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Objective <p>Although women’s autonomy is key to patient care, the extent to which patients exercise autonomy during clinical consultations in resource-limited contexts such as Zambia remains unknown. This study aimed to examine women’s experiences of autonomy in decision-making and respectful treatment in Zambian maternal healthcare.</p> Methods <p>The study was conducted in Lusaka and used a cross-sectional survey design. The sample consisted of 305 women who were conveniently recruited. Data was collected using a questionnaire consisting of sociodemographic data and two validated instruments: the 7-item Mothers Autonomy and Decision-Making Scale (MADM), and the 14-item Measure of Respect (MOR) index.</p> Results <p>Higher levels of decision-making autonomy, according to MADM, are significantly associated with higher levels of perceived respect in maternal healthcare settings, according to MOR (<i>p</i> &lt; .001). Furthermore, higher education was found to correlate significantly with higher autonomy and respect (<i>p</i> &lt; .001). Both instruments showed an excellent (MADM) and good (MOR) internal consistency among this sample (Cronbach’s alpha = 0.959 and 0.851, respectively). Overall, while there’s significant variation in responses, there is a slight tendency towards positive experiences in both autonomy and respect in maternal healthcare settings.</p> Conclusions for Practice <p>Health authorities should promote the implementation of autonomous and respectful care for all women, regardless of socioeconomic or educational background, and provide a supportive environment that fosters user participation in decision-making.</p>

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Women’s Autonomy and Respectful Maternity Care in Zambia: A Cross-Sectional Study Using Validated Patient-Reported Measures

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月9日

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  • Atika Khalaf,
  • Francis Sichimba,
  • Kalunga Cindy Nakazwe,
  • Lena Halawi

摘要

Objective

Although women’s autonomy is key to patient care, the extent to which patients exercise autonomy during clinical consultations in resource-limited contexts such as Zambia remains unknown. This study aimed to examine women’s experiences of autonomy in decision-making and respectful treatment in Zambian maternal healthcare.

Methods

The study was conducted in Lusaka and used a cross-sectional survey design. The sample consisted of 305 women who were conveniently recruited. Data was collected using a questionnaire consisting of sociodemographic data and two validated instruments: the 7-item Mothers Autonomy and Decision-Making Scale (MADM), and the 14-item Measure of Respect (MOR) index.

Results

Higher levels of decision-making autonomy, according to MADM, are significantly associated with higher levels of perceived respect in maternal healthcare settings, according to MOR (p < .001). Furthermore, higher education was found to correlate significantly with higher autonomy and respect (p < .001). Both instruments showed an excellent (MADM) and good (MOR) internal consistency among this sample (Cronbach’s alpha = 0.959 and 0.851, respectively). Overall, while there’s significant variation in responses, there is a slight tendency towards positive experiences in both autonomy and respect in maternal healthcare settings.

Conclusions for Practice

Health authorities should promote the implementation of autonomous and respectful care for all women, regardless of socioeconomic or educational background, and provide a supportive environment that fosters user participation in decision-making.