Influence of women's autonomy on place of delivery
Omungo, Edgar O
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Despite various international efforts initiated to improve maternal health, more than half a million women worldwide die each year as a result of complications arising from pregnancy and childbirth. Current research and policy on maternal and child health-care in Kenya focuses primarily on female education and employment, while Iittle attention is placed on women's decision-making autonomy. In this paper, different dimensions of women's decision-making autonomy and their relationship to place of delivery are investigated using data from the Kenya Demographic and Health Survey 2008/09. The study simultaneously considers the role of socio economic (indirect) indicators and demographic indicators of women's status and shows that autonomy indicators are important predictors of place of delivery. The strength and statistical significance vary by place of delivery and significance is lost when socio-economic and demographic indicators are held constant. The strong positive effect of women's participation in making decisions about purchase of household items for daily needs on use of health facilities for delivery is particularly impressive. On the other hand, the loss of significance when socio-economic and demographic factors are controlled for indicates that some health-care seeking behaviour are more dependent on socio-economic factors like education and employment and demographic factors. The results show that most socio-economic and demographic indicators have strong influence on both women's decision-making autonomy and on choice of place of delivery. These findings suggest that both women's autonomy and socio-economic indicators should be analyzed in order to derive a complete understanding of the determinants of maternal and child healthcare utilization. The paper further argues in favor of more research into the role of women's autonomy on use of maternal health care services in Kenya. It also supports the call for more appropriate data that could further support this line of action. It highlights the need for efforts to improve households' livelihoods and increase girls' education.