Gender inequality and the use of maternal healthcare services in rural sub-Saharan Africa

Adjiwanou, Vissého; Legrand, Thomas

doi:10.1016/j.healthplace.2014.06.001

Cited by 82 publications

(88 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other factors included: employment status, wealth levels, distance to health facility and the availability of money for accessing care. Similar to Adjiwanou and LeGrand (2014), we included gender inequality at the household level as well contextual gender norms regarding intimate partner violence that, if present, can inhibit access and utilization of maternal care. Gender inequality index was created based on answers to five questions about whether women had a "final say" in terms of household decision-making related to: (1) who usually decides on respondent's health care issues; (2) making large household purchases; (3) making household expenses for daily needs; (4) on visits to family or friends; and (5) deciding what to do with what husband earns.…”

Section: Explanatory Variablesmentioning

confidence: 99%

“…Contextual gender norms was conceptualized from five questions regarding violence against women formulated as follows: "Sometimes a husband is annoyed or angered by things that his wife/partner does, in your opinion, is a husband justified in hitting or beating his wife in the following situations: (1) she goes out without her husband's permission; (2) she neglects her children; (3) she argues with her husband; (4) she refuses to have sexual relations with him; or (5) she burns the food". The relevance of these factors as either enabling or inhibiting utilization of maternal health care has been demonstrated elsewhere (Adjiwanou and LeGrand, 2014). We also used birth-parity, which is as a proxy for birthing experience as an enabling factor.…”

Section: Explanatory Variablesmentioning

confidence: 99%

“…Similarly, women with some autonomy within the household were more likely to access skilled delivery. Such autonomy enables women to be proactive in decisions concerning themselves and their children's health (Adjiwanou and Legrand, 2014). Even though Liberia has made great strides in health infrastructure post-civil war, a large number of the population are still without access to health care.…”

Section: Variable Timing Of Anc Visit (Tr a ) Four Anc Visits Or B (Smentioning

confidence: 99%

See 2 more Smart Citations

Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context

Luginaah

Kangmennaang

Fallah

et al. 2016

Social Science & Medicine

View full text Add to dashboard Cite

Section: Explanatory Variablesmentioning

confidence: 99%

Section: Explanatory Variablesmentioning

confidence: 99%

Section: Variable Timing Of Anc Visit (Tr a ) Four Anc Visits Or B (Smentioning

confidence: 99%

See 1 more Smart Citation

Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context

Luginaah

Kangmennaang

Fallah

et al. 2016

Social Science & Medicine

View full text Add to dashboard Cite

“…La variation des effets entre pays est moins importante si on compare les femmes qui n'interviennent dans aucune décision au sein de leur ménage (absence d'autonomie) aux femmes à forte autonomie décisionnelle. Cette influence négative des normes de genre est observée aussi par Koenig et ses collaborateurs (2006) sur l'exercice de la violence physique envers les femmes en Inde, et par Adjiwanou et LeGrand (2014) sur le recours à l'accouchement assisté au Ghana.…”

Section: Discussion Et Conclusionunclassified

Effets des normes de genre, de l’éducation et de l’emploi sur l’autonomie décisionnelle des femmes en Afrique subsaharienne

Adjiwanou

Legrand

2015

cqd

Self Cite

View full text Add to dashboard Cite

L’autonomie des femmes a été reconnue comme une condition essentielle au développement lors de la Conférence internationale sur la population et le développement de Caire en 1994. Cette étude examine les facteurs contextuels (notamment des normes de genre légitimant la violence envers les femmes) et les facteurs individuels (dont le niveau d’instruction et le type d’emploi) sur l’autonomie décisionnelle des femmes en milieu rural au Ghana, au Kenya, en Ouganda et en Tanzanie. Elle utilise les données issues des enquêtes démographiques et de santé (EDS) de ces pays. La mesure des normes de genre à partir de la perception qu’ont les femmes de la violence domestique (d’un homme sur son épouse) dans leur communauté en recourant à l’analyse factorielle confirmatoire a donné de bons indices d’ajustement qui renforcent la validité de cette méthode. Une augmentation d’un écart-type de cette variable contextuelle est associée à un accroissement des risques pour une femme d’avoir une faible autonomie décisionnelle de 54 % au Ghana, de 45 % au Kenya, de 48 % en Ouganda et de 25 % en Tanzanie. L’instruction et le statut socioéconomique des femmes ne présentent pas la même stabilité sur l’autonomie décisionnelle des femmes. Nos résultats témoignent de la nécessité d’une politique plus globale pour renforcer l’autonomie des femmes en Afrique subsaharienne.Since the ICPD conference in Cairo in 1994, women’s autonomy has become a core element of the development agenda. This study examines the contextual level factors (especially the gender norms that legitimate violence against women), and the individual level factors (including education and employment status) in women’s decision-making authority in four sub-Saharan African countries. Using multilevel structural equations modelling on DHS data from Ghana, Kenya, Tanzania and Uganda, we found good model fits in all four countries, confirmed by factor analysis, using a measure of gender norms based on the attitudes of women in the community towards domestic violence (specifically wife-beating). We found that one standard deviation of this contextual latent variable is associated with an increase of 54 % in Ghana, 45 % in Kenya, 48 % in Uganda and 25 % in Tanzania in the odds of a woman having low decision-making authority. Education and socio-economic status both at individual and contextual level did not show the same strong effect on women’s decision-making authority. The results reinforce the need for more appropriate global policies to enhance women’s autonomy in the sub-Saharan African context

show abstract

“…A primary driver of these maternal deaths, particularly in rural areas [6,7], is lack of access to appropriate maternal health care, notably skilled birth attendance and utilization of health facilities for childbirth [8][9][10][11][12]. A number of sociodemographic, sociocultural, and structural correlates of facility delivery have been identified, including educational attainment [13,14], economic status [15][16][17][18], geographic proximity [5,19,20], out of pocket costs [17,21,22], autonomy and empowerment [23,24], and perceived benefit or need [25][26][27]. Literature reviews about the determinants of facility delivery use have also been conducted [28,29].…”

Section: Introductionmentioning

confidence: 99%

Proximate Context of HIV-Related Stigma and Women’s Use of Skilled Childbirth Services in Uganda

Tsai

2016

AIDS Behav

View full text Add to dashboard Cite

HIV-related stigma compromises both HIV prevention and treatment and has recently been described as a barrier to utilization of skilled childbirth services in sub-Saharan Africa. This study uses the 2011 Uganda Demographic Health Survey to estimate the associations between HIV-related stigma, measured both at the individual and community level, and use of facility delivery among women. Consistent with theoretical predictions, higher levels of stigma are associated with reduced likelihood of facility delivery. The negative relationship between stigma and facility delivery is especially pronounced when stigma is measured at the community level, highlighting the importance of understanding the proximate context of HIV-related stigma and its potential effects on behavior. Reducing the stigma of HIV will be critical to achieving the twin goals of reducing overall maternal mortality and preventing mother-to-child HIV transmission.

show abstract

Gender inequality and the use of maternal healthcare services in rural sub-Saharan Africa

Cited by 82 publications

References 62 publications

Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context

Timing and utilization of antenatal care services in Liberia: Understanding the pre-Ebola epidemic context

Effets des normes de genre, de l’éducation et de l’emploi sur l’autonomie décisionnelle des femmes en Afrique subsaharienne

Proximate Context of HIV-Related Stigma and Women’s Use of Skilled Childbirth Services in Uganda

Contact Info

Product

Resources

About