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Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey

BACKGROUND: Women’s decision-making autonomy has a potential impact on the scale-up of health care utilization. In high fertility countries, evidence regarding women’s decision-making autonomy on their health care utilization and its associated factors is limited and inconclusive. Hence, it is impor...

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Autores principales: Negash, Wubshet Debebe, Kefale, Getachew Teshale, Belachew, Tadele Biresaw, Asmamaw, Desale Bihonegn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343071/
https://www.ncbi.nlm.nih.gov/pubmed/37440579
http://dx.doi.org/10.1371/journal.pone.0288603
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author Negash, Wubshet Debebe
Kefale, Getachew Teshale
Belachew, Tadele Biresaw
Asmamaw, Desale Bihonegn
author_facet Negash, Wubshet Debebe
Kefale, Getachew Teshale
Belachew, Tadele Biresaw
Asmamaw, Desale Bihonegn
author_sort Negash, Wubshet Debebe
collection PubMed
description BACKGROUND: Women’s decision-making autonomy has a potential impact on the scale-up of health care utilization. In high fertility countries, evidence regarding women’s decision-making autonomy on their health care utilization and its associated factors is limited and inconclusive. Hence, it is important to investigate women decision-making autonomy on their health care utilization and associated factors in high fertility countries in sub-Saharan Africa. METHODS: The data source for this study was obtained from recent Demographic and Health Surveys that were comprised of a weighted sample of 178875 reproductive age women. A multilevel mixed-effect binary logistic regression model was fitted. The odds ratios, along with the 95% confidence interval were generated to identify individual and community-level factors associated with women’s autonomy in health care decision-making. A p-value less than 0.05 was declared as statistical significance. RESULTS: In this study, 42% (95% CI: 41.7, 42.3) of women were able to exercise their reproductive autonomy. The highest (74.8%) and the lowest (19.74%) magnitude of women autonomy was found in Angola and Mali, respectively. In multilevel analysis; age of women 25–34 years, 35 and above (AOR = 1.34, 95% CI: 1.29, 1.39), and (AOR = 1.78, 95% CI: 1.75, 1.90), women’s primary and secondary educational level (AOR = 1.25, 95% CI: 1.20, 1.31), and (AOR = 1.44, 95% CI: 1.32, 1.54), husband primary and secondary educational level (AOR = 1.24, 95% CI: 1.18, 1.29), and (AOR = 1.21, 95% CI: 1.15, 1.27), women who had work (AOR = 1.67, 95% CI: 1.59, 1.74) female household heads (AOR = 1.44, 95% CI: 1.37, 1.51), media exposure (AOR = 1.04, 95% CI: 1.09, 1.18), health insurance coverage (AOR = 1.26, 95% CI: 1.17, 1.36), urban residence (AOR = 1.14, 95% CI: 1.09, 1.19), community education (AOR = 2.43, 95% CI: 2.07, 2.85) and low community poverty level (AOR = 1.27, 95% CI: 1.08, 1.49) were predictor variables. CONCLUSION AND RECOMMENDATION: Although every woman has the right to make her own health care decisions, this study showed that almost 58% of them had no role in making decisions about their health care utilization. Thus, each country Government should support women’s decision making autonomy regarding their healthcare utilization through mass media and extensive behavioral education.
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spelling pubmed-103430712023-07-14 Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey Negash, Wubshet Debebe Kefale, Getachew Teshale Belachew, Tadele Biresaw Asmamaw, Desale Bihonegn PLoS One Research Article BACKGROUND: Women’s decision-making autonomy has a potential impact on the scale-up of health care utilization. In high fertility countries, evidence regarding women’s decision-making autonomy on their health care utilization and its associated factors is limited and inconclusive. Hence, it is important to investigate women decision-making autonomy on their health care utilization and associated factors in high fertility countries in sub-Saharan Africa. METHODS: The data source for this study was obtained from recent Demographic and Health Surveys that were comprised of a weighted sample of 178875 reproductive age women. A multilevel mixed-effect binary logistic regression model was fitted. The odds ratios, along with the 95% confidence interval were generated to identify individual and community-level factors associated with women’s autonomy in health care decision-making. A p-value less than 0.05 was declared as statistical significance. RESULTS: In this study, 42% (95% CI: 41.7, 42.3) of women were able to exercise their reproductive autonomy. The highest (74.8%) and the lowest (19.74%) magnitude of women autonomy was found in Angola and Mali, respectively. In multilevel analysis; age of women 25–34 years, 35 and above (AOR = 1.34, 95% CI: 1.29, 1.39), and (AOR = 1.78, 95% CI: 1.75, 1.90), women’s primary and secondary educational level (AOR = 1.25, 95% CI: 1.20, 1.31), and (AOR = 1.44, 95% CI: 1.32, 1.54), husband primary and secondary educational level (AOR = 1.24, 95% CI: 1.18, 1.29), and (AOR = 1.21, 95% CI: 1.15, 1.27), women who had work (AOR = 1.67, 95% CI: 1.59, 1.74) female household heads (AOR = 1.44, 95% CI: 1.37, 1.51), media exposure (AOR = 1.04, 95% CI: 1.09, 1.18), health insurance coverage (AOR = 1.26, 95% CI: 1.17, 1.36), urban residence (AOR = 1.14, 95% CI: 1.09, 1.19), community education (AOR = 2.43, 95% CI: 2.07, 2.85) and low community poverty level (AOR = 1.27, 95% CI: 1.08, 1.49) were predictor variables. CONCLUSION AND RECOMMENDATION: Although every woman has the right to make her own health care decisions, this study showed that almost 58% of them had no role in making decisions about their health care utilization. Thus, each country Government should support women’s decision making autonomy regarding their healthcare utilization through mass media and extensive behavioral education. Public Library of Science 2023-07-13 /pmc/articles/PMC10343071/ /pubmed/37440579 http://dx.doi.org/10.1371/journal.pone.0288603 Text en © 2023 Negash et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Negash, Wubshet Debebe
Kefale, Getachew Teshale
Belachew, Tadele Biresaw
Asmamaw, Desale Bihonegn
Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
title Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
title_full Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
title_fullStr Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
title_full_unstemmed Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
title_short Married women decision making autonomy on health care utilization in high fertility sub-Saharan African countries: A multilevel analysis of recent Demographic and Health Survey
title_sort married women decision making autonomy on health care utilization in high fertility sub-saharan african countries: a multilevel analysis of recent demographic and health survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343071/
https://www.ncbi.nlm.nih.gov/pubmed/37440579
http://dx.doi.org/10.1371/journal.pone.0288603
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