WOMEN’S AUTONOMY ON MATERNALAND CHILD HEALTH SERVICE UTILIZATION AND ASSOCIATED FACTORS IN GURAGE ZONE, CENTRAL ETHIOPIA, 2025: ACOMMUNITY BASED CROSSSECTIONAL STUDY

Abstract

Background: women status often has impact on their autonomy and decision making ability about different aspects of their own lives. While women’s autonomy is basic for prevention of maternal and child mortality, it has not been given more attention. Beyond that maternal mortality is still remains as a public concern, it is necessary to assess women's autonomy and associated factors on the use of maternal and child health care services in the Gurage zone. Objective: To assess women's autonomy on maternal and child health services utilization and associated factors in Gurage Zone, central Ethiopia in 2025. Method: A Community-based cross-sectional study was employed on 601 participants from December 15/2024 to January 15/2025. Women's autonomy is the capacity and freedom of women in the reproductive age group to act independently and make decisions. Epi data version 3.2 was used to store the collected data, which was then exported to SPSS 25 for analysis. Multivariable and bi-variable logistic regression models have both been applied. A P-value of < 0.05 was used as statistically significant at a 95% confidence interval. Result: - Respondent rate of this study was 98 %. About 355 (59 %, 95% CI: 56 % - 62 %) of women had higher autonomy. women who had attended primary school (AOR: 2.28, 95% CI: 1.40-3.69), secondary school and above (AOR: 3.40, 95% CI: 2.03, 5.69), Women of aged 36-49 years (AOR: 3.68, 95% CI: 2.18, 6.21), having media exposure (AOR: 4.71, 95% CI: 3.13-7.09), women whose wedding ceremony practice were by partners agreement (AOR: 4.12, 95% CI: 1.95-5.02) ,who married by their custom based ceremony (AOR: 2.55, 95%CI: 1.39-4.66),and women who have selected their boyfriend by their own decision (AOR: 2.85, 95% CI: 1.61-5.02) were significantly associated with women’s decision-making autonomy. Conclusion: The prevalence of women decision making autonomy regarding maternal and child health service utilization in this study was 59 %. But, still which found to be low. Women education and media exposure are necessary for their health service utilization at the community level. Recommendation: An inclusive strategy needs to be applied in order to empower women to have access and health services utilization and to enhance women decision making ability in household performances through education and media exposure.