Women's decision-making autonomy and use of maternal health services in Burkina Faso: Analysis of the 2021 DHS data
DOI:
https://doi.org/10.64707/revstss.v49i1.2180Keywords:
Keywords: Women's decision-making autonomy; Adequate antenatal care (ANC ≥ 4); Assisted delivery; Contextual and organizational determinants; Burkina FasoAbstract
Introduction: Women’s decision-making autonomy is often regarded as a key determinant of the use of maternal health services in sub-Saharan Africa. However, empirical findings remain mixed, particularly across the different stages of the continuum of care. This study analyses the association between women’s decision-making autonomy and two key indicators of maternal health in Burkina Faso: adequate antenatal care (four or more antenatal visits) and delivery attended by a skilled birth attendant.
Methods: The data used were drawn from the 2021 DHS. The analysis focused on women aged 15–49 who had recently given birth. Logistic regression models were estimated sequentially to assess the net effects of decision-making autonomy, after controlling for organisational, environmental, individual and socio-economic factors.
Results: After adjustment, decision-making autonomy remains significantly associated with adequate antenatal care. Compared with women reporting complete autonomy, those with partial autonomy (OR = 1.65; p < 0.05) or no autonomy (OR = 1.49; p < 0.05) are more likely to receive adequate antenatal care. Geographical distance is also an important determinant, and regional disparities persist, particularly to the detriment of the Sahel. In contrast, decision-making autonomy is not significantly associated with assisted delivery after adjustment. This appears to be more influenced by distance, region, age and educational level.
Conclusion: These results suggest that the use of antenatal care in Burkina Faso is less a matter of strictly individual autonomy than of relational and structural dynamics. Maternal health policies would benefit from combining gender-transformative approaches with interventions targeting geographical and regional inequalities.
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