Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi, India.
Department of Women's Studies, The University of Burdwan, Bardhaman, West Bengal, India.
PLoS One. 2020 Dec 9;15(12):e0243553. doi: 10.1371/journal.pone.0243553. eCollection 2020.
The present study aims to examine the association between women's decision-making autonomy and utilization of maternal healthcare services among the currently married women in India.
A total of 32,698 currently married women aged 15-49 years who had at least one live birth in the past five years preceding the survey and had information regarding autonomy collected by the National Family Health Survey 2015-16 were used for analysis. Bivariate and multivariate logistic regression models were employed for the analyses of this study.
Utilization of maternal healthcare services was higher among the women having a high level of decision-making autonomy compared to those who had a low autonomy in the household. The regression results indicate that women's autonomy was significantly associated with increased odds of maternal healthcare services in India. Women with high autonomy had 37% and 33% greater likelihood of receiving ANC (AOR: 1.37, 95% CI: 1.25-1.50) and PNC care (AOR: 1.33, 95% CI: 1.24-1.42) respectively compared to women having low autonomy. However, no significant association was observed between women's autonomy and institutional delivery in the adjusted analysis.
This study recommends the need for comprehensive strategies involving improvement of women's autonomy along with expansion of education, awareness generation regarding the importance of maternity care, and enhancing public health infrastructure to ensure higher utilization of maternal healthcare services that would eventually reduce maternal mortality.
本研究旨在探讨印度已婚妇女的决策权与利用孕产妇保健服务之间的关联。
本研究使用了 2015-2016 年全国家庭健康调查中至少有一名过去五年内活产且信息中包含自主权的 15-49 岁的 32698 名目前已婚妇女。本研究采用了双变量和多变量逻辑回归模型进行分析。
与自主权较低的妇女相比,决策权较高的妇女更有可能利用孕产妇保健服务。回归结果表明,妇女的自主权与印度孕产妇保健服务的利用呈显著正相关。自主权较高的妇女接受 ANC(AOR:1.37,95%CI:1.25-1.50)和 PNC 护理(AOR:1.33,95%CI:1.24-1.42)的可能性分别比自主权较低的妇女高 37%和 33%。然而,在调整后的分析中,妇女自主权与机构分娩之间没有显著关联。
本研究建议需要采取综合策略,包括提高妇女的自主权,同时扩大教育、提高对产妇保健重要性的认识,并加强公共卫生基础设施,以确保更高的孕产妇保健服务利用率,最终降低孕产妇死亡率。