Mohammad Rifat Haider1, Zaina P Qureshi2, M Mahmud Khan3. 1. Dept. of Health Services Policy and Management, University of South Carolina, Columbia, SC, USA; Dept. of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh. Electronic address: mhaider@email.sc.edu. 2. Dept. of Health Services Policy and Management, University of South Carolina, Columbia, SC, USA; Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC, USA; William Jennings Bryan Dorn VA Medical Center, Columbia, SC, USA. Electronic address: qureshiz@mailbox.sc.edu. 3. Dept. of Health Services Policy and Management, University of South Carolina, Columbia, SC, USA. Electronic address: mkhan@mailbox.sc.edu.
Abstract
OBJECTIVES: This study aims to construct an index of women's autonomy to analyze its effect on maternal healthcare utilization in Bangladesh. Empirical modeling of the study used instrumental variable (IV) approach to correct for possible endogeneity of women's autonomy variable. METHODS: Data from the Bangladesh Demographic and Health Survey (BDHS) 2011 was used for the study. Women's autonomy variable was obtained through factor analysis of variables related to autonomy in decision making regarding healthcare, financial autonomy and freedom of movement. Conditional mixed process (CMP) models were fitted for three maternal healthcare indicators: at least four antenatal care (ANC) by trained personnel, institutional delivery and postnatal care (PNC) by trained personnel. RESULTS: Study sample consisted of 8753 women with 5.5 mean years of schooling. Women with no formal education, of Islamic faith, from poorest wealth quintile, residing in rural areas and with low autonomy used the maternal healthcare least. Marginal effect shows that if women's autonomy score is increased by one unit, probability of maternal healthcare utilization will increase by 0.14 for ANC, 0.14 for institutional delivery, and 0.13 for PNC. CONCLUSIONS: Women's autonomy is an important driver of maternal healthcare utilization in Bangladesh. Results suggest that women participating in social and economic activities enhances their autonomy. Other factors affecting women's autonomy are female literacy, educational attainment and households' economic status.
OBJECTIVES: This study aims to construct an index of women's autonomy to analyze its effect on maternal healthcare utilization in Bangladesh. Empirical modeling of the study used instrumental variable (IV) approach to correct for possible endogeneity of women's autonomy variable. METHODS: Data from the Bangladesh Demographic and Health Survey (BDHS) 2011 was used for the study. Women's autonomy variable was obtained through factor analysis of variables related to autonomy in decision making regarding healthcare, financial autonomy and freedom of movement. Conditional mixed process (CMP) models were fitted for three maternal healthcare indicators: at least four antenatal care (ANC) by trained personnel, institutional delivery and postnatal care (PNC) by trained personnel. RESULTS: Study sample consisted of 8753 women with 5.5 mean years of schooling. Women with no formal education, of Islamic faith, from poorest wealth quintile, residing in rural areas and with low autonomy used the maternal healthcare least. Marginal effect shows that if women's autonomy score is increased by one unit, probability of maternal healthcare utilization will increase by 0.14 for ANC, 0.14 for institutional delivery, and 0.13 for PNC. CONCLUSIONS:Women's autonomy is an important driver of maternal healthcare utilization in Bangladesh. Results suggest that women participating in social and economic activities enhances their autonomy. Other factors affecting women's autonomy are female literacy, educational attainment and households' economic status.
Authors: Sajia Islam; Janet Perkins; Md Abu Bakkar Siddique; Tapas Mazumder; Mohammad Rifat Haider; Mohammad Masudur Rahman; Cecilia Capello; Dewan Md Emdadul Hoque; Carlo Santarelli; Shams El Arifeen; Ahmed Ehsanur Rahman Journal: PLoS One Date: 2018-06-07 Impact factor: 3.240
Authors: Phuong Hong Nguyen; Long Quỳnh Khương; Priyanjana Pramanik; Sk Masum Billah; Purnima Menon; Ellen Piwoz; Hannah H Leslie Journal: BMJ Open Date: 2021-01-20 Impact factor: 2.692
Authors: Mohammad Masudur Rahman; Mohammad Rifat Haider; Md Moinuddin; Ahmed Ehsanur Rahman; Shakil Ahmed; M Mahmud Khan Journal: PLoS One Date: 2018-09-12 Impact factor: 3.240