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Maternal and Child Health Journal

, Volume 14, Issue 6, pp 988–998 | Cite as

Women’s Autonomy and Maternal Health-Seeking Behavior in Ethiopia

  • Gebremariam WoldemicaelEmail author
  • Eric Y. Tenkorang
Article

Abstract

This paper examines the net effect of women’s autonomy on their health seeking behavior in Ethiopia. We hypothesize that women with higher autonomy are more likely to seek health care during pregnancy and delivery than those with lower autonomy. The paper also examines whether the autonomy-health utilization relationship is influenced by individual (education, work status, religion) and, household (wealth and rural–urban residence) level factors, all of which are important for both autonomy and health-care utilization. Results indicate that women’s autonomy remains significant even after adjusting for other individual and household variables. Besides autonomy, our results highlight other individual and household level influences on the health seeking behaviors of women in Ethiopia. Results also demonstrate the need to look beyond individual level factors when examining the health seeking behaviors of women in Ethiopia. The statistical significance of some individual-level measures, such as education means it cannot be used as proxy for women’s autonomy. This calls for policy makers not only to empower women, but also provide them with better formal education.

Keywords

Ethiopia Women’s autonomy Health-seeking behaviors Hierarchical logit models Household factors 

References

  1. 1.
    WHO. (2009). World health statistics: WHO statistical information system (WHOSIS). ISBN 97892 4 156381 9, Paris, France.Google Scholar
  2. 2.
    Furtuna, M., & Salway, S. (2006). Women’s position within the household as a determinant of maternal health care use in Nepal. International Family Planning Perspectives, 32(1), 17–27.CrossRefGoogle Scholar
  3. 3.
    Koblinsky, M., Matthews, Z., Hussein, J., et al. (2006). Going to scale with professional skilled care. Lancet, 368(9554), 1377–1386.CrossRefPubMedGoogle Scholar
  4. 4.
    UN. (2006). The millennium development goals report 2006. New York. Google Scholar
  5. 5.
    Govindasamy, P., & Malhotra, A. (1996). Women’s position and family planning in Egypt. Studies in Family Planning, 27, 328–340.CrossRefPubMedGoogle Scholar
  6. 6.
    Mullany, B., Hinde, M., & Becker, S. (2005). Can women’s autonomy impede male involvement in pregnancy health in Kathmandu. Nepal? Social Science and Medicine, 61(9), 1993–2006.CrossRefPubMedGoogle Scholar
  7. 7.
    Balk, D. (1994). Individual and community aspects of women’s status and fertility in rural Bangladesh. Population Studies, 48, 21–45.CrossRefGoogle Scholar
  8. 8.
    Saleem, S., & Bobak, M. (2005). Women’s autonomy, education and contraceptive use in Pakistan: A nation study. Reproductive Health, 2(8), 1–8.Google Scholar
  9. 9.
    Shaikh, B., Haran, D., & Hatcher, J. (2008). Women’s social position and health seeking behaviors: Is the healthcare system accessible and responsive in Pakistan? Health Care for Women International, 29, 945–959.CrossRefPubMedGoogle Scholar
  10. 10.
    Mason, K. (1995). Gender and demographic change: What do we know? ISBN 2–87108-052–14. Liege: International Union for the Scientific Study of Population.Google Scholar
  11. 11.
    Basu, A. (1992). Culture, the status of women and demographic behaviour: Illustrated with the case of India. Oxford: Clarendon Press.Google Scholar
  12. 12.
    Mason, K. (1984). The status of women: A review of its relationships to fertility and mortality. New York: Rockefeller Foundation.Google Scholar
  13. 13.
    Ware, H. (1984). Effects of maternal education, women’s roles, & child care on child mortality. Population and Development Review, Vol. 10 Supplement: Child Survival, Strategies for Research. pp. 191–214.Google Scholar
  14. 14.
    Mason, K. (1994). Conceptualizing and measuring women’s status. Paper presented at the Annual Meeting of the Population Association of America. Miami, Florida.Google Scholar
  15. 15.
