Effects of Women’s Autonomy and Male Involvement on Reproductive and Child Health (RCH) Service Utilization in Uttar Pradesh

Abstract

Introduction: Effective utilization of reproductive and child health (RCH) services is important to reduce morbidity and mortality among mothers as well as children under-five. After International Conference on Population and Development (ICPD), 1994 India has increasingly integrated male participation in women's reproductive health to improve the women's health care during pregnancy and child birth. This study examined effect of women's autonomy and male involvement on RCH services utilization in Uttar Pradesh State of India. Methodology: State level data of Uttar Pradesh from National Family Health Survey (NFHS-3), India for currently married women and men aged 15 -49 years was considered. The study was restricted to couples whose youngest child was born during the three years preceding the survey (N = 2685). Pearson chi-square test was used to determine the association of background characteristics with woman's autonomy and male involvement in RCH utilization. Logistic regression was used to understand the effects of male involvement and women's autonomy, using both computed indices after controlling for socio-economic and background characteristics of women and their husbands. Subsequently, the exercise was extended using individual component of both the indices. All findings were reported for 95% CI and p < 0.05. Results: Findings show that except religion, other socio-economic and demographic variables such as age of women, place of residence, number of living children, caste/tribe, women's work status, education, wealth index, household structure and exposure to mass media, husband's age, education, and occupation were statistically significant and associated with women's autonomy and male involvement. Multivariate analysis indicated women's autonomous decision making and support from their husbands (male involvement) How to cite this paper: Sahu, D., Dutta, T., Kumar, S., Mishra, N.R., Neogi, S., Mondal, S., Dadhwal-Singh, A. and Levitt-Dayal, M. 261significantly influenced their utilization of RCH services after controlling for all socio-economic and demographic variables. Conclusion: To improve RCH service utilization and overall health status of women and children male involvement and women's autonomous decision-making should be addressed in all future RCH programs in the State.

Determinants of health care decision making autonomy among mothers of children under five years in Ghana: analysis of 2014 Ghana demographic and health survey

“…Existing studies from developing countries have shown that women's autonomy in health care decisions is related to child's health, women's health, utilization of healthcare services and empowerment amongst others [4][5][6][7][8][9].…”

“…For example, Alemayehu and Meskele [2] noted that the ability of a woman to visit health care facilities and receive treatment is somewhat dependent on their ability to take personal decisions. However, societal norms, culture, gender roles, gender inequality, religious norms and other socio-cultural factors influence the way women live their lives in developing countries [3].Existing studies from developing countries have shown that women's autonomy in health care decisions is related to child's health, women's health, utilization of healthcare services and empowerment amongst others [4][5][6][7][8][9].Similarly, higher risk of malnutrition has been observed from households where women had little or no autonomy in making household decisions [10]. The ability of women to take health care decision has also been reported in literature to improve the survival rates of their children [11][12][13][14].…”

Determinants of utilization of antenatal care services among recently delivered women residing in urban poor areas of Rishikesh, Uttarakhand, India—a cross-sectional study

“…The most interesting finding was that husbands accompanying their wives to antenatal visits and the autonomy of study participants were the only two significant independent factors related to four or more ANC visits after adjusting for other significant factors. Sahu et al secondary data analysis of NFHS 3 (2005NFHS 3 ( -2006 reported that greater spousal involvement and women's decision-making autonomy were associated with the utilization of full antenatal care services 25) . Similar findings related to husbands' involvement were reported by Mohammad et al and Redshaw et al 26,27) The involvement of husbands during antenatal visits has become an important factor for ANC visits, as their knowledge regarding various health issues during pregnancy would improve and could further motivate wives to utilize antenatal care services.…”

Systematic review of the concept ‘male involvement in maternal health’ by natural language processing and descriptive analysis

“…Certain aspects of MI such as communication, decision making and 'feeling supported' were rarely included as MI indicators (10.64%, 8.51% and 6.38%, respectively) in the studies included in our review, while both quantitative and qualitative research have shown that these aspects of men's involvement play an important role in maternal health care access, utilisation and outcomes. [37][38][39][40][41][42] The narrow focus on specific actions of men (such as financial support and ANC attendance) without taking into other aspects (such as couple dynamics and gender equality) clearly entails a risk of missing essential information and underreporting negative consequences. The need for greater incorporation of gender-transformative conceptual approaches into MI interventions, with effective measures, was already emphasised by Comrie-Thomson et al 13 Another recent systematic review reported that worldwide only a minority of the interventions aiming at engaging men and boys in sexual reproductive health and rights (SRHR) includes a gender transformative approach.…”