Women's Decision-Making Autonomy and Exposure to Maternal Mortality Risks in Nigeria

The statistics on maternal mortality clearly show that Nigeria is lagging in the struggle to significantly improve maternal health. Annually, an estimated 50,000 to 59,000 Nigeria women of reproductive age die because of pregnancy and childbirth. One of the main reasons for this high rate has been the low level of involvement of women in decision-making process. Men generally view some of reproductive health issues as their prerogative, issues in which the compliance of their wives is taken for granted. The study employed the women’s data from the 2008 NDHS to examine the relationship between women’s decision-making autonomy and exposure to mortality risks. Given that the study was interested in the risks of maternal mortality in the country, the analysis was restricted to only the women who had at least a birth in the last five years (preceding the survey). A total of 17635 women out of the 33385 women interviewed nationwide in the 2008 NDHS, met the inclusion criteria. The analysis was done at univariate and bivariate levels. Also, using logistic regression models, multivariate analyses were performed to estimate the odds ratios for each of the predictor variables in the models. The study shows that 36% of the women did not make a single antenatal visit to a hospital during the duration of their last pregnancy; as many as 63% did not deliver in a health facility (government or privately owned); and about 60% did not deliver with the assistance of a skilled provider. After controlling for the confounding influence of some other independent variables, the study suggests that the “strong authority” of women in household decision-making gives them a voice that is heard in the house and ability to initiate moves to obtain healthcare without necessarily waiting for “administrative clearance” from adult males within the husband’s family.