    Presser, H., & Sen, G. (2000). Women’s empowerment and demographic processes: Moving beyond Cairo. UK: Oxford University Press.Google Scholar
  16. 16.
    Jejeebhoy, S. (2000). Women’s autonomy in rural India: Its dimentions, determinants, and the influence of context. In H. B. Presser & G. Sen (Eds.), Women’s empowerment and demographic processes: Moving beyond Cairo. New York: Oxford University Press.Google Scholar
  17. 17.
    Jejeebhoy, S., & Sathar, Z. (2001). Women’s autonomy in India and Pakistan: The influence of religion and region. Population and Development Review, 27, 687–712.CrossRefGoogle Scholar
  18. 18.
    Morgan, P., & Niraula, B. (1995). Gender inequality and fertility in two Nepali villages. Population and Development Review, 21, 541–561.CrossRefGoogle Scholar
  19. 19.
    Kishor, S. (2005). A focus on gender: Collected papers on gender using DHS data. Calverton, Maryland, USA: ORC Macro.Google Scholar
  20. 20.
    Mason, K. (1996). Wives economic decision-making in the family in five Asian Countries. East–west center working papers population series, no. 86. Honolulu, HI: East–West Center.Google Scholar
  21. 21.
    Bloom, 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, 28, 67–78.CrossRefGoogle Scholar
  22. 22.
    Das Gupta, M. (1987). Selective discrimination against female children in rural Punjab, India. Population and Development Review, 13, 77–100.CrossRefGoogle Scholar
  23. 23.
    Matthews, Z., Ramasubban, R., Rishyasringa, B., & Stones, W. (2006). Autonomy and maternal health-seeking among slum populations of Mumbai. Social Statistics research center (SSRC) applications and policy working paper A03/06. SSRC, University of Southampton.Google Scholar
  24. 24.
    Lasee, A., & Becker, S. (1997). Husband-wife communication about family planning contraceptive use in Kenya. International Family Planning Perspectives, 23, 15–20.CrossRefGoogle Scholar
  25. 25.
    IUSSP. (1997). Report of Seminar on female empowerment and demographic processes: Moving beyond Cairo. 21–24 April 1997, Lund, Sweden.Google Scholar
  26. 26.
    Uzochukwu, B., & Onwujekwe, O. (2004). Socio-economic differences and health seeking behavior for the diagnosis and treatment of malaria: A case study of four local government areas operating the Bamako initiatives in South East Nigeria. International Journal of Equity in Health, 3, 1–10.CrossRefGoogle Scholar
  27. 27.
    Kazembe, L., Appleton, C., & Kelindchmidt, I. (2007). Choice of treatment for fever at household level in Malawi: Examining spatial pattern. Malaria Journal, 6, 1–13.CrossRefGoogle Scholar
  28. 28.
    Michael, K., Kanta, S., Peter, S., Tulshi, S., Al-Sabir, A., Shams, A., et al. (2007). Maternal health and care seeking behavior in Bangladesh: Findings from a national survey. International Family Planning Perspectives, 33(2), 75–82.CrossRefGoogle Scholar
  29. 29.
    Rani, M., & Bonu, S. (2003). Rural Indian Women’s care seeking behavior and choice of provider for gynecological symptoms. Studies in Family Planning, 34, 173–185.CrossRefPubMedGoogle Scholar
  30. 30.
    Nigussie, M., Haile Mariam, D., & Mitike, G. (2004). Assessment of safe delivery services utilization among women of childbearing age in North Gondar. Ethiopian Journal of Health Development, 18(3), 145–152.Google Scholar
  31. 31.
    Lindelow, M. (2005). The utilization of curative healthcare in Mozambique: Does income matter? Journal of African Economies, 14, 10–18.CrossRefGoogle Scholar
  32. 32.
    Okojie, C. (1994). Gender inequalities of health in the third world. Social Science and Medicine, 39, 1237–1247.CrossRefPubMedGoogle Scholar
  33. 33.
    Jejeebhoy, S., & Koenig, M. (2003). The social context of gynecological morbidity: Correlates, consequences and health seeking behavior. In S. Jejeebhoy, M. Koenig, & E. Christopher (Eds.), Investigating reproductive tract infections and other gynecological disorders (pp. 30–73). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  34. 34.
    Kritz, M., & Gurak, D. (1989). Women’s status, education and family formation in sub-Saharan Africa. International Family Planning Perspectives, 15, 100–105.CrossRefGoogle Scholar
  35. 35.
