Two-fifths of women are not autonomous in maternal health service utilization: A community-based cross-sectional study

Abstract

Background: Autonomy of women in health care decision-making is tremendously crucial for improved maternal health outcomes and women’s empowerment. Women with greater freedom of movement are more likely to receive maternal health services. However, little has been investigated about women’s autonomy in maternal health care decision-making and contributing factors in Ethiopia. The aim of this study was to assess decision-making autonomy on maternal health care services utilization and associated factors among women.Methods: A community-based cross-sectional study was conducted in Mettu rural Woreda, Ilu Aba Bor zone, southwest Ethiopia from June 19 to August 20, 2021. Data was collected using a pretested interviewer-administered questionnaire from 541 randomly selected women. The collected data was entered into Epi-Data version 3.1 and exported to SPSS version 22 for analysis. Bivariate and multivariate logistic regression was used to identify factors associated with women's decision-making autonomy on maternal health service utilization. The significance of association was declared by using the odds ratio with a 95% confidence interval and a p-value less than 0.05 in the multivariable model.Results: Out of 522 women included in the analysis, 322 (60.5%) (95% CI: 56.2%-64.7%) were found to be autonomous on maternal health service utilization. Age category from 30-39 years, AOR=4.27 (95%CI: 1.59-11.43), attending primary education and above, AOR=3.87 (95%CI: 2.15-6.99), greater than five family size, AOR=0.25 (95%CI: 0.15-0.41), and distance from the health facility, AOR=5.33 (95%CI: 2.50-11.33) were significantly associated with women's decision-making autonomy on maternal health care services utilization.Conclusion: Even though every woman has the right to participate in her own health care decision-making, around two fifths of them have no role in making health care decisions about their own health. Socio-demographic factors like age and education were found to influence women’s autonomy. Special attention has to be given to women living in rural areas in order to reduce their dependency through education.

Women decision-making autonomy on maternal health service and associated factors in low- and middle-income countries: Systematic review and meta-analysis

“…At the qualification stage, 70 articles were completely approved and evaluated for eligibility. Finally, this systematic review and meta-analysis included 19 studies 29,31–33,35,37,43,46,54–65 with 103,983 study participants (Figure 1).…”

“…13 43.76-66.49 Alemayehu and Meskel 35 54.97 43.57-66.37 Eshetu et al 55 54.98 43.60-66.36 Diriba et al 57 54.54 43.16-65.91 Tadesse 56 55. 16 43.79-66.54 Kebede et al 63 54.04 42.65-65.44 Duha and Adisah-Atta 31 54.04 42.34-65.70 Nigatu et al 29 55.91 44.56-67.27 Situ 37 56.27 44.99-67.56 Tesema et al 60 53.68 41.79-65.57 Adhikari 64 56.11 44.75-67.47 Ameyaw et al 43 57.00 46.47-67.54 Feijen-de Jong et al 32 54.77 43.39-66.15 Kassahun and Zewudie 54 54.85 43.48-66.23 Haque et al 65 56.50 45.22-67.77 Obsanoha et al 59 55.97 44.86-67.08 Chilinda et al 62 55. 50 43.83-67.17 Abedin and Arunachalan 62 54.80 43.44-66.16 Mondal et al 46 53.63 43.49-63.76…”

“…At the qualification stage, 70 articles were completely approved and evaluated for eligibility. Finally, this systematic review and meta-analysis included 19 studies 29,[31][32][33]35,37,43,46,[54][55][56][57][58][59][60][61][62][63][64][65] with 103,983 study participants (Figure 1). All of the included studies were cross-sectional.…”