Periodontal disease is a possible risk factor for preterm delivery in this population.

Introduction: Women’s autonomy is one of the predictors of maternal health care service utilization. This study aimed to construct and validate a scale for measuring women’s autonomy with relevance to developing countries. Methods: We conducted a study for construction and validation of a scale in Rupandehi and further validated in Kapilvastu districts of Nepal. Initially, we administered a 24-item preliminary scale and finalized a 23-item scale using psychometric tests. After defining the construct of women’s autonomy, we pooled 194 items and selected 24 items to develop a preliminary scale. The scale development process followed different steps i.e. definition of construct, generation of items pool, pretesting, analysis of psychometric test and further validation. Results: The new scale was strongly supported by Cronbach’s Alpha value (0.84), test-retest Pearson correlation (0.87), average content validity ratio (0.8) and overall agreement- Kappa value of the items (0.83) whereas all values were found satisfactory. From factor analysis, we selected 23 items for the final scale which show good convergent and discriminant validity. From preliminary draft, we removed one item; the remaining 23 items were loaded in five factors. All five factors had single loading items by suppressing absolute coefficient value less than 0.45 and average coefficient was more than 0.60 of each factor. Similarly, the factors and loaded items had good convergent and discriminant validity which further showed strong measurement capacity of the scale.   Conclusions: The new scale is a reliable tool for assessing women’s autonomy in developing countries. We recommend for further use and validation of the scale for ensuring the measurement capacity. Keywords: maternal health care; scale construction and validation; women’s autonomy measurement.

Although community based interventions along with promotion of hospital birth has an impact in reducing neonatal deaths in this community, sustaining this momentum may demand more long-term policy interventions to promote better living standards and better reproductive health.

This survey of obstetricians' knowledge and practices in two districts in Kerala, India, finds a number of unethical practices: most providers are unaware of the value of the rapid screening test for HIV, they do not give pregnant women the option to refuse testing; testing is done without counselling, private doctors refer pregnant women who test positive to government hospitals, and some health services have separate facilities for pregnant women who test positive.

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