Onah Michael Nnachebe, Onah Roseline Chinwe, Onah Felix Ezema
Institute of Public Policy and Administration, Graduate School of Development, University of Central Asia, Bishkek, Kyrgyzstan.
Department of Public Administration and Local Government, Faculty of Social Sciences, University of Nigeria Nsukka, Nsukka, Enugu State, Nigeria.
PLOS Glob Public Health. 2023 Jun 20;3(6):e0000406. doi: 10.1371/journal.pgph.0000406. eCollection 2023.
Characteristics which reflect a particular context and unique to individuals, households, and societies have been suggested to have an impact on the association between women's empowerment and women's well-being indicators. However, there is limited empirical evidence of this effect. We used access to antenatal care (ANC) to examine the main and interaction effects of women's empowerment, religion, marriage type, and uptake of services in 13 West African countries. Data was extracted from Phase 6 and 7 of the Demographic and Health Survey, and we measured women's empowerment using the survey-based women's empowerment (SWPER) index for women's empowerment in Africa. ANC visits as the outcome variable was analyzed as a count variable and the SWPER domains, religion, and marriage type were the key independent variables. We utilised ordinary least square (OLS) and Poisson regression models where appropriate to examine main and interaction effects and analyses were appropriately weighted and key control variables were applied. Statistical significance was established at 95% confidence interval. Findings suggest that being Muslim or in a polygynous household was consistently associated with disempowerment in social independence, attitude toward violence, and decision-making for women. Although less consistent, improved social independence and decision-making for women were associated with the probability of increased ANC visits. Polygyny and Islamic religion were negatively associated with increased number of ANC visits. Decision-making for Muslim women appear to increase the probability of increased number of ANC visits. Improving the conditions that contribute towards women's disempowerment especially for Muslim women and to a lesser extent for those who reside in polygynous households is key towards better uptake of antenatal care services. Furthermore, targeting of interventions and polices that could empower women towards better access to health services should be tailored on existing contextual factors including religion and marriage type.
有观点认为，反映特定背景且为个人、家庭和社会所独有的特征会对妇女赋权与妇女福祉指标之间的关联产生影响。然而，关于这种影响的实证证据有限。我们利用获得产前护理（ANC）的情况，来研究13个西非国家中妇女赋权、宗教、婚姻类型以及服务利用情况的主要影响和交互作用。数据取自人口与健康调查的第6阶段和第7阶段，我们使用基于调查的非洲妇女赋权（SWPER）指数来衡量妇女赋权情况。将ANC就诊次数作为结果变量，作为计数变量进行分析，SWPER领域、宗教和婚姻类型为关键自变量。我们在适当情况下使用普通最小二乘法（OLS）和泊松回归模型来检验主要影响和交互作用，并进行适当加权分析，同时应用关键控制变量。在95%置信区间确定统计显著性。研究结果表明，身为穆斯林或处于一夫多妻制家庭，始终与妇女在社会独立性、对暴力的态度以及决策方面的无权状况相关。虽然不太一致，但妇女社会独立性和决策能力的提高与ANC就诊次数增加的可能性相关。一夫多妻制和伊斯兰教与ANC就诊次数增加呈负相关。穆斯林妇女的决策似乎会增加ANC就诊次数增加的可能性。改善导致妇女无权状况的条件，特别是对穆斯林妇女而言，在较小程度上对那些居住在一夫多妻制家庭中的妇女而言，是更好地利用产前护理服务的关键。此外，针对能够使妇女更有能力获得更好医疗服务的干预措施和政策，应根据包括宗教和婚姻类型在内的现有背景因素进行调整。
