Women's decision-making autonomy and utilization of antenatal, natal and post-natal healthcare services: Insights from Tajikistan's national surveys

BACKGROUND

The purpose of this article is to investigate the link between women's autonomy and their utilization of antenatal, natal and post-natal healthcare services in Tajikistan. Previous studies focused only on a single dimension of such services, for instance, utilization of antenatal care. By contrast, we explore antenatal, natal and post-natal healthcare services utilization using the number of indicator for each of the dimensions.

METHODS

Data come from two national surveys that were conducted in 2012 and 2017. The target population is women of reproductive age (16-49) who were married or cohabitating with a partner (N = 7540). Several regression models were estimated to quantify association between women's autonomy and the utilization.

RESULTS

Lack of women's autonomy is associated with a lower probability of: (a) having had at least four antenatal check-ups during pregnancy, (b) beginning first antenatal check-up early, (c) delivering in a healthcare facility, (d) having the skilled attendance during pregnancy, (e) having a mother post-delivery check-up, and (f) having a child post-delivery check-up. The size effect of women's autonomy is stronger than that of well-developed precursors of utilization such as poverty and mothers' education.

CONCLUSION

Women autonomy should be improved to achieve higher rates of child and maternal healthcare utilization. Studies of maternal and child healthcare utilization should control explicitly for women's autonomy.

A national survey of attitudes toward intimate partner violence among married women in Kazakhstan, Kyrgyzstan, and Tajikistan: Implications for health prevention and intervention

Attitudes toward intimate partner violence (IPV) can affect the prevalence of IPV, response of victims' to IPV (e.g., whether to seek help), and the response of professionals (e.g., police, social workers, health care professionals) to IPV. Knowledge about IPV-related attitudes is essential for developing effective social work and violence-related programs. Using data from the 2005-2006 Multiple Indicator Cluster Surveys, this study examines attitudes toward IPV and socio-demographic predictors of these attitudes among married women in Kazakhstan, Kyrgyzstan, and Tajikistan. Women were asked whether they approved of a husband beating his wife: if she goes out without telling him, neglects their children, argues, refuses to have sex, and burns food. The prevalence of IPV acceptance for at least one of the five reasons varied from 12.3% in Kazakhstan to 45.3% in Kyrgyzstan and 74.5% in Tajikistan. Women who were less educated, members of Asian ethnic groups, resided in middle-class urban areas, and lived in specific regions were more likely to accept IPV. Few age differences that emerged indicated that young women were more approving of IPV. Proactive efforts are needed to confront attitudes about gender roles and IPV in Tajikistan and Kyrgyzstan.