The impact of partner autonomy constraints on women's health-seeking across the maternal and newborn continuum of care. (November 2022)

• Record Type: Journal Article
• Authors: Wood, Shannon N.; Yirgu, Robel; Karp, Celia; Tadesse, Meseret Zelalem; Shiferaw, Solomon; Zimmerman, Linnea A.
• Is Part Of: EClinicalMedicine. Volume 53(2022)
• Publication Date: 2022-11
• Subjects: Maternal and child health -- Intimate partner violence -- Reproductive coercion -- Partner involvement -- Care-seeking behaviors; AAU Addis Ababa University -- ANC antenatal care -- FMoH Federal Ministry of Health -- IPV intimate partner violence -- JHBSPH Johns Hopkins Bloomberg School of Public Health -- MNH maternal and newborn health -- PMA Performance Monitoring for Action -- PNC postnatal care -- RC reproductive coercion; Medicine -- Research -- Periodicals; Medical policy -- Periodicals; Clinical Medicine; Health Policy; Public Health; Medical policy; Medicine -- Research; Periodical; Electronic journals; Periodicals; 613
• DOI: 10.1016/j.eclinm.2022.101715
• Languages: English
• ISSNs: 2589-5370

Abstract

Summary: 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.