Married women’s decision-making autonomy in the household and maternal and neonatal healthcare utilization and associated factors in Debretabor, northwest Ethiopia

• Published in: PloS one Vol. 16; no. 9; p. e0255021
• Main Authors: Kebede, Azmeraw Ambachew, Cherkos, Endeshaw Admasu, Taye, Eden Bishaw, Eriku, Getachew Azeze, Taye, Birhan Tsegaw, Chanie, Wagaye Fentahun
• Format: Journal Article
• Language: English
• Published: San Francisco Public Library of Science 27.09.2021; Public Library of Science (PLoS)
• Subjects: Autonomy; Biology and Life Sciences; Childrens health; Confidence intervals; Decision analysis; Decision making; Developing countries; Economic aspects; Empirical analysis; Empowerment; Health aspects; Health care; Health care facilities; Health facilities; Health sciences; Health services utilization; Households; Income; Infant mortality; Infants (Newborn); LDCs; Maternal & child health; Maternal mortality; Medical care; Medical schools; Medicine; Medicine and Health Sciences; Men; Midwifery; Neonates; Newborn babies; People and Places; Regression models; Sample size; Sampling techniques; Social aspects; Social factors; Social Sciences; Socioeconomics; Statistical analysis; Utilization; Variables; Women; Womens health; Ethiopia; Nigeria
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0255021

Women's decision-making autonomy is very crucial for the improvement of women empowerment, and maternal, neonatal, and child healthcare utilization. As time immemorial, Ethiopian culture is largely gender stratified, and the position of women is subordinate to men in various household and health-seeking decision-making matters. However, there is a dearth of empirical evidence on women's decision-making autonomy, especially in the household and on maternal and newborn healthcare utilization. Therefore, this study assessed married women's decision-making autonomy in the household and on maternal and neonatal healthcare utilization and associated factors in Debretabor, Northwest Ethiopia. A community-based cross-sectional study was conducted from October 1.sup.st to 30.sup.th, 2019. A two-stage sampling technique was used to select 730 married women. Data were collected using a structured, pretested, and interviewer-administered questionnaire. Data were entered into EPI INFO 7 and analyzed by SPSS version 23. Multivariable logistic regression model was fitted to identify factors associated with women's decision-making autonomy in the household and maternal and neonatal healthcare utilization. The adjusted odds ratio with its 95% confidence interval was computed to determine the level of significance at a p-value of [less than or equal to] 0.05. A total of 730 married women were included in the analysis. Thus, three-fourths (75.1%) of women had higher decision-making autonomy on their health, neonatal health, and other socio-economic aspects. Besides, the proportion of four and above antenatal visits, delivery at a health facility, postnatal checkup, knowledge of neonatal danger signs, and appropriate health-seeking practices for sick newborns among autonomous women were 52.1%, 56.1%, 71.4%, 32%, and 80% respectively. Age greater than 35 years old (AOR = 2.08; 95% CI: 1.19, 3.62), monthly income of > 5000 ETB (AOR = 3.1; 95% CI: 1.36, 7.07), husband involvement (AOR = 2.36; 95% CI: 1.55, 3.43), and adequate knowledge of neonatal danger signs (AOR = 2.11; 95% CI: 1.4, 3.2) were factors independently associated with women's decision-making autonomy on maternal and neonatal healthcare utilization and other socio-economic affairs. Our findings show that women's decision-making autonomy in the household and maternal and neonatal healthcare utilization was optimal. Increasing household income level, promotion of husband's involvement starting from the prenatal period, and increasing women's knowledge of maternal and neonatal danger signs will have a great role in the improvement of women's decision-making autonomy.