Academic journal article The Journal of Developing Areas

Women Empowerment and Antenatal Care Utilization in Bangladesh1

Academic journal article The Journal of Developing Areas

Women Empowerment and Antenatal Care Utilization in Bangladesh1

Article excerpt

(ProQuest: ... denotes formulae omitted.)

INTRODUCTION

The risk of infant and maternal mortalities is often high in most of the developing countries. Adequate antenatal care is necessary to improve the health status of a country as it contributes to the reduction of infant and maternal mortalities. Studies (Hong and Ruiz-Beltran, 2007; Halim, Bohara and Ruan, 2011; Mcdonagh, 1996; and Habibov, 2011) show that antenatal care is negatively related to both infant and maternal mortalities. Women receiving adequate antenatal care usually have better opportunity to learn more about their health during pregnancy, child birth and parenting; and have their health problems diagnosed and treated early. These cares result in higher chances of normal delivery with better health for both newborn baby and the mother, which may lead to lower infant and maternal mortalities.

There is a healthy body of literature on the determinants of antenatal care. Simkhada et al. (2008) and Say and Raine (2007) have done a systematic review and summarized most of the studies on this issue. The former examine 28 peer-reviewed studies published since 1990, while the later examine 30 for the same period. These studies identify and analyze main factors affecting the utilization of antenatal care in developing countries. The major determinants of antenatal care utilization in developing countries are divided into four categories: (1) women socio-demographic characteristics (e.g., age, education and age at birth); (2) current pregnancy characteristics (e.g., birth order, gender of the child, multiple births and wanting the last child or current pregnancy); (3) affordability (e.g., socio-economic status such as spouse's education, household wealth/income and insurance coverage); and (4) accessibility to the services (e.g., place of residence such as rural/urban and region, travel time to health facilities and public/private facilities). Other factors such as ethnicity, religion and culture are also found to be significant determinants of antenatal care utilization.

Women empowerment is believed to be an important factor in determining the utilization of antenatal care. Duflo (2012) highlights three dimensions of women empowerment: (i) education; (ii) participation in the decision making process; and (iii) involvement in economic activities. She refers education as the first and most important dimension of empowerment followed by other two.

Higher the level of education of a woman, better the chance that she would be enlightened and be more conscious; and therefore can make better decisions for herself as well as for her family. Educated women can easily comprehend the benefits of antenatal care and thus expected to utilize antenatal care more effectively. They may also be better informed about how the healthcare system functions and hence can get better access to it. Furthermore, educated women can easily interact and communicate with the health service providers to get required cares (Bloom et al., 2001).

In many developing countries, where a man is typically the head of a household makes most of the household decisions and the wife experiences no equity in this process (Holland and Hogg, 2001). For instance, men often control the financial matters no matter who earns the cash and make decisions regarding major household purchases. This translates into financial vulnerability and lack of autonomy of a woman and more dependent on her spouse. In such cases, a woman who needs antenatal care has to rely on her husband's judgment and willingness to spend money on such cares. So, we hypothesize that the higher the participation in the household decisions making process by a woman, the higher is the likelihood that she would utilize the antenatal care in the developing countries.

In a developing country like Bangladesh, the opportunity of women involvement in economic activities is limited. Microcredit organizations increase the scope of being involved in economic activities for women as most of their members are women in Bangladesh (Microcredit Regulatory Authority, 2013). …

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