Abstract:
Background:women’s autonomy encompasses the ability to obtain information and make
decisions about one’s own concerns, have some control over finances and freedom of
movement. Women's autonomy in health-care decision making is central to the improvements
of maternal and child health. Little is known about women’s autonomy and its influencing
factors on maternal and child health care service utilization in Ambo town, West showa zone
Oromia region as well as in Ethiopia.
Objectives: The objective of this study was to assess the women’s autonomy of deciding on
their maternal health service utilization &associated factors in Ambo Town, Ethiopia.
Methods: Community based cross-sectional study was conducted on 381 women of having
under five childrenfrom March 3- April 3 2018. Face to face interview was carried out to
collect data using structured questionnaires adapted from different literatures. Four BSc midwives who have lived in Ambo town for at least one year were recruited from Ambo general
hospital andtrained for two days for data collection. Women’s autonomy was measured by
using the composite index of the three constructs of women’s autonomy: control over finance,
decision-making power and extent of freedom of movement. Proportional and Systematic
sampling method was used to get required sample. Descriptive statics, binary andmultiple
logistic regression analysis was conducted by using SPSS version 22 analytical software to
identify factors associated with autonomy of women. The explanatory variables having P
value <0.05 inmultiple logistic regression analysis was taken as significant association and
reported using p-value and adjusted odd ratio.
Result: Out of 381 women, more than half (55.6%) had higher autonomy regarding their
maternal health service utilization. In the multiple logistic regression models, after adjusting
for the potential confounders; being in 3-4 Parity, adjusted odds ratio [(AOR):0.28(95%
C.I:.10-.76)],having 3-4 living children[(AOR):6(95% C.I: 2.42-14.94)], being in tertiary
Educational status (Women’s) [(AOR):0. .007(95% C.I:.00-.27)], having exposure to media
[(AOR):0.008(95% C.I:. 001-.079)],Being in monogamy marriage type and having
>=18year age at marriage [(AOR):0.038 (95% C.I:.003-.42)],were the final predictors of
women’s autonomy.
Conclusion: In improving MHSU, women’s autonomy of decision making plays a central role
and needs strong focus.Socio-demographic and socio cultural factors were found to influence
women’s autonomy.
Recommendation: Interventions targeting women’s autonomy with regards to deciding their
maternal health service utilization should get focus equal to that of expanding health
institution and health professionals and priority should be given to women with a lower
socioeconomic status
