Women's involvement in decision-making and receiving husbands’ support for their reproductive healthcare: a cross-sectional study in Lalitpur, Nepal

BACKGROUND: Sociocultural factors remain an important determinant for women's involvement with decision making and getting husbands’ support for their reproductive healthcare. Therefore this study was conducted to examine sociodemographic factors associated with women's involvement in decision making and getting husbands’ support for their reproductive healthcare. METHODS: An institutional-based cross-sectional study was conducted in Lalitpur, Nepal. A total of 600 respondents were selected from 15 immunization clinics. Participants were women ≥18 y of age who came to the child's immunization clinic. The association between sociodemographic variables and women's involvement in decision making and getting husbands’ support for their reproductive healthcare was analysed through multivariate logistic regression models. RESULTS: While women's involvement in decision making was greater for childcare, it was less in the area related to financial matters. In contrast, husbands supported more in the area related to finances than for childcare and accompanying to health facilities. The significant determinants for women's involvement in decision making and getting husbands’ support were the woman's caste, education level, employment status, household income, age group and number of children. Madhesi/Muslim/other women were less likely (adjusted odds ratio [AOR] 0.31 [95% confidence interval {CI} 0.12 to 0.73]) to decide the number of babies and birth spacing. These women were also less likely (AOR 0.18 [95% CI 0.02 to 0.86]) to be accompanied by their husbands to the family planning (FP) clinic. Janajati, Dalit and Madhesi/Muslim/other women were less likely to receive their husbands’ support for birth preparedness. Women who were <20 y of age and had a single child were less likely to get involved in decision making and getting their husbands’ support for FP services. CONCLUSIONS: The findings call for reproductive health programs that encourage women's involvement in decision making and receiving husbands’ support in women's reproductive healthcare. When designing such a program in the FP area, the woman's caste, age and parity should be given special consideration. Also, caste should be considered when designing such a program related to birth preparedness.