Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
BMC Womens Health. 2024 Apr 3;24(1):216. doi: 10.1186/s12905-024-03058-3.
Decisions made at the household level have great impact on the welfare of the individual, the local community, as well as the welfare of the nation. Women's independent decision on reproductive health increases women's access to health information and utilization of reproductive services. This has great impact on maternal and child health outcomes. However, women in developing or low-income countries often have limited autonomy and control over their household decisions. Therefore the main purpose of this research project is to investigate the potential determinants of rural women's household decision making autonomy.
A multi level analysis was performed using the fourth Ethiopian Demographic and Health Survey (EDHS) 2016 data set. A weighted sample of 8,565 married rural women was included in the final analysis. Women were considered to be autonomous if they made decisions alone or jointly with their husband in all three household decision components. It was dichotomized as yes = 1 and no = 0. Multico linearity and chi-square tests were checked and variables which did not fulfill the assumptions were excluded from the analysis. Four models were fitted. Variables with p-value ≤ 0.25 in the bi-variable multilevel logistic regression were included in the multivariable multilevel logistic regression. The Adjusted Odds Ratio (AOR) with a 95% confidence interval (95% CI) was computed. Variables with a P-value of less than 0.05 in the multi-variable multilevel logistic regression were declared as statistically significant predictors.
A total of 8,565 weighted participants involved. From the total respondents, 68.55% (CI: 67.5%, 69.5%) of women had decision making autonomy. wealth index (poor: AOR: 0.84; 95% CI: 0.72, 0.97 and middle: AOR: 0.85; 95% CI 0.73, 0.98), literacy (illiterate: AOR: 0.75; 95% CI: 0.66, 0.86), respondents working status (Not working; AOR 0.68; 95% CI; 0.60, 0.76) ,who decides on marriage (parents: AOR 0.76; 95% CI; 0.67, 0.87), and proportion of early marriage in the community (high proportion of early marriage AOR: 1.35; 95% CI; 1.10, 1.72).
Women decision making autonomy was significantly determined by women economic participation (their wealth and their working status), women's literacy, proportion of early marriage in the community and women's involvement in decision of their marriage. Improving women's economic participation and enhancing women's participation to decide on their marriage will enhance women's decision making autonomy.
家庭层面的决策对个人、当地社区乃至国家的福利都有重大影响。妇女在生殖健康方面的独立决策增加了她们获得健康信息和利用生殖服务的机会。这对母婴健康结果有很大影响。然而，发展中国家或低收入国家的妇女往往对家庭决策的自主权有限。因此，本研究项目的主要目的是调查农村妇女家庭决策自主性的潜在决定因素。
使用 2016 年第四次埃塞俄比亚人口与健康调查（EDHS）数据集进行多层次分析。最终分析包括 8565 名已婚农村妇女的加权样本。如果妇女在所有三个家庭决策组成部分中独自或与丈夫共同做出决策，则认为她们具有自主权。将其分为是=1 和否=0。检查了多线性性和卡方检验，并从分析中排除了不符合假设的变量。拟合了四个模型。在双变量多层次逻辑回归中 p 值≤0.25 的变量被纳入多变量多层次逻辑回归。计算了调整后的优势比（AOR）和 95%置信区间（95%CI）。在多变量多层次逻辑回归中 p 值小于 0.05 的变量被宣布为具有统计学意义的预测因子。
共有 8565 名加权参与者参与。在总受访者中，68.55%（CI：67.5%，69.5%）的妇女具有决策自主权。财富指数（贫困：AOR：0.84；95%CI：0.72，0.97 和中等：AOR：0.85；95%CI 0.73，0.98）、文化程度（文盲：AOR：0.75；95%CI：0.66，0.86）、受访者工作状况（未工作；AOR 0.68；95%CI；0.60，0.76）、谁决定婚姻（父母：AOR 0.76；95%CI；0.67，0.87）和社区中早婚的比例（早婚比例高 AOR：1.35；95%CI；1.10，1.72）。
妇女的决策自主权显著取决于妇女的经济参与（她们的财富和工作状况）、妇女的文化程度、社区中早婚的比例以及妇女参与决定自己婚姻的程度。提高妇女的经济参与并增强妇女在决定婚姻方面的参与将增强妇女的决策自主权。
