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    Healthcare utilization and empowerment among women in Liberia

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    Date
    2013-11
    Author
    Sipsma, Heather
    Callands, Tamora A.
    Bradley, Elizabeth
    Harris, Benjamin
    Johnson, Billy
    Hansen, Nathan B.
    Publisher
    BMJ Publishing Group
    Metadata
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    Abstract
    Background: Many efforts have been undertaken to improve access to healthcare services in low-income settings; nevertheless, underutilization persists. Women’s lack of empowerment may be a central reason for underutilization, but empirical literature establishing this relationship is sparse. Methods: We conducted a cross-sectional study using data from the 2007 Liberia Demographic and Health Survey. Our sample included all non-pregnant women who were currently married or living with a partner (N=3,925 unweighted). We used multivariate logistic regression to assess the associations between constructs derived from the Theory of Gender and Power (TGP) and healthcare utilization. Results: Two-thirds of women (65.6%) had been to a healthcare facility for herself or her children in the past 12 months. Constructs from the three major theoretical structures were associated with healthcare utilization. Women with no education, compared with women with some education, were less likely to have been to a healthcare facility (OR=0.77; 95%CI=0.64, 0.94) as were women who had experienced sexual abuse (OR=0.63, 95%CI=0.42, 0.93) and women who were married (OR=0.69, 95%CI=0.54, 0.88). Women in higher wealth quintiles, compared with women in the next lower wealth quintile, and women with more decision-making power had greater odds of having been to a healthcare facility (OR=1.22; 95%CI=1.09, 1.36 and OR=1.46; 95%CI=1.03, 2.08; respectively). Conclusions: Strong associations exist between healthcare utilization and empowerment among women in Liberia, and gender imbalances are prevalent. This fundamental issue likely needs to be addressed before large-scale improvement in health service utilization can be expected.
    Subject
    empowerment
    health services
    maternal health
    Type
    Article
    Date available in INDIGO
    2015-09-23T09:30:11Z
    URI
    http://hdl.handle.net/10027/19638
    Collections
    • Publications - Women, Child, and Family Health Science

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