Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-24T05:06:26.770Z Has data issue: false hasContentIssue false
  • English
  • Français

FACTORS ASSOCIATED WITH WOMEN’S HEALTH CARE DECISION-MAKING AUTONOMY: EMPIRICAL EVIDENCE FROM NIGERIA

Published online by Cambridge University Press:  10 February 2017

Pauline Osamor  and
Christine Grady
Pauline Osamor*
Affiliation:
Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, USA
Christine Grady
Affiliation:
Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, USA
*
1Corresponding author. Email: pauline.osamor@nih.gov
Get access Rights & Permissions [Opens in a new window]

Summary

Women’s decision-making autonomy has been poorly studied in most developing countries. The few existing studies suggest that it is closely linked to women’s socio-demographic characteristics and the social settings in which they live. This study examined Nigerian women’s perceived decision-making autonomy about their own health care using nationally representative data from the 2013 Nigerian Demographic and Health Survey. The study sample consisted of 27,135 women aged 15–49 years who lived with their husbands/partners. Responses to questions about who usually makes decisions about the respondent’s health care were analysed. Factors associated with women’s health care decision-making were investigated using logistic regression models. Only 6.2% of the women reported making their own decisions about health care. For most women (61.1%), this decision was made by their husband/partner alone and 32.7% reported joint decision-making with their husband/partner. Factors independently associated with decision-making by the woman included: geographical region, rural/urban residence, age, education, religion, wealth index, occupation, home ownership and husband’s occupation. A strong association between women making their own health care decision was seen with region of residence (χ2=3221.48, p<0.0001), even after controlling for other factors. Notably, women from the South West region were 8.3 times more likely to make their own health care decisions than women from the North West region. Factors that were significantly associated with joint health care decision-making were also significantly associated with decision-making by the woman alone. The study found that individual-level factors were significantly associated with Nigerian women’s decision-making autonomy, as well as other factors, in particular geographic region. The findings provide an important perspective on women’s health care decision-making autonomy in a developing country.

