Goals (SDGs), namely the third goal. An important determinant of child and maternal mortality risk is the utilization of maternal and child health (MCH). This study aims to analyze the relationship between women's autonomy and the continuum of MCH services utilization in Indonesia using IDHS 2017. The unit of analysis was women of childbearing age who were married or living together, gave birth to at least one child in the five years before the survey, and had the last child aged 1 to 3 years, totalling as many as 6,575 samples. The analytical method used is multinomial logistic regression. The dependent variable in this study is the continuity of MCH services utilization and is divided into three categories, namely not a continuum, partial continuum, and whole continuum. The primary independent variable used in this study is women's autonomy with the demographic and socioeconomic factors as control variables. The results show that the proportion of mothers who used all MCH services continuously in Indonesia was 22.14 percent. Utilization of PNC and K4 became the most dominant services from disconnection of every mother from utilizing all MCH services continuously. Mothers with higher autonomy had a higher probability of taking advantage of some and all stages of the continuum of MCH services utilization. Therefore, the government must continue to increase women's autonomy to increase the continuum of MCH services utilization and achieve the SDGs targets.