Women’s autonomy and associated factors regarding maternal health service utilization in Nekemte town, east Wollega, Ethiopia

Abstract

Women’s autonomy encompasses the ability to obtain information and make decisions about one’s own concerns; and have some control over finances and freedom of movement. Women’s autonomy in healthcare decision making is central to the improvements of maternal and child health. Little is known about the women’s autonomy and its associated factors on maternal health care service utilization in Nekemte town, East Wollega zone, Oromia regional state, Ethiopia. Objectives: The objective of this study is to assess the women’s autonomy of deciding on their maternal health service utilization and associated factors in Nekemte town. Methods: Community based cross-sectional study was conducted on 410 married women having under two years children from February 21-March 20, 2020. Women’s autonomy was measured by using the composite index of three constructs: Control over finance, decision making power and extent of freedom of movement. Single population proportion formula and systematic random sampling technique were used to get required sample. The list of eligible mothers who live in the selected kebeles was obtained from health extension worker family data, sampling frame corresponding to house number was prepared, then simple random sampling technique was used. For qualitative data the sample size was purposively determined. Face to face interview was used to collect data using structured questionnaires adapted from similar studies. Descriptive statistics, binary and multiple logistic regression analysis were conducted by using SPSS version 22 analytical software to identify factors associated with autonomy of women. Result: Out of the total 410 sampled women, interviews were conducted with 401 of them and the response rate was 97.8%. More than half (57.1%) had higher autonomy of decision making regarding their maternal health service utilization. Conclusion: women’s autonomy of decision making plays a central role on their maternal health service utilization and still needs strong focus.