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Maternal health in resource-poor urban settings: how does women's autonomy influence the utilization of obstetric care services?

Integrating reproductive health, family planning and STI/HIV prevention and treatment services is critical for achieving universal access. Integration requires that health care workers can provide an appropriate comprehensive package of services under one roof, and refer patients to other services if required. Linking STI/HIV with SRH services improves access to HIV/STI services for women who might otherwise not visit them because of issues of stigma [1]. It also improves access to reproductive health services for people living with HIV and AIDS whose reproductive health needs and rights are often overlooked [12]. Integrating. | Reproductive Health BioMed Central Research Maternal health in resource-poor urban settings how does women s autonomy influence the utilization of obstetric care services Jean-Christophe Fotso Alex C Ezeh and Hildah Essendi Open Access Address African Population and Health Research Center APHRC Nairobi Kenya Email Jean-Christophe Fotso - jcfotso@aphrc.org Alex C Ezeh - aezeh@aphrc.org Hildah Essendi - hessendi@aphrc.org Corresponding author Published 16 June 2009 Received 29 December 2008 Reproductive Health 2009 6 9 doi 10.1186 1742-4755-6-9 Accepted 16 June 2009 This article is available from http www.reproductive-health-journal.cOm content 6 1 9 2009 Fotso et al licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License http creativecommons.org licenses by 2.0 which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Background Despite various international efforts initiated to improve maternal health more than half a million women worldwide die each year as a result of complications arising from pregnancy and childbirth. This research was guided by the following questions 1 How does women s autonomy influence the choice of place of delivery in resource-poor urban settings 2 Does its effect vary by household wealth and 3 To what extent does women s autonomy mediate the relationship between women s education and use of health facility for delivery Methods The data used is from a maternal health study carried out in the slums of Nairobi Kenya. A total of 1 927 women out of 2 482 who had a pregnancy outcome in 2004-2005 were selected and interviewed. Seventeen variable items on autonomy were used to construct women s decisionmaking freedom of movement and overall autonomy. Further all health facilities serving the study population were assessed with regard to the number training and competency of obstetric staff services .