Women’s empowerment and male involvement in antenatal care: analyses of Demographic and Health Surveys (DHS) in selected African countries

Abstract

BackgroundIncreasing women’s status and male involvement are important strategies in reducing preventable maternal morbidity and mortality. While efforts to both empower women and engage men in maternal health care-seeking can work synergistically, in practice they may result in opposing processes and outcomes. This study examines whether a woman’s empowerment status, in sum and across economic, socio-familial, and legal dimensions, is associated with male partner accompaniment to antenatal care (ANC).MethodsWomen’s empowerment was measured based on the sum of nine empowerment items in the 2010–2011 Demographic and Health Surveys in eight sub-Saharan African countries: Burkina Faso (n = 2,490), Burundi (n = 1,042), Malawi (n = 1,353), Mozambique (n = 414), Rwanda (n = 1,211), Senegal (n = 505), Uganda (n = 428) and Zimbabwe (n = 459). In cross-sectional analyses, bivariate and multivariable logistic regressions models were used to examine the odds of male partner accompaniment to ANC between women with above-average versus below-average composite and dimensional empowerment scores.ResultsIn the majority of countries, male accompaniment to ANC was not uncommon. However, findings were mixed. Positive associations in women’s composite empowerment and male involvement were observed in Burkina Faso (OR = 1.27, 95% CI: 1.08, 1.50) and Uganda (OR = 1.53, 95% CI: 1.00-2.35), and in the economic empowerment dimension in Burkina Faso (OR = 1.24, 95% CI: 1.05-1.47). In Malawi, significant negative associations were observed in the odds of male accompaniment to ANC and women’s composite (OR = 0.77, 95% CI: 0.62-0.97) and economic empowerment scores (OR = 0.75, 95% CI: 0.59-0.94). No significant differences were observed in Burundi, Mozambique, Rwanda, Senegal, or Zimbabwe.ConclusionWomen’s empowerment can be positively or negatively associated with male antenatal accompaniment. Male involvement efforts may benefit from empowerment initiatives that promote women’s participation in social and economic spheres, provided that antenatal participation does not undermine women’s preferences or autonomy. The observation of mixed and null findings suggests that additional qualitative and longitudinal research may enhance understanding of women’s empowerment in sub-Saharan African settings.

Reported Knowledge, Attitude and Practice of Antenatal Care Services among Women in Dodoma Municipal, Tanzania

“…This is an important point to be considered in every pregnancy women and as usually in high proportion of them receiving SP very late during their antenatal booking [26][27][28][29][30][31][32][33][34][35][36]. These practices were significantly associated with poor pregnancy outcome regarding intermittent presumptive treatment against malaria in pregnancy during antenatal care.…”

“…To achieve maximum ANC services and practices among pregnancy women with high and low risk, there is a need to integrate public and private sector concerning ANC services planned and conducted in order to improve their maternal health and eventually improve the health status of newborn child. Empowered of women toward the primary level of education should be focused in order to have good maternal health outcome [36][37][38][39][40][41][42][43][44][45][46][47][48].…”

Association between women’s empowerment and infant and child feeding practices in sub-Saharan Africa: an analysis of Demographic and Health Surveys

“…Following an established coding scheme (38) we aggregated each item using dichotomous codes, with 1 indicating higher empowerment and 0 indicating lower empowerment. The summative dimensional sub-scores over items within each dimension and a total empowerment score over all nine items were calculated.…”

Development and validation of a new tool to measure Iranian pregnant women's empowerment

“…However, before this study, there was no specific scale that measured all aspects of empowerment in the specific cultural context of Iranian women. Also, during the literature review, it was noticed that different tools (8)(9)(10)14) only focussed on certain dimensions of empowerment and there was no tool that evaluated all dimensions of women's empowerment cumulatively. The SSPEQ developed in this study measures the 3 main dimensions of empowerment: sociopolitical, autonomy and educational.…”

“…The common dimensions of women's empowerment which have been evaluated include financial, social, cultural, legal, political, psychological and family, which cover some of the key terms used to define empowerment such as option, control, power and choice (5)(6)(7). Some researchers have measured empowerment with tools based on a small number of questions which evaluate only one or two aspects of empowerment (8)(9)(10). Meanwhile, different dimensions of empowerment may be conceptualized differently depending on the context (4,5).…”