Banda Pamela C, Odimegwu Clifford O, Ntoimo Lorretta F C, Muchiri Evans
a Demography and Population Studies Programme , Schools of Public Health and Social Sciences, University of the Witwatersrand , Johannesburg , South Africa.
b Provincial Education Offices, Ministry of Education , Lusaka , Zambia.
Women Health. 2017 Apr;57(4):405-429. doi: 10.1080/03630242.2016.1170092. Epub 2016 Mar 25.
Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.
性别不平等已被证明是负面健康结果的关键驱动因素，尤其是在女性中。然而，研究尚未明确考察非洲背景下性别不平等在孕产妇健康中的作用。因此，本研究的作者考察了以女性缺乏自主权为指标的性别不平等在使女性面临孕产妇健康风险方面的作用。数据来自2007年赞比亚人口与健康调查，样本为3906名年龄在15至49岁之间的已婚或有伴侣的女性，采用加权抽样。多变量分析显示，家庭决策权方面的低自主权与孕产妇健康风险相关（比值比（OR）=1.52，p<0.001）。自主权与家庭财富的相互作用表明，在较富裕家庭中且家庭决策权自主权较低的受访者（OR=2.03，p<0.05）比自主权较高的同行更有可能面临孕产妇健康风险。在赞比亚，降低女性孕产妇死亡率和发病率的努力应包括采取干预措施，以改变限制女性在怀孕和分娩期间积极参与自身健康决策的现行性别规范。
