Evidence map›Paper›PMID 30867200›Full record

ArticleBMJ open2019

Women's autonomy and utilisation of maternal healthcare services in 31 Sub-Saharan African countries: results from the demographic and health surveys, 2010-2016.

Chol Chol, Joel Negin, Kingsley Emwinyore Agho, Robert Graham Cumming

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 4 pooled it
20.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 4 syntheses or guidelines pooled it, 103 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Observational
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 2 institutions in 1 country.

Chol CholSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Joel NeginSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Kingsley Emwinyore AghoSchool of Science and Health, Western Sydney University, Penrith, New South Wales, Australia.
Robert Graham CummingSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
University of Sydney · AUWestern Sydney University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine the association between women's autonomy and the utilisation of maternal healthcare services across 31 Sub-Saharan African countries. DESIGN, SETTING AND

participantsWe analysed the Demographic and Health Survey (DHS) (2010-2016) data collected from married women aged 15-49 years. We used four DHS measures related to women's autonomy: attitude towards domestic violence, attitude towards sexual violence, decision making on spending of household income made by the women solely or jointly with husbands and decision making on major household purchases made by the women solely or jointly with husbands. We used multiple logistic regression analyses to examine the association between women's autonomy and the utilisation of maternal healthcare services adjusted for five potential confounders: place of residence, age at birth of the last child, household wealth, educational attainment and working status. Adjusted ORs (aORs) and 95% CI were used to produce the forest plots. OUTCOME MEASURES: The primary outcome measures were the utilisation of ≥4 antenatal care visits and delivery by skilled birth attendants (SBA).

resultsPooled results for all 31 countries (194 883 women) combined showed weak statistically significant associations between all four measures of women's autonomy and utilisation of maternal healthcare services (aORs ranged from 1.07 to 1.15). The strongest associations were in the Southern African region. For example, the aOR for women who made decisions on household income solely or jointly with husbands in relation to the use of SBAs in the Southern African region was 1.44 (95% CI 1.21 to 1.70). Paradoxically, there were three countries where women with higher autonomy on some measures were less likely to use maternal healthcare services. For example, the aOR in Senegal for women who made decisions on major household purchases solely or jointly with husbands in relation to the use of SBAs (aOR=0.74 95% CI 0.59 to 0.94).

conclusionOur results revealed a weak relationship between women's autonomy and the utilisation of maternal healthcare services. More research is needed to understand why these associations are not stronger.

Indexed as

Personal AutonomyPrenatal CareAdolescentAdultAfrica South of the SaharaDecision MakingDelivery, ObstetricFemaleHealth Care SurveysHealth Knowledge, Attitudes, PracticeHumansLogistic ModelsMaternal Health ServicesMiddle AgedPatient Acceptance of Health CarePregnancyantenatal careautonomyempowermentmaternal health servicesskilled birth attendantssub-Saharan Africa

Identifiers

PMID30867200
PMCPMC6429737
OpenAlexW2920812254

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.