Women Autonomy and the Use of Antenatal and Delivery Services in Nigeria

Abstract

The ability of a woman to make independent decision and appropriate action on her reproductive desires is dependent on her level of autonomy. This study was undertaken to determine whether the level of autonomy of Nigerian women influences the use of antenatal and delivery services. A quantitative cross-sectional study using the Demographic and Health Survey (DHS) to determine whether an association exists between women's autonomy and the appropriate use of prenatal and delivery services. A total of 22,556 women aged 15-49 years were recruited using a stratified two stage proportionate to size cluster sampling from all parts of Nigeria. About 43% of respondents indicated that they do not independently take decision on health issues relating to their health, are not allowed to venture out of their matrimonial homes without seeking for permission and have no income and thus categorized as having no any form of autonomy. North East and South West zones had the lowest (18%) and highest (62%) proportion of women with full autonomy). Women with full autonomy are more likely to use prenatal (unadjusted odd ratio=2.229; CI 2.094-2.373) and delivery (Unadjusted Odd Ratio=3.795; CI 3.523-4.088)) services as recommended compared to women with no any form of autonomy (Adjusted Odd Ratio=1.129; CI 1.117-1.146; p<.05). This study demonstrated that autonomy influences the use of Maternal Health Services (MHS) in Nigeria. There is the need for policy change on girl's education and women employment as well as dialogue with relevant Sociocultural structure like religious and traditional leaders in order to improve the level of autonomy and ultimately high use of MHS.

Only 9% of mothers have eight and more ANC visit in 14 sub-saharan African countries; evidence from the most recent DHS 2018–2023: a multilevel analysis

“…This may be due to the fact that using their autonomy women can make decisions about getting healthcare for themselves. Similar studies also showed similar finding [39,[53][54][55].…”

Women’s autonomy and maternal health decision making in Kenya: implications for service delivery reform - a qualitative study

“…Research on patient-centered care for women shows that women’s autonomy (i.e., the freedom of women to exercise their judgment in order to act for their own interests) influences reproductive, maternal, and child health outcomes [ 6 – 11 ]. Conversely, the absence of women’s autonomy in decision-making results in delays and poor utilization of maternal health services and ultimately increased maternal morbidity and mortality [ 12 ]. Thus, empowered women can make informed decisions about their reproductive health, including family planning, timing and spacing of pregnancies, and the type of care they receive during pregnancy and childbirth [ 13 – 16 ].…”

The role of women’s autonomy and empowerment in maternal health decision making: Implications on the implementation process of a service delivery reform in Kenya. A qualitative exploratory study

“…Research on patient-centered care for women shows that women's autonomy (i.e., the freedom of women to exercise their judgment in order to act for their own interests) in uences reproductive, maternal, and child health outcomes (6)(7)(8)(9)(10)(11). Conversely, the absence of women's autonomy in decision-making results in delays and poor utilization of maternal health services and ultimately increased maternal morbidity and mortality (12). Thus, empowered women have the ability to make informed decisions about their reproductive health, including family planning, timing and spacing of pregnancies, and the type of care they receive during pregnancy and childbirth (13)(14)(15).…”