The impact of women’s agency on accessing and using maternal healthcare services: a systematic review and meta-analysis

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Abstract

Agency, defined as the ability to identify one’s goals and act upon them, has been recognized as a prominent strategy to access maternal healthcare services (MHS). The purpose of this study was to synthesize evidence of the association between women’s agency and MHS utilization. A systematic review was performed on five academic databases, comprising Scopus, PubMed, Web of Science, Embase, and ProQuest. Meta-analysis was performed with a random-effects method using the STATA™ Version 17 software. A total of 82 studies were selected following the PRISMA guidelines. The meta-analysis demonstrated that an increase in women’s agency was associated with a 34% increase in the odds of receiving skilled antenatal care (ANC) (OR = 1.34, 95% CI = 1.18–1.52); 7% increase in the odds of initiating the first ANC visit during the first trimester of pregnancy (OR = 1.07, 95% CI = 1.01–1.12); 20% increase in the odds of receiving at least one ANC visit (OR = 1.20, 95% CI = 1.04–1.4); 16% increase in the odds of receiving more than four ANC visits during pregnancy (OR = 1.16, 95% CI = 1.12–1.21); 17% increase in the odds of receiving more than eight ANC visits (OR = 1.17, 95% CI = 1.04–1.32); 13% increase in the odds of facility-based delivery (OR = 1.13, 95% CI = 1.09–1.17); 16% increase in the odds of using skilled birth attendants (OR = 1.16, 95% CI = 1.13–1.19); and 13% increase in the odds of receiving postnatal care (OR = 1.13, 95% CI = 1.08–1.19) compared to low level of agency. Any efforts to improve MHS utilization and reduce maternal morbidity and mortality should include the promotion of women’s agency.
Original languageEnglish
Article number3966
Pages (from-to)1-17
Number of pages17
JournalInternational Journal of Environmental Research and Public Health
Volume20
Issue number5
DOIs
Publication statusPublished - 23 Feb 2023

Bibliographical note

Copyright the Author(s) 2023. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • maternal health services
  • health services
  • women’s agency
  • empowerment
  • systematic review
  • meta-analysis

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