Women’s autonomy and utilization of maternal healthcare in India: Evidence from a recent national survey

Abstract

Objective The present study aims to examine the association between women’s decision-making autonomy and utilization of maternal healthcare services among the currently married women in India. Methods A total of 32,698 currently married women aged 15–49 years who had at least one live birth in the past five years preceding the survey and had information regarding autonomy collected by the National Family Health Survey 2015–16 were used for analysis. Bivariate and multivariate logistic regression models were employed for the analyses of this study. Results Utilization of maternal healthcare services was higher among the women having a high level of decision-making autonomy compared to those who had a low autonomy in the household. The regression results indicate that women’s autonomy was significantly associated with increased odds of maternal healthcare services in India. Women with high autonomy had 37% and 33% greater likelihood of receiving ANC (AOR: 1.37, 95% CI: 1.25–1.50) and PNC care (AOR: 1.33, 95% CI: 1.24–1.42) respectively compared to women having low autonomy. However, no significant association was observed between women’s autonomy and institutional delivery in the adjusted analysis. Conclusion This study recommends the need for comprehensive strategies involving improvement of women’s autonomy along with expansion of education, awareness generation regarding the importance of maternity care, and enhancing public health infrastructure to ensure higher utilization of maternal healthcare services that would eventually reduce maternal mortality.

Relationship between maternal healthcare utilisation and empowerment among women in Bangladesh: evidence from a nationally representative cross-sectional study

“… 45 Additionally, higher decision-making power and control over household resources allows a woman to more capably communicate with family members and to demand care for herself when needed. 46 47 However, in contrast to our findings, some other results indicated no association between women’s decision-making power and maternal healthcare utilisation, 14 16 48 suggesting the need for further in-depth investigation.…”

“…Not justifying wife beating for any reason is indicative of a greater sense of entitlement, self-esteem and status which positively reflect a woman’s sense of empowerment and ability to claim their rights. 4 38 The association found in this study, along with similar findings from other studies, 14 18 19 36 37 indicates that women’s attitude towards violence needs to be considered a vital sociocultural factor for utilisation of MHS during pregnancy.…”

“…Although this study used a newly developed index (SWPER) to measure women's empowerment status, the relationships between women's empowerment and utilisation of maternal healthcare found in this study are consistent with previous studies around the world which used different measures of women's empowerment. [10][11][12][13][14][15][16][17][18][19] Therefore, the findings of this study reaffirmed the association between women's empowerment and maternal healthcare utilisation in a patriarchal society such as Bangladesh.…”

“…5 Extensive research from developing countries has attempted to identify various sociodemographic, geographic and cultural correlates associated with utilisation of MHS from skilled professionals. 3 6-9 A handful of studies from developing countries, [10][11][12][13][14] including Bangladesh, [15][16][17][18][19][20] has documented the relationship between women's empowerment and maternal healthcare utilisation. However, these studies were mainly focused on women's involvement in household decision-making, 10-14 16-18 20 freedom of movement 11 17 18 or attitude towards violence, 12 13 18 19 which provide a narrow scope of women's empowerment for understanding this relationship.…”

Individual and Community-Level Factors of Perinatal Mortality in The High Mortality Regions of Ethiopia: A Multilevel Mixed-Effect Analysis

“…This is in agreement with the study conducted in Bangladesh 14 . The possible explanation may be due to those women who are autonomous in making health care decisions were more likely to have antenatal follow up 1,20,30 , postnatal cares 20,30 , and delivered at health facility 1,30 . It is crucial to identify and treat an existing complication in pregnancy and early in the newborn baby.…”