Do women with higher autonomy seek more maternal and child health-care? Evidence from Ethiopia and Eritrea

Current research and policy on maternal and child health-care in Eritrea and Ethiopia focus primarily on female education and employment, while little attention is placed on women’s decision-making autonomy. However, the role of women’s decision-making in reproductive health cannot be overemphasized. In this paper, different dimensions of women’s decision-making autonomy and their relationship to maternal and child health-care utilization are investigated using data from the Demographic and Health Surveys of Ethiopia and Eritrea. We simultaneously consider the role of socio-economic (indirect) indicators of women’s status . The study shows that most autonomy indicators are important predictors of maternal and child health-care utilization although the strength and statistical significance vary by health-care utilization outcome and country, and in some cases significance is lost when socio-economic indicators are held constant. The strong positive effect of women’s sole decision-making in visiting family or relatives on use of antenatal care and child immunization is particularly impressive. On the other hand, the loss of significance of other dimensions of women’s decision-making when socio-economic factors are controlled for indicates that some health-care seeking behaviours are more dependent on socio-economic factors like education and employment. The results show that most socio-economic indicators have strong influence on both women’s decision-making autonomy and on maternal and child health-care utilization. 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 health-care utilization.