Abstract:
Background: Decision-making is the process of identifying and selecting a course
of action to solve a specific problem. Reproductive ill health being much greater for women which
represents one-third of the total burden of the diseases among women of 15-44 years, with unsafe
sex a major risk factor. Women with lower decision-making power were more likely to have a low
birth weight and high rates of unintended pregnancy.
Objective: To assess level of decision making power on reproductive health and rights and
associated factors among married women in Mettu Rural District, South West Ethiopia.
Methods: Community based cross sectional study was conducted from March 14 to April 10, 2017.
415 married women’s of 15-49 age were identified using family folder at health post and sampled
using simple random sampling technique. The data were entered into Epidata v 4.1 then exported to
SPSS v 21.0. Binary logistic regression analysis was carried out.
Result: Four hundred five women were interviewed yield a response rate of 97.6%. Among
interviewed women, 41.5% had higher decision-making power. Women’s primary education AOR
2.62[95% C.I 1.15, 5.97], secondary (9+) education AOR 3.18[95% C.I 1.16, 8.73] and Husband’s
Primary education AOR 4.00 [95% C.I 1.53, 10.42], secondary (9+) education AOR 3.95 [95% C.I
1.38, 11.26], being knowledgeable about RHR AOR 3.57 [95% C.I 1.58, 8.09], marriage duration
of > 10 years AOR 2.95 [95% C.I 1.19, 7.26], Having access to micro-credit enterprises AOR
4.26[95% C.I 2.06, 8.80], gender equitable attitude AOR 6.38 [95% C.I 2.52, 12.45] and good
qualities of spousal relation AOR 2.95 [95% C.I 1.30, 6.64] were the predictors of women’s higher
decision making power.
Conclusion and recommendation: Lower than half of rural women have higher decision making
power. External pressures (qualities of spousal relation, gender equitable attitude) and knowledge
about RHR were found to influence women’s decision making power. Public health interventions
targeting women’s RHR should take into account strengthening rural micro-credit enterprises,
qualities of spousal relations and priority should be given to women with no formal education of
husband or herself and marriage duration of < 5 years.