Type
Research Article
Information
Journal of Biosocial Science , Volume 50 , Issue 1 , January 2018 , pp. 70 - 85
Copyright
Copyright © Cambridge University Press, 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Acharya, D. R., Bell, J. S., Simkhada, P., van Teijlingen, E. R. & Regmi, P. R. (2010) Women’s autonomy in household decision-making: a demographic study in Nepal. Reproductive Health 7, 15.Google Scholar
Al Riyami, A., Afifi, M. & Mabry, R. M. (2004) Women’s autonomy, education and employment in Oman and their influence on contraceptive use. Reproductive Health Matters 12, 144–154.Google Scholar
Balk, D. (1994) Individual and community aspects of women’s status and fertility in rural Bangladesh. Population Studies 48(1), 21–45.Google Scholar
Basu, A. M. (1992) Culture, the Status of Women, and Demographic Behaviour: Illustrated with the Case of India. Clarendon Press, Oxford.Google Scholar
Becker, S., Fonseca-Becker, F. & Schenck-Yglesias, C. (2006) Husbands’ and wives’ reports of women’s decision-making power in Western Guatemala and their effects on preventive health behaviours. Social Science & Medicine 62, 2313–2326.Google Scholar
Bloom, S. S., Wypij, D. & Das Gupta, M. (2001) Dimensions of women’s autonomy and the influence on maternal health care utilization in a north Indian city. Demography 38, 67–78.Google Scholar
Brunson, E. K., Shell‐Duncan, B. & Steele, M. (2009) Women’s autonomy and its relationship to children’s nutrition among the Rendille of northern Kenya. American Journal of Human Biology 21, 55–64.Google Scholar
Enabudoso, E. & Igbarumah, S. (2012) Maternal autonomy on health in a community as assessed by signing of consent for caesarean section and its sociodemographic correlates. Journal of Maternal–Fetal & Neonatal Medicine 25, 1980–1982.Google Scholar
Feyisetan, B. J. (2000) Spousal communication and contraceptive use among the Yoruba of Nigeria. Population Research and Policy Review 19, 29–45.CrossRefGoogle Scholar
Fikree, F. F. & Pasha, O. (2004) Role of gender in health disparity: the South Asian context. British Medical Journal 328, 823–826.CrossRefGoogle ScholarPubMed
Gage, A. J. (1995) Women’s socioeconomic position and contraceptive behaviour in Togo. Studies in Family Planning 26(5), 264–277.Google Scholar
Haque, S. E., Rahman, M., Mostofa, M. G. & Zahan, M. S. (2012) Reproductive health care utilization among young mothers in Bangladesh: does autonomy matter? Womens Health Issues 22, e171–e180.CrossRefGoogle ScholarPubMed
Jejeebhoy, S. J. & Sathar, Z. A. (2001) Women’s autonomy in India and Pakistan: the influence of religion and region. Population and Development Review 27, 687–712.CrossRefGoogle Scholar
Kritz, M. M. & Makinwa-Adebusoye, P. (1999) Determinants of women’s decision-making authority in Nigeria: the ethnic dimension. Sociological Forum 14, 399.Google Scholar
Lamidi, E. O. (2016) Multilevel analysis of state variations in women’s participation in household decision-making in Nigeria. Journal of International Women’s Studies 17, 186–201.Google Scholar
Mason, K. O. (1987) The impact of women’s social position on fertility in developing countries. Paper presented at the Sociological Forum 2(4), 718–745.Google Scholar
Meekers, D. & Oladosu, M. (1996) Spousal communication and family planning decision-making in Nigeria. Population Research Institute 3, 33.Google Scholar
Mistry, R., Galal, O. & Lu, M. (2009) Women’s autonomy and pregnancy care in rural India: a contextual analysis. Social Science & Medicine 69, 926–933.Google Scholar
Morgan, S. P. & Niraula, B. B. (1995) Gender inequality and fertility in two Nepali villages. Population and Development Review 21(3), 541–561.Google Scholar
National Population Commission (2007) The 2006 National Census Report. National Population Commission, Abuja, Nigeria.Google Scholar
Nigatu, D., Gebremariam, A., Abera, M., Setegn, T. & Deribe, K. (2014) Factors associated with women’s autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study. BioMed Central Women’s Health 14, 79.Google Scholar
Ojo, M. A. (1997) Sexuality, marriage and piety among charismatics in Nigeria. Religion 27, 65–79.Google Scholar
Oyediran, K. A. (1998) Changes in womens reproductive health and male involvement in Nigeria: post evaluation findings: 1996–1998. ARFH Monograph Series No. 2. Association for Reproductive and Family Health, Ibadan.Google Scholar
Rahman, M. M., Mostofa, M. G. & Hoque, M. A. (2014) Women’s household decision-making autonomy and contraceptive behaviour among Bangladeshi women. Sexual and Reprod Health 5, 9–15.CrossRefGoogle ScholarPubMed
Saleem, S. & Bobak, M. (2005) Women’s autonomy, education and contraception use in Pakistan: a national study. Reproductive Health 2, 1–8.Google Scholar
Sathar, Z. A. & Kazi, S. (1997) Women’s autonomy, livelihood and fertility: a study of rural Punjab. Pakistan Institute of Development Economics [PIDE], Islamabad, Pakistan.Google Scholar
Senarath, U. & Gunawardena, N. S. (2009) Women’s autonomy in decision making for health care in South Asia. Asia Pacific Journal of Public Health 2, 137–143.Google Scholar
Singh, K., Singh, K., Singh, B. & Pathak, A. (2014) Impact of education and autonomy on fertility of women in eastern Uttar Pradesh. Demography India 31, 223–233.Google Scholar
Thapa, D. K. & Niehof, A. (2013) Women’s autonomy and husbands’ involvement in maternal health care in Nepal. Social Science & Medicine 93, 1–10.Google Scholar