Maternal autonomy and associated factors in making decision to utilize health service for themselves and neonates in south Ethiopia: A community based cross-sectional survey

• Published in: PloS one 2022-10, Vol.17 (10), p.e0275303-e0275303
• Main Authors: Tesfaye, Degefa Gomora, Efa, Yohannes Tekalegn, Desta, Fikreab, Gebeyehu, Mulugeta Adugnew, Abdella, Sana'a Kedir
• Format: Article
• Language: English
• Subjects: Autonomy; Autonomy (Psychology); Beliefs, opinions and attitudes; Biology and Life Sciences; Care and treatment; Cesarean section; Childrens health; Contraceptives; Cross-sectional studies; Decision making; Demographic aspects; Earth Sciences; Fertility; Health aspects; Health care; Health services; Health services utilization; Health surveys; Infant mortality; Infants (Newborn); Marriage; Maternal & child health; Maternal health services; Medicine and Health Sciences; Mothers; Neonates; Newborn babies; People and Places; Postpartum; Prenatal care; Random sampling; Sampling techniques; Social Sciences; Socioeconomic factors; Statistical analysis; Statistical sampling; Surveys
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0275303

The definition of women's autonomy used in the study is control over finances, decision-making power, and the extent of freedom of movement by women. Lower autonomy of women affects the socio-economic, emotional, fertility decision, contraceptive use, and sexual life of the women. Thus, this study aimed to assess maternal autonomy and associated factors in making a decision to utilize health services for themselves and neonates in south Ethiopia. Community-based cross-sectional study design was conducted from January 1 to March 2, 2021, in Shashamane town. Four hundred ten postpartum mothers were selected using a stratified random sampling technique and interviewed for the survey using questions composed of decision-making autonomy components (decision-making power, control over finances, and freedom of movement). The data were checked for consistency, coded, and entered using EpiData Manager (version 4.6.0.4) and analyzed using Statistical Package for Social Science (SPSS) version 26. Descriptive statistics, composite score analysis, and binary and multivariate logistic regression were done to capture the objectives. 410 postpartum mothers were interviewed while the mean and standard deviation of the participants' age was 26.96 ± 5.38. About 48.5% of mothers had high decision-making autonomy for their own and their neonates' health service utilization. Being in monogamous marriage (AOR = 1.82, 95% CI: 1.21, 2.74), and mode of delivery (Cesarean section) (AOR = 1.91, 95% CI: 1.18, 3.07) were significantly associated with having high maternal decision-making autonomy. More than half of the study participants had low maternal decision-making autonomy for their own and their neonates' health service utilization. Being in monogamous marriage, and mode of delivery (Cesarean section) were factors significantly associated with high maternal decision-making autonomy. Encouraging mothers to use facility delivery was recommended.