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. 2025 Apr 18;25(1):192.
doi: 10.1186/s12905-025-03666-7.

Determinants of healthcare decision-making autonomy among Bangladeshi women: mixed-effect logistic regression analysis

Rafsaniat Binte Mustafiz #  1 , Syed Sharaf Ahmed Chowdhury #  1   2 , Satyajit Kundu  3 , Nurjahan Binte Munaf  1 , Azaz Bin Sharif  4   5
Affiliations

Determinants of healthcare decision-making autonomy among Bangladeshi women: mixed-effect logistic regression analysis

Rafsaniat Binte Mustafiz et al. BMC Womens Health. .

Abstract

Background: Women's healthcare decision-making autonomy is observed to play a significant role in improving maternal and child health outcomes. However, there is a dearth of research that addressed this issue in the Bangladeshi context. Therefore, this study aimed to estimate the prevalence of healthcare decision-making autonomy and its determinants among Bangladeshi women.

Methods: Data on 18,890 (weighted) women's healthcare autonomy were driven from the Bangladesh Demographic and Health Survey (BDHS) 2017-18. A multilevel (mixed-effect) logistic regression model was applied to explore the determinants of healthcare autonomy.

Results: Overall weighted prevalence of healthcare autonomy was 76.5% (95% CI: 75.85-77.06). The odds of having healthcare autonomy were higher among women belonging to 25-34 years (aOR: 1.69, 95% CI: 1.52-1.87), and 35-49 years (aOR: 1.89, 95% CI: 1.65-2.17) age group, attaining secondary (aOR: 1.31, 95% CI: 1.14-1.50), and higher education (aOR: 1.61, 95% CI: 1.33-1.94), who were employed (aOR: 1.37, 95% CI: 1.26-1.50), who read newspaper/magazine at least once a week (aOR: 1.45, 95% CI: 1.13-1.84), having 1-2 (aOR: 1.91, 95% CI: 1.67-2.17), and 3 or more (aOR: 1.94, 95% CI: 1.65-2.27) living children, gave no birth in the last 3 years (aOR: 1.17, 95% CI: 1.06-1.29), and from urban areas (aOR: 1.43, 95% CI: 1.25-1.63).

Conclusion: Around one-quarter of the women were not autonomous regarding their healthcare decision-making. So, it is necessary to implement strategies and policies that can enable and empower women in the healthcare aspects of their lives.

Keywords: Bangladesh; Decision-making; Healthcare autonomy; Mixed-effect analysis; Women empowerment.

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Conflict of interest statement

Declarations. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. Ethics approval and consent to participate: The study used deidentified data from the Demographic Health Survey program, which has already received ethical approval from the participating countries, no further ethical permission was sought to carry out this research. Data was collected from online source ( https://dhsprogram.com ) with appropriate request. Written informed consent from the respondents enrolled in the survey and other ethical review documents are available at: https://dhsprogram.com/methodology/Protecting-the-Privacy-of-DHS-Survey-Respondents.cfm . The data set is available online publicly for all researchers, hence there is no need to approve.

Figures

Fig. 1
Fig. 1
Flow chart of the exclusion criteria and selection of the participants
See this image and copyright information in PMC

References

    1. OHCHR. Women’s autonomy, equality and reproductive health. (2023).
    1. Idris IB, et al. Women’s autonomy in healthcare decision making: a systematic review. BMC Womens Health. 2023;23:643. - PMC - PubMed
    1. Asabu MD, Altaseb DK. The trends of women’s autonomy in health care decision making and associated factors in Ethiopia: evidence from 2005, 2011 and 2016 DHS data. BMC Womens Health. 2021;21:1–9. - PMC - PubMed
    1. Alemayehu M, Meskele M. Health care decision making autonomy of women from rural districts of Southern Ethiopia: A community based cross-sectional study. Int J Womens Health. 2017;9:213–21. - PMC - PubMed
    1. Osamor P, Grady C. Factors associated with women’s health care decision-making autonomy: empirical evidence from Nigeria. J Biosoc Sci. 2018;50:70–85. - PMC - PubMed

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