Effect of Gender on the Utilization of Maternal and Child Health Services among Pastoralist Caregivers in Somali Region of Ethiopia
Archives of Current Research International,
Ethiopia has made great effort in recent years to improve maternal and child health outcomes, however the uptake of services by women in the pastoralist communities of the country is still very low. This study was a cross-sectional study aimed to identify the effect of gender on the utilization of health services among pastoralists women. The study was conducted in Somali Region of Ethiopia between February and March 2020. A mix of qualitative and quantitative methods was used, and study population were married caregivers aged 15years and above. Bivariate analysis was done using t test and chi-square to test association among variables and p value was set at significant level of 5%. Husbands were reported as the main influence of the respondents’ decision about almost all the key households’ activities including health care seeking and financial decision making. Almost all caregivers (93.6%) who used the health facility took permission from their husbands and the test of association shows significant relationship between level of education and permission from respondents’ husbands which decreases with increasing level of education, p<0.05) but not affected by age. The care givers visited the health facilities because of their children more than themselves(58 per cent compared to 49.5 per cent for themselves) due to fear of being attended to by male health work. The study demonstrated the negative effect of gender inequities on health care seeking behaviours with women having limited control over family resources and decision-making over their health or that of their children.
- decision making
- health services
- maternal and child health
How to Cite
Available: http://et.one.un.org/content/unct/ethiopia/en/home/assistance-framework/millennium-development-goals. html. Accessed 12 March 2020
Ethiopia Central Statistical Agency (CSA) and ICF. Ethiopia Demographic and Health Survey 2016: Key Indicators Report. Addis Ababa, Ethiopia, and Rockville, Maryland, USA. CSA and ICF; 2016.
Available:https://dhsprogram.com/pubs/pdf/SR241/SR241.pdf accessed 28February 2020
Federal Ministry of Health of Ethiopia. Health Sector Development Plan (HSDP) IV, 2010/11-2014/15. Addis Ababa, Ethiopia: Ministry of Health; 2010.
Available:http://www.nationalplanningcycles.org/sites/default/files/country_docs/Ethiopia/ethiopia_hsdp_iv_final_draft_2010_-2015.pdf) Accessed 20February 2020
Andinet H. Challenges and opportunities in community-based nutrition adaptation in pastoral areas. Technical Report. Ethiopian Public Health Institute in collaboration with FMOH and World Bank. Research Gate; 2013.
Available:https://www.ephi.gov.et/images/nutrition/adaptation%20pastoralto.pdfaccessed 12th April 2020
Ethiopia Central Statistical Agency and ICF. Mini Ethiopia Demographic and Health Survey 2019. Addis Ababa, Ethiopia, and Rockville, Maryland, USA; 2019.
Available:https://dhsprogram.com/pubs/pdf/PR120/PR120.pdf. Accessed 26February 2020
Jaykaran,Charan.,&Tamoghna Biswas. How to Calculate Sample Size for Different Study Designs in Medical Research?Indian J Psychol Med. 2013;35(2):121–126.
DOI: 10.4103/0253-7176.116232: 10.4103/0253-7176.116232 PMCID: PMC3775042
Ethiopia Central Statistical Authority 2007 Population and Housing Census of Ethiopia. Administrative Report; Addis Ababa; 2012.
Nicole, Bergen, Grace, Zhu, Shifera Asfaw, Yedeneka, Abebe, Mamo. Promoting equity in maternal, newborn and child health – how does gender factor in? Perceptions of public servants in the Ethiopian health sector Global Health Action. 2020;13:1704530.
Ganle J, Obeng B, Segbefia A. How intra-familial decision-making affects women’s access to and use of maternal healthcare services in Ghana: a qualitative study. BMC Pregnancy and Childbirth. 2015;15:173.
Sougou E. Women’s autonomy in health decision making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis. BMC Public Health. 2020; 20:872.
Rahman M, Mostofa G, Hoque A. Women’s household decision-making autonomy and contraceptive behaviour among Bangladeshi women. Sex Reprod Health. 2015;5(1):9–15.
Mistry R, Galal O, Lu M. Women’s autonomy and pregnancy care in rural India: a contextual analysis”. Soc Sci Med. 2009;69(6):926–933.
Namasivayam A, Osuorah C, Syed R, Antai D. The role of gender inequities in women’s access to reproductive health care: a population-level study of Namibia, Kenya, Nepal, and India. International Journal of Women’s Health. 2012;4:351–64.
