The role of women's empowerment in the uptake of maternal health services in low- and middle-income countries: a propensity score-matched analysis

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dc.contributor.authorBelay, D.G.
dc.contributor.authorTessema, G.A.
dc.contributor.authorDunne, J.
dc.contributor.authorRoy, A.
dc.contributor.authorNorman, R.
dc.date.issued2025
dc.description.abstractBackground Women’s empowerment directly influences the quality and timeliness of the maternal health care they receive; a lack thereof, particularly in low- and middle-income countries (LMICs), is likely to contribute to poor uptake of maternal healthcare. We aimed to evaluate the role of women’s empowerment in maternal healthcare in LMICs. Methods We used the recent Demographic and Health Survey (DHS) data on 71 077 married/partnered women from 35 LMICs. We categorised women as empowered if they participated in all decision-making activities and were able to disagree that a husband is justified in hitting or beating his wife for any reason. We used logit propensity score matching (PSM) analysis to estimate the effect of women’s empowerment on maternal health services. Result Only one-third (33.8%) of reproductive-age women in LMICs (95% confidence interval = 27.7–40.8) were estimated to be empowered. Women’s empowerment was associated with an 11.2 percentage point increase in having adequate antenatal care (ANC) visits (average treatment effects on the treated (ATT) = 0.112, standard error (SE) = 0.026) and an 8.0 percentage point increase in the likelihood of health facility childbirth (ATT = 0.078, SE = 0.039). However, there was insufficient evidence for early postnatal care visits. Conclusions Empowering women has a positive association with the utilisation of adequate ANC visits and health facility childbirth in LMICs. These findings underscore the necessity for public health programmes to empower women and enhance their decision-making abilities to improve maternal healthcare uptake, such as health facility childbirth and ANC visits.
dc.description.statementofresponsibilityDaniel Gashaneh Belay, Gizachew A Tessema, Jennifer Dunne, Aditi Roy, Richard Norman
dc.identifier.citationJournal of Global Health, 2025; 15:04188-1-04188-14
dc.identifier.doi10.7189/jogh.15.04188
dc.identifier.issn2047-2978
dc.identifier.issn2047-2986
dc.identifier.orcidTessema, G.A. [0000-0002-4784-8151]
dc.identifier.urihttps://hdl.handle.net/2440/147819
dc.language.isoen
dc.publisherInternational Society of Global Health
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1195716
dc.rights© 2025 The Author(s). Open Access. The material published in JoGH is licensed under a CC BY 4.0. license. This means that all published articles can be shared (copied and redistributed in any medium or format), and/or adapted (remixed, transformed, and built upon for any purpose, even commercially). As a publisher, ISoGH cannot revoke this, provided that these terms are followed: Attribution. You must give appropriate credit, provide a link to the licence, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the publisher endorses you or your use. No additional restrictions. You may not apply legal terms or technological measures that legally restrict others from doing anything the CC BY 4.0 licence permits The copyright for all published articles remains with the authors or their employers, while the journal copyright remains with the Journal.
dc.source.urihttps://doi.org/10.7189/jogh.15.04188
dc.subjectempowerment; maternal healthcare; LMICs (low- and middle-income countries); utilisation
dc.titleThe role of women's empowerment in the uptake of maternal health services in low- and middle-income countries: a propensity score-matched analysis
dc.typeJournal article
pubs.publication-statusPublished

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