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. 2022 Oct 31:53:101715.
doi: 10.1016/j.eclinm.2022.101715. eCollection 2022 Nov.

The impact of partner autonomy constraints on women's health-seeking across the maternal and newborn continuum of care

Shannon N Wood  1 , Robel Yirgu  2 , Celia Karp  1 , Meseret Zelalem Tadesse  3 , Solomon Shiferaw  2 , Linnea A Zimmerman  1
Affiliations

The impact of partner autonomy constraints on women's health-seeking across the maternal and newborn continuum of care

Shannon N Wood et al. EClinicalMedicine. .

Abstract

Background: Gendered health inequities impede women's reproductive autonomy over the life course. Pregnancy is a critical time point for assessing inequities and partners are integral actors in the achievement or impediment of women's and children's health during this time.

Methods: Among a nationally representative cohort of Ethiopian women 5-9 weeks postpartum with data collected from October 2019-September 2020, this study aimed to 1) understand the prevalence and interplay of partner-related autonomy constraints (intimate partner violence (IPV), reproductive coercion (RC), lack of encouragement from seeking antenatal care (ANC), and lack of encouragement from seeking postnatal care (PNC), and 2) examine the impact of autonomy constraints on the maternal and newborn health (MNH) continuum of care.

Findings: Sixty percent of women experienced a partner-related autonomy constraint prior to or during pregnancy. Approximately 20% of women were not encouraged to seek antenatal care and postpartum care, respectively, whereas fewer women experienced IPV during pregnancy (12.3%) and RC (11.0%). Less than one in five women completed the MNH continuum of care. Lack of encouragement of ANC and PNC were associated with decreased care-seeking at every point across the MNH continuum of care. Lack of encouragement of ANC (aOR = 0.45; p = 0.05) and of PNC (aOR = 0.16; p < 0.001) were associated with reductions in completing the continuum.

Interpretation: Partner engagement, interventions, and messaging are critical to enhance MNH care-seeking behaviors.

Funding: This work was supported, in whole, by the Bill & Melinda Gates Foundation [INV 009466]. Under the grant conditions of the Foundation, a Creative Commons Attribution 4.0 Generic License has already been assigned to the Author Accepted Manuscript version that might arise from this submission.

Keywords: AAU, Addis Ababa University; ANC, antenatal care; Care-seeking behaviors; FMoH, Federal Ministry of Health; IPV, intimate partner violence; Intimate partner violence; JHBSPH, Johns Hopkins Bloomberg School of Public Health; MNH, maternal and newborn health; Maternal and child health; PMA, Performance Monitoring for Action; PNC, postnatal care; Partner involvement; RC, reproductive coercion; Reproductive coercion.

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Conflict of interest statement

Shannon Wood, Celia Karp, and Linnea Zimmerman report support for the present manuscript and attending meetings and/or travel from the 10.13039/100000865Bill and Melinda Gates Foundation, with payment to 10.13039/100007880Johns Hopkins University.

Figures

Fig. 1
Fig. 1
Venn diagram of partner-related autonomy constraints, unweighted. RC_sev = RC; SWipv = IPV during pregnancy; anc_discourage = lack of encouragement of ANC; pnc_discourage = lack of encouragement for PNC.
See this image and copyright information in PMC

Comment in

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