BACKGROUND Our study investigates the associations between women's autonomy and attitudes toward the acceptability of intimate-partner violence against women (IPVAW) and maternal health-care utilization outcomes. METHODS We combine data from 113 Demographic and Health Surveys conducted between 2003 and 2016, which give us a pooled sample of 765 169 mothers and 777 352 births from 63 countries. We generate composite scores of women's autonomy (six-point scale with reference: no contribution) and acceptability of IPVAW (five-point scale with reference: no acceptance) and assess the associations between these measures and women's use of antenatal care services and facility delivery in pooled and unique country samples. RESULTS A change in a woman's autonomy score from 'no contribution to any decision-making domain' (a composite autonomy score of 0) to 'contribution to all decision-making domains' (a score of 6) is associated with a 31.2% increase in her odds of delivering in a facility and a 42.4% increase in her odds of receiving at least eight antenatal care visits over the course of her pregnancy. In contrast, a change in a woman's attitude towards acceptability of IPVAW from 'IPVAW is not acceptable under any scenario' (a score of 0) to 'IPVAW is acceptable in all scenarios' (a score of 5) is associated with an 8.9% decrease in her odds of delivering in a facility and a 20.3% decrease in her odds of receiving eight antenatal care visits. CONCLUSIONS Our findings suggest that strong and significant associations exist between autonomy, acceptability of IPVAW and utilization of maternal health-care services.

中文翻译：

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评估63个低收入和中等收入国家妇女自主权和亲密伴侣暴力在接受孕产妇保健方面的作用。

背景技术我们的研究调查了女性自主权与对女性的亲密伴侣暴力行为（IPVAW）的可接受性与孕产妇保健利用结果之间的联系。方法我们结合了2003年至2016年进行的113次人口与健康调查的数据，这些数据汇总了来自63个国家/地区的765169名母亲和777352名婴儿。我们生成了女性自主权（六分制，参考标准：无贡献）和IPVAW的可接受性（五分制参考标准：未接受）的综合评分，并评估了这些衡量标准与妇女使用产前护理服务和设施提供之间的关联在汇总的独特国家样本中。结果妇女的自主权得分从“对任何决策领域无贡献”变化 （综合自主权得分为0）到“对所有决策领域的贡献”（得分为6）与她在机构中提供服务的几率增加31.2％，在机构获得该信息的机会增加42.4％相关联在怀孕期间至少要进行八次产前检查。相比之下，女性对IPVAW可接受性的态度从“在任何情况下都不可接受”（0分）变为“在所有情况下都可接受”（5分）是与8.9％相关的接受分娩的几率降低了，接受了八次产前检查的几率降低了20.3％。结论我们的研究结果表明，自主权，IPVAW的可接受性与孕产妇保健服务的利用之间存在密切而重要的联系。