Women’s autonomy: new paradigm in maternal health care utilization

Abstract

Autonomy is multidimensional concept and difficult

to quantify. It refers independence or freedom of the

will or one’s action and it is explained as the capacity

of an agent to act in accordance with objective

morality rather than under the influence of desires.1

Women’s autonomy is a complex and general term

which has contextual meaning and is influenced by

personal attributes of women as well as socio-cultural

norms of the society. 2 Most of researchers prefer

proxy indicators such as educational attainment,

employment, income, spousal age difference, type of

family and so on to measure the women’s decision

making autonomy in the utilization of maternal and

reproductive health care services.3 Early literature on

women’s autonomy focused on education,

occupation, and demographic characteristics like age

at marriage and age differences between spouses as

proxies for women’s autonomy. 4 More recently,

autonomy has been defined as women’s enacted

ability to influence decisions, control economic

resources, and move freely.5–7

The Millennium Development Goal Five aims to

improve maternal health and reduce maternal

mortality by three-quarters between 1990 and 2015.8

The maternal mortality is extremely high in low

income countries of sub-Saharan Africa and South

East Asia. Approximately 800 women die every day

and 2,87000 women died in 2010 around the world

because of pregnancy related complications. Most of

the deaths occurred in low resource countries which

could have been avoided by extending the access of

maternal health care services.9 Even though maternal

mortality has declined to some extent worldwide,10

the achievements are still not enough to meet the

Millennium Development Goal by the year 2015