Women’s Decision-Making Autonomy and ICT Utilization on Access to Antenatal Care Services: Survey Results From Jinja and Kampala Cities, Uganda

Abstract

There is growing evidence in Uganda that the non-attendance of antenatal care is largely influenced by the lack of decision-making autonomy, inadequate information and poor services offered in health facilities. Although previous studies have examined barriers and facilitators of antenatal care, a few of them have investigated the extent of decision making autonomy and ICT adoption among expectant mothers. A cross sectional design through focus group discussions and survey questionnaires was used to collect data. Three hundred and twenty households were randomly sampled in Kampala and Jinja districts. The Chi-square tests (χ 2 ) for independence to analyze group differences among women's socio-demographic characteristics and decision-making autonomy was used. Inclusion criteria included respondents aged 18 and 50 years, completion of primary school education, expectant mothers and mothers who gave birth two years prior to the study. A hundred and sixty-four respondents participated in this survey. About 59.5% of women lacked decision making autonomy. Midwives (37.6%) and village health teams (35%) were a major source of antenatal care information, and 49.5% of expectant mothers lacked ANC information. Ninety percent (90%) of mothers did not use any form of ICT's to enhance their decisions yet 79% possessed mobile phones. We observed a strong association between antenatal care decision-making autonomy and women with higher education (χ 2 = 8.63, ρ = 0.035), married (χ 2 = 4.1, ρ = 0.043) and mature (36-50) (χ 2 = 8.81, ρ = 0.032). The main findings in this study suggest that ICT adoption and decision making autonomy among expectant mothers is still low and less appreciated. Control measures and interventions should be geared towards empowering women to influence their decisions.