Alfian Sofa D, Griselda Meliana, Pratama Mochammad A A, Alshehri Sameer, Abdulah Rizky
Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.
Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia.
Sci Rep. 2025 Mar 21;15(1):9770. doi: 10.1038/s41598-025-94057-3.
Women's autonomy in healthcare decision-making is crucial not only for improving maternal health but also enhancing their overall health and well-being. However, most studies focused solely on fertility, child health, or maternal healthcare use, often overlooking the broader aspects of women's health. Due to this reason, the magnitudes and factors associated with women's autonomy in other types of healthcare remain unclear. Therefore, this study aimed to estimate the magnitude and identify factors associated with healthcare decision-making autonomy among married women in Indonesia. A national cross-sectional study was conducted among married women using the Indonesia Demographic and Health Surveys 2017. Women's healthcare decision-making autonomy was measured based on responses regarding the individual typically responsible for making healthcare decisions on behalf of the respondent. Potential factors, such as intrapersonal, interpersonal, community, and policy-related were obtained. Multinomial logistic regression was used to determine the associations between potential factors and outcomes. The odds ratio (OR) and 95% confidence intervals (CI) of the analysis were reported. The respondents in this study comprised 16,050 married women across 34 provinces in Indonesia. Most respondents (46.4%) reported making healthcare decisions independently. The result showed that several factors were associated with either women's full autonomy or jointly with the husbands in the healthcare decision-making. These factors included ownership of mobile telephones, urban living, residency in Java, Bali, Sulawesi, Maluku and Papua islands, participation of women in decision-making on how to spend their earnings, on large household purchases, no financial barrier in accessing treatment, and independence in visiting a medical center. Public health interventions should focus on vulnerable women, such as those who live in rural areas, participate less in the decision-making of earnings spending and household purchase, and are incapable of visiting a medical center alone to increase the healthcare decision-making autonomy. Collaborative efforts with health facilities in each region can support the implementation of this intervention.
女性在医疗保健决策中的自主权不仅对改善孕产妇健康至关重要,而且对提升其整体健康和福祉也很关键。然而,大多数研究仅关注生育、儿童健康或孕产妇医疗保健的使用情况,常常忽视了女性健康的更广泛方面。由于这个原因,与女性在其他类型医疗保健中的自主权相关的程度和因素仍不明确。因此,本研究旨在估计印度尼西亚已婚女性在医疗保健决策自主权方面的程度,并确定相关因素。利用2017年印度尼西亚人口与健康调查对已婚女性进行了一项全国性横断面研究。女性的医疗保健决策自主权是根据关于通常代表受访者做出医疗保健决策的个人的回答来衡量的。获取了潜在因素,如个人内部、人际、社区和政策相关因素。使用多项逻辑回归来确定潜在因素与结果之间的关联。报告了分析的比值比(OR)和95%置信区间(CI)。本研究的受访者包括印度尼西亚34个省份的16,050名已婚女性。大多数受访者(46.4%)报告称独立做出医疗保健决策。结果表明,有几个因素与女性在医疗保健决策中的完全自主权或与丈夫共同决策有关。这些因素包括拥有移动电话、城市居住、居住在爪哇、巴厘、苏拉威西、马鲁古和巴布亚岛屿、女性参与如何支配收入的决策、参与大宗家庭购买决策、获得治疗没有经济障碍以及独立前往医疗中心。公共卫生干预应关注弱势群体,如那些生活在农村地区、较少参与收入支配和家庭购买决策且无法独自前往医疗中心的女性,以提高医疗保健决策自主权。与各地区卫生设施的合作努力可以支持这一干预措施的实施。