    UN. (1994). Program of action of the United Nations international conference on population and development. New York.Google Scholar
  36. 36.
    CSA (Central Statistical Agency), ORC Macro Inc. (2006). Ethiopia demographic and health survey 2005. Addis Ababa, Ethiopia and Calverton, Maryland, USA: Central Statistical Agency and ORC Macro.Google Scholar
  37. 37.
    Berhane, Y., Gossaye, Y., Emmelin, M., & Hogberg, U. (2001). Women’s health in a rural setting in societal transition in Ethiopia. Social Science and Medicine, 53, 1525–1539.CrossRefPubMedGoogle Scholar
  38. 38.
    WHO. (2004). Maternal mortality in 2000. Estimates developed by WHO, UNICEF and UNFPA. WHO, Geneva: Department of Reproductive Health and Research.Google Scholar
  39. 39.
    Kloos, H. (1998). Primary health care in Ethiopia under three political systems: Community participation in a war-torn society. Social Science and Medicine, 46(4–5), 505–522.PubMedGoogle Scholar
  40. 40.
    Barnabas, G., & Zewi, A. (1997). Health policy development in wartime, establishing the Baito health system in Tigray, Ethiopia. Health Policy and Planning, 12(1), 38–49.CrossRefPubMedGoogle Scholar
  41. 41.
    Office of the Prime Minister. (1993). National Population Policy of April 1993. Retrieved September 15, 2009, from http://Cyber.law.harvard.edu/population/policies/Ethiopia.htm.
  42. 42.
    Transitional Government of Ethiopia. (1993). Health policy of the Transitional Government of Ethiopia. Addis Ababa, Ethiopia: Ministry of Health.Google Scholar
  43. 43.
    Institute for Resource Development. (1990). An assessment of DHS-I data quality. DHS methodological reports no. 1. Maryland: Institute for Resource Development/Macro Systems Inc. Columbia.Google Scholar
  44. 44.
    Raudenbusch, S., & Bryk, A. (2002). Hierarchical linear models applications and data analysis methods. New York: Sage Publications Inc.Google Scholar
  45. 45.
    Makinwa, P., & Jensen, A. (Eds.). (1995). Women’s position and development change in sub-Saharan Africa. Liege, Belgium: IUSSP.Google Scholar
  46. 46.
    UN. (1985). Socio-economic differentials in child mortality in developing countries. New York.Google Scholar
  47. 47.
    UNICEF. (2004). Maternal health: Millennium development goals. http://www.unicef.org/mdg/maternal.html.
  48. 48.
    Kishor, S. (2000). Empowerment of women in Egypt and links to the survival and health of their infants. In H. Presser & G. Sen (Eds.), Women’s empowerment and demographic processes: Moving beyond Cairo. New York: Oxford University Press.Google Scholar
  49. 49.
    Sathar, Z., & Mason, K. (1993). How female education affects reproductive behavior in Urban Pakistan. Asian and Pacific Population Forum, 6, 93–103.PubMedGoogle Scholar
  50. 50.
    Caldwell, J., & Caldwell, P. (1991). What have we learnt about the culture, social and behavioral determinants of health? Health Transition Review, 1, 3–19.PubMedGoogle Scholar
  51. 51.
    Bhutta, Z., Gupta, I., de Silva, H., Manandhar, D., Hossain, S. M., & Salam, M. (2004). Maternal and child health: Is South Asia ready for change? British Medical Journal, 328, 816–819.CrossRefPubMedGoogle Scholar
  52. 52.
    Habib, S., & Vaugan, P. (1986). Factors affecting maternal health care. International Epidemology, 15, 394–402.Google Scholar
  53. 53.
    Saverborn, R. (1989). Low utilization of health workers: Results from household interview survey in Burkina Faso. Social Science and Medicine, 29, 1163–1174.CrossRefGoogle Scholar
  54. 54.
    Keyfitz, N. (1996). Internal migration and urbanization. In Colombo, et al. (Eds.), Resources and population: Natural, institutional and demographic dimensions of development (pp. 269–285). New York: The Population Council.Google Scholar
  55. 55.
    Atuyambe, L., Mirembe, F., Tumwesigye, N., Annike, J., Kirumira, E., & Faxelid, E. (2008). Adolescent and adult first time mother’s health seeking practices during pregnancy and early motherhood in Wakiso district, Central Uganda. Reproductive Health, 5(13), 1–11.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of Sociology, Population Studies CentreThe University of Western OntarioLondonCanada

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