The role of mothers-in-law in antenatal care decision-making in Nepal: a qualitative study

Background Antenatal care (ANC) has been recognised as a way to improve health outcomes for pregnant women and their babies. However, only 29% of pregnant women receive the recommended four antenatal visits in Nepal but reasons for such low utilisation are poorly understood. As in many countries of South Asia, mothers-in-law play a crucial role in the decisions around accessing health care facilities and providers. This paper aims to explore the mother-in-law’s role in (a) her daughter-in-law’s ANC uptake; and (b) the decision-making process about using ANC services in Nepal. Methods In-depth interviews were conducted with 30 purposively selected antenatal or postnatal mothers (half users, half non-users of ANC), 10 husbands and 10 mothers-in-law in two different (urban and rural) communities. Results Our findings suggest that mothers-in-law sometime have a positive influence, for example when encouraging women to seek ANC, but more often it is negative. Like many rural women of their generation, all mothers-in-law in this study were illiterate and most had not used ANC themselves. The main factors leading mothers-in-law not to support/ encourage ANC check ups were expectations regarding pregnant women fulfilling their household duties, perceptions that ANC was not beneficial based largely on their own past experiences, the scarcity of resources under their control and power relations between mothers-in-law and daughters-in-law. Individual knowledge and social class of the mothers-in-law of users and non-users differed significantly, which is likely to have had an effect on their perceptions of the benefits of ANC. Conclusion Mothers-in-law have a strong influence on the uptake of ANC in Nepal. Understanding their role is important if we are to design and target effective community-based health promotion interventions. Health promotion and educational interventions to improve the use of ANC should target women, husbands and family members, particularly mothers-in-law where they control access to family resources

Married women’s decision making power on family planning use and associated factors in Mizan-Aman, South Ethiopia: a cross sectional study

BACKGROUND: Women’s use of family planning service is influenced by many factors, especially by their decision making power. A woman’s decision-making power, be it individual or decision made in collaboration with a partner, is the most important factor in the use of family planning in a household. The purpose of this study was to assess the impact of women’s decision making power on family planning use and its associated factors. METHODS: A community-based cross-sectional study was conducted on married women in the child bearing age. The women who were living in Mizan city were selected using the simple random sampling method. Trained nurses collected the data by interview, using a structured and pre-tested questioner. Bivariable and multivariable binary logistic regression analysis was used to identify the associated factors, and the odds ratio with a 95 % CI was computed to assess the strength of the association. Collinearity was also assessed by looking at standard errors in the final fitted model. RESULT: Overall, more than two-thirds [67.2 %: 95 % CI (63–71 %)] of the married women were found to be more autonomous to decide family planning use. Secondary education [AOR: 9.04, 95 % CI: (4.50, 18.16)], government employment [AOR: 4.84, 95 % CI: (2.03, 11.52)], being wives of government employed spouses [AOR 2.71, 95 % CI: (1.24, 7.97)], having husbands with college or university education [AOR: 11.29, 95 % CI: (4.66, 27.35)], and being in the younger age [AOR: 0.27, 95 % CI :(0.09, 0.75)] were significantly associated with women’s decision-making power on family planning. CONCLUSIONS: In this study, women had a high decision making power in family planning use. Age category (34–44-years), formal education, and occupational status had effects on women’s decision making power. Promoting parental adult education and engaging women in out of house employment is essential to improve their decision making power in using family planning

Women's efficiency in decision making and their perception of their status in the family

This study is descriptive in nature. Three hundred ten women who applied to the Maternal-Child Health and Family Planning Center in Erzurum, Turkey, between June 1 and August 30, 2001 were included in this study. Data were collected through the inquiry form, which was prepared to determine women's efficiency in decision making, their perception of their status within the family, and their demographic characteristics. Women's decision-making rate was lower than that of men, except for selecting clothes. Couples' joint decision-making rate was high on personal matters but low on official matters. The women's educational level affected their decision making in the family. The majority of the women perceived themselves as wives sharing everything within the family. Women's perception of their positions in the family was related to their status and decision making. The results can be used in primary care practice for women's health promotion. The sample in this study reflects only one area of Turkey

Turkish women's satisfaction with family planning services

This research was designed to identify women's satisfaction with family planning services and, secondly, to establish a standardized scale of satisfaction for use in the evaluation of women's satisfaction with family planning services. The population for this study comprised Turkish women living in Erzurum, and attending one of five primary health-care centers in Erzurum for services. The study included 406 women who were selected by random sampling from the population who used current family planning methods. Data were collected using the satisfaction with family planning services scale from 1 April to 20 June 2002. Cronbach's alpha of the scale is 0.86. Alpha coefficients ranged from 0.83 to 0.77 for seven dimensions. Factor analysis oil the 37 items revealed that the seven factors that resulted were the same as the seven components of intrinsic motivation. The score mean of the scale was 132.2 +/- 26.8, and the score mean per item was 3.5. In terms of both the mean overall score and the score per item, women were reasonably satisfied with family planning services. This study provided a standardized scale of women's satisfaction with family planning services. The sample of the present study was collected from only the Eastern Anatolia region of Turkey. Utilization of such methods as all interview form that would identify factors and rate their importance while women are in health-care centers and offices would be helpful