A woman’s autonomy on maternal health service utilization and associated factors in ambo town, west showa zone, Ethiopia

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