Singh K, Bloom S, Brodish P. Gender equality as a means to improve maternal and child health in Africa. Health Care for Women International. 2015;36:57–69.
Mathole T, Lindmark G, Majoko F, Ahlberg M. A qualitative study of women’s perspectives of antenatal care in a rural area of Zimbabwe. Midwifery. 2004;20(2): 122–32.
Minsung, Sohn, Minsoo, Jung. Effects of Empowerment and Media Use by Women of Childbearing Age on Maternal Health Care Utilization in Developing Countries of Southeast Asia. International Journal of Health Services. 2020;50(1):32–43
Adedini S, Somefun O, Odimegwua C. Gender inequality and maternal and child healthcare utilization in sub-Saharan Africa. Gender & Behaviour. 2014;12(4).
Choudhury N, Ahmed M. Maternal care practices among the ultra-poor households in rural Bangladesh: qualitative exploratory study. BMC Pregnancy Childbirth. 2011;11:15.
DOI: 10.1186/1471- 2393-11-15 PMID: 21362164
Story T, Burgard A, Lori R, Taleb F, Ali A, Hoque E. Husbands' involvement in delivery care utilization in rural Bangladesh: A qualitative study. BMC Pregnancy Childbirth. 2012;12:28.
DOI: 10.1186/ 1471-2393-12-28 PMID: 22494576.
Haque E, Rahman M, Mostofa G, Zahan S. Reproductive health care utilization among young mothers in Bangladesh: does autonomy matter? Women’s Health Issues. 2012;22(2): 171–180.
Nigatu D, Gebremariam A, Abera M, Setegn T, Deribe K. Factors associated with women’s autonomy regarding maternal and child health care utilization in Bale Zone: a community based cross-sectional study. BMC Women’s Health. 2014;14:79
Acharya R, Bell S, Simkhada P, Van Teijlingen R, Regmi R. Women’s autonomy in household decision-making: a demographic study in Nepal. Reprod Health. 2010;7:15.
Kamiya Y. Women’s autonomy and reproductive health care utilization: empirical evidence from Tajikistan. Health Policy. 2011;102(2–3):304–313.
Jackson R, Tesfaye F, Gebrehiwot T, Godefay H. Factors that hinder or enable maternal health strategies to reduce delays in rural and pastoralist areas in Ethiopia. Tropical Med Int Health. 2017;22(2):148–60.
Moazzam Ali, Joanna, Cordero, Faria, Khan., Rachel, Folz. Leaving no one behind’: a scoping review on the provision of sexual and reproductive health care to nomadic populations BMC Women's Health. 2019;19:161
Ibrahim MA, Demissie M, Medhanyie AA, Worku A, Berhane Y. Reasons for low level of skilled birth attendance in Afar pastoralist community, North East Ethiopia: a qualitative exploration. Pan Afr Med J. 2018;30:51
Babker, El Shiekh, Anke, Van der Kwaak. Factors influencing the utilization of maternal health care services by nomads in Sudan. Pastoralism: Research, Policy and Practice. 2015;5:23.
Kamala, Lamichhane. Women’s autonomy and utilization of maternal health care services in rural Nepal . Nepal Population Journal. 2018;18(17): ISSN: 2645-8349
Fotso JC, Ezeh AC, Essendi H. Maternal health in resource-poor urban settings: how does women’s autonomy influence the utilization of obstetric care services? Reprod Health. 2009;6:9.
Okereke E, Unumeri G, Akinola A, Eluwa G, Adebajo S. Female clients’ gender preferences for frontline health workers who provide maternal, newborn and child health (MNCH) services at primary health care level in Nigeria. BMC Health Services Research. 2020;20:441.
Brooks F, Phillips D. Do women want women health workers? Women's views of the primary health care service. J Adv Nur. 1996;23:1207–11
Kelley, Lee, Meri, Koivusalo, Eeva, Ollila, Ronald, Labonté, Ted, Schrecker. (2007). Human resources for health: a gender analysis. WHO Commission on Social Determinants of Health: Globalization and Health Knowledge Network.Research Papers. Geneva; 2007.
Available:http://www. sarpn.org.za/documents/d0002790.Accesed 7 March 2020
Bhana N, McDougalb L, Singh A, Atmavilasd Y, Raje A. Access to women physicians and uptake of reproductive, maternal and child health services in India. EClinicalMedicine. 2020;20:100309.
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