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Influence of women’s empowerment indices on the utilization of skilled maternity care: evidence from rural Nigeria
Journal of Biosocial Science ( IF 2.148 ) Pub Date : 2020-12-02 , DOI: 10.1017/s0021932020000681
Lorretta Favour C Ntoimo 1, 2 , Friday E Okonofua 2, 3, 4 , Josephine Aikpitanyi 3 , Sanni Yaya 5, 6 , Ermel Johnson 7 , Issiaka Sombie 7 , Olabisi Aina 8 , Wilson Imongan 1
Affiliation  

There is increasing evidence that women with the ability to exercise control over their sexual and reproductive lives have greater access to prompt prevention and treatment of maternal health disorders, resulting in a concomitant reduction in maternal morbidity and mortality. This study assessed the association between indices of women’s empowerment and utilization of skilled antenatal, intrapartum and postnatal maternity care in two rural Local Government Areas in Edo State, Nigeria. Data were taken from a household survey conducted in July and August 2017, and the study sample comprised 1245 ever-married women currently in a union who had given birth in the 5 years preceding the survey. A Gender Roles Framework guided the selection of independent women’s empowerment variables. Using hierarchical logistic regression, the likelihood of receiving all three levels of skilled maternal health care service (antenatal, intrapartum and postnatal) by women’s empowerment variables, grouped into resource, decision-making and influencer domains following the model of Anderson and Neuman, was assessed. Of the resource domain variables, respondent’s education and respondent’s participation in payment for their own health care positively predicted their use of all three levels of skilled maternal care, whereas their ownership of land negatively predicted this. Two decision-making domain variables were significantly associated with respondent’s use of all three levels of service: those who made decisions alone about major household purchases were twice as likely to use all three levels of services than when decisions were made by their partners or others, while respondent making decisions alone about what food to cook each day was a negative predictor. Of the influencer variables, religion and a large spousal education gap were strong positive factors, whereas living in a consensual union rather than being legally married was a negative factor. Although health system factors are important, interventions geared towards changing gender norms that constrain women’s empowerment are critical to achieving maternal health-related development goals in Nigeria. A composite strategy that targets all women’s empowerment indices is recommended, as Nigeria strives towards achieving SDG-3.

中文翻译:

妇女赋权指数对熟练产妇护理利用的影响:来自尼日利亚农村的证据

越来越多的证据表明,能够控制自己的性生活和生殖生活的妇女更容易获得及时预防和治疗孕产妇健康障碍,从而降低孕产妇发病率和死亡率。本研究评估了尼日利亚埃多州两个农村地方政府地区的妇女赋权指数与熟练的产前、产时和产后产后护理的利用之间的关联。数据取自于 2017 年 7 月和 8 月进行的一项家庭调查,研究样本包括 1245 名在调查前 5 年内分娩的目前同居的已婚妇女。性别角色框架指导了独立女性赋权变量的选择。使用分层逻辑回归,根据 Anderson 和 Neuman 的模型,按照妇女赋权变量分为资源、决策和影响者领域,评估了接受所有三个级别的熟练孕产妇保健服务(产前、产时和产后)的可能性。在资源域变量中,受访者的受教育程度和受访者参与支付自己的医疗保健正向预测他们对所有三个级别的熟练产妇护理的使用,而他们的土地所有权负向预测这一点。两个决策域变量与受访者对所有三个级别的服务的使用显着相关:那些独自决定主要家庭购买的人使用所有三个级别的服务的可能性是由他们的合作伙伴或其他人做出决定的人的两倍,而受访者独自决定每天煮什么食物是一个负面预测因素。在影响因素变量中,宗教和较大的配偶教育差距是强烈的积极因素,而生活在自愿结合而不是合法结婚是消极因素。尽管卫生系统因素很重要,但旨在改变限制妇女赋权的性别规范的干预措施对于在尼日利亚实现与孕产妇健康相关的发展目标至关重要。随着尼日利亚努力实现 SDG-3,建议采用针对所有妇女赋权指数的综合战略。而生活在自愿结合而不是合法结婚是一个负面因素。尽管卫生系统因素很重要,但旨在改变限制妇女赋权的性别规范的干预措施对于在尼日利亚实现与孕产妇健康相关的发展目标至关重要。随着尼日利亚努力实现 SDG-3,建议采用针对所有妇女赋权指数的综合战略。而生活在自愿结合而不是合法结婚是一个负面因素。尽管卫生系统因素很重要,但旨在改变限制妇女赋权的性别规范的干预措施对于在尼日利亚实现与孕产妇健康相关的发展目标至关重要。随着尼日利亚努力实现 SDG-3,建议采用针对所有妇女赋权指数的综合战略。
更新日期:2020-12-02
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