Examining the Relationship Between Individual Characteristics, Community-Level Traits, Multidimensional Empowerment, and Maternal Health Care Utilization in the Islamic Republic of Pakistan.

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  • Additional Information
    • Source:
      Publisher: Kluwer Academic/Plenum Publishers Country of Publication: United States NLM ID: 9715672 Publication Model: Print Cited Medium: Internet ISSN: 1573-6628 (Electronic) Linking ISSN: 10927875 NLM ISO Abbreviation: Matern Child Health J Subsets: MEDLINE
    • Publication Information:
      Publication: 1999- : New York, NY : Kluwer Academic/Plenum Publishers
      Original Publication: New York : Plenum Press, c1997-
    • Subject Terms:
      Islam* ; Patient Acceptance of Health Care*/ethnology ; Patient Acceptance of Health Care*/psychology ; Power, Psychological* ; Residence Characteristics* ; Women's Rights*; Maternal Health/*ethnology ; Maternal Health Services/*statistics & numerical data ; Pregnant Women/*psychology; Adult ; Decision Making ; Educational Status ; Family ; Female ; Health Literacy ; Health Services Research ; Healthcare Disparities ; Humans ; Pakistan ; Pregnancy ; Social Class ; Social Environment ; Socioeconomic Factors ; Surveys and Questionnaires
    • Abstract:
      Introduction The Islamic Republic of Pakistan's maternal mortality ratio is particularly high, and the nation ranks 126 out of 149 countries on the Human Development Report-Gender Inequality Index. This is because Pakistani women have low levels of empowerment, make limited economic contributions, and underutilization of maternal health care. The aim of this study is to create a multidimensional index of women's empowerment and assess the association between this index and maternal health care utilization in Pakistan, controlling for individual characteristics and community-level traits. Methods Data from the 2012-2013 Pakistan Demographic and Health Surveys were employed to investigate the relationship between this index and the latent construct of maternal health care utilization. Results Using exploratory factor analysis, four indicators of maternal health care utilization were loaded onto a single latent factor. Multivariate analyses found support for the association between empowerment and health care utilization, despite adjustments for individual and area level factors. Positive associations between education, wealth, and maternal health care utilization were found. Conclusions Although we find support for the association of educational attainment with maternal health care utilization, the multidimensional women's empowerment index was independently a consistent associate of maternal health care utilization. This illustrates a complex mechanism with both-education and empowerment, being necessary for improved maternal health care utilization. Policy makers seeking to improve outcomes should expand their focus beyond simply improving rates of education to examining effects of cultural norms which constrain the independence of women in making decisions about their own health care.
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    • Contributed Indexing:
      Keywords: Empowerment; Health care utilization; Health services research; Maternal health; Pakistan
    • Publication Date:
      Date Created: 20180308 Date Completed: 20190110 Latest Revision: 20191210
    • Publication Date:
      20231215
    • Accession Number:
      10.1007/s10995-018-2512-3
    • Accession Number:
      29512052