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Aim <p>Maternal mortality remains a serious public health concern in developing countries, accounting for about&#xa0;99% of total maternal deaths globally. Women’s autonomy, reflected in their decision-making power in matters concerning mobility, finance, and self-healthcare is crucial in determining maternal healthcare utilization. The present study aims to elucidate the link between women’s autonomy and utilization of maternal healthcare services among currently married women in the eight Empowered Action Group (EAG) states of India.</p> Subject and methods <p>Drawing from the fifth round of the National Family Health Survey (NFHS-5), a total of 12,881 currently married women aged 15–49&#xa0;years were selected from the EAG states, all of whom had experienced at least one live birth in the 5 years preceding the survey and had provided autonomy-related information. Bivariate and logistic regression models were used for the analysis in this study.</p> Results <p>With an increase in women’s autonomy from low to high, utilization of all maternal healthcare services also increased. Women with higher autonomy were 1.34 (unadjusted odds ratio [uOR] = 1.34, 95% confidence interval [CI] = 1.16–1.54] times as likely to have received full antenatal care (ANC) and 1.1 (uOR = 1.10, 95% CI = 0.99–1.24) and 1.17 times (uOR = 1.17, 95% CI = 1.04–1.32) as likely to have postnatal care within 48&#xa0;h from skilled attendants. Amongst EAG states, Odisha had the highest likelihood of having ANC services, whereas Rajasthan had the highest probability of having institutional deliveries.</p> Conclusion <p>This study concludes that enhancing women’s autonomy significantly improves maternal healthcare utilization in the EAG states. Strengthening gender equality through education, financial independence, and awareness among both partners can further enable&#xa0;informed health&#xa0;choices during pregnancy and help&#xa0;prevent&#xa0;post-delivery complications.</p>

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Women’s decision-making autonomy and maternal healthcare utilization in Empowered Action Group states: Results from the National Family Health Survey (2019–2021)

  • 期刊论文

  • 发表日期：

    2025年10月18日

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  • Puja Krishna,
  • Nilanjana Gupta

摘要

Aim

Maternal mortality remains a serious public health concern in developing countries, accounting for about 99% of total maternal deaths globally. Women’s autonomy, reflected in their decision-making power in matters concerning mobility, finance, and self-healthcare is crucial in determining maternal healthcare utilization. The present study aims to elucidate the link between women’s autonomy and utilization of maternal healthcare services among currently married women in the eight Empowered Action Group (EAG) states of India.

Subject and methods

Drawing from the fifth round of the National Family Health Survey (NFHS-5), a total of 12,881 currently married women aged 15–49 years were selected from the EAG states, all of whom had experienced at least one live birth in the 5 years preceding the survey and had provided autonomy-related information. Bivariate and logistic regression models were used for the analysis in this study.

Results

With an increase in women’s autonomy from low to high, utilization of all maternal healthcare services also increased. Women with higher autonomy were 1.34 (unadjusted odds ratio [uOR] = 1.34, 95% confidence interval [CI] = 1.16–1.54] times as likely to have received full antenatal care (ANC) and 1.1 (uOR = 1.10, 95% CI = 0.99–1.24) and 1.17 times (uOR = 1.17, 95% CI = 1.04–1.32) as likely to have postnatal care within 48 h from skilled attendants. Amongst EAG states, Odisha had the highest likelihood of having ANC services, whereas Rajasthan had the highest probability of having institutional deliveries.

Conclusion

This study concludes that enhancing women’s autonomy significantly improves maternal healthcare utilization in the EAG states. Strengthening gender equality through education, financial independence, and awareness among both partners can further enable informed health choices during pregnancy and help prevent post-delivery complications.