Can women's autonomy impede male involvement in pregnancy health in Katmandu, Nepal?
Can women's autonomy impede male involvement in pregnancy health in Katmandu, Nepal?
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DOI：
10.1016/j.socscimed.2005.04.006
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发表时间：
2005-11-01
影响因子：
5.4
通讯作者：
Becker, S
中科院分区：
文献类型：
--
作者：
Mullany, BC;Hindin, MJ;Becker, S
增强妇女权能方案主要侧重于增加妇女的决策权，而男性参与/夫妇友好方案则强调夫妇之间在决策过程中的沟通和谈判。深入访谈和焦点小组讨论进行了调查模式的家庭决策和男性参与的行为在加德满都，尼泊尔。对在一家大型妇产医院接受产前服务的592名孕妇进行了一份关于家庭决策和丈夫在怀孕期间的作用的问卷调查。多元回归技术被用来比较男性的参与行为在不同水平的妇女的自主权，代表不同的决策模式。较高的妇女的自主权，作为衡量她唯一的最终决策权，与显着降低男性参与怀孕健康。在调整其他协变量后，女性拥有最终决定权的每一个额外决定与其丈夫陪同她进行产前护理的可能性显着降低相关（OR = 0.70，p < 0.01）。相反，丈夫和妻子之间的共同决策与男性参与怀孕健康的水平显着提高有关。对于与丈夫共同做出的每一个额外的决定，女性更有可能与丈夫讨论健康问题（OR = 1.47，p < 0.001），做分娩准备（OR = 1.19，p < 0.05），并经历高水平的男性参与（OR = 1.29，p < 0.05）。共同决策和男性参与之间的积极关联意味着，夫妇沟通和共享的谈判策略可以改善健康的做法。这些结果表明，旨在增强妇女权能和/或妇女健康的方案必须考虑到在其努力中包括或排除男性的动态和后果。让丈夫参与和鼓励夫妇在生殖健康和家庭健康方面共同作出决定，可为实现赋予妇女权力和妇女健康目标提供一项重要战略。(c)2005爱思唯尔有限公司保留所有权利。
Women's empowerment programs focus primarily on increasing the decision-making power of women, while male involvement/couple-friendly programs emphasize communication and negotiation within couples in making decisions. In-depth-interviews and focus group discussions were conducted to investigate patterns of household decision-making and the context of male involvement behaviors in Katmandu, Nepal. A questionnaire focusing on household decision-making and husbands' roles during pregnancy was administered to 592 pregnant women receiving antenatal services at a large maternity hospital. Multivariate regression techniques were used to compare male involvement behaviors across varying levels of women's autonomy, represented by different decision-making patterns. Higher women's autonomy, as measured by her sole final decision-making power, was associated with significantly lower male involvement in pregnancy health. After adjustment for other covariates, each additional decision in which a woman had final say was associated with a significantly lower likelihood of her husband accompanying her to antenatal care (OR = 0.70, p < 0.01). Conversely, joint decision-making between the husband and wife was associated with significantly higher levels of male involvement in pregnancy health. For each additional decision made jointly with husbands, women were more likely to discuss health with their husbands (OR = 1.47, p < 0.001), to make birth preparations (OR = 1.19, p < 0.05), and to experience a high level of male involvement (OR = 1.29, p < 0.05). The positive associations between joint decision-making and male involvement imply that couple communication and shared negotiation strategies can improve health practices. These results indicate that programs intended to increase women's empowerment and/or women's health must consider the dynamics and ramifications of including or excluding males in their efforts. Involving husbands and encouraging couples' joint decision-making in reproductive and family health may provide an important strategy in achieving both women's empowerment and women's health goals. (c) 2005 Elsevier Ltd. All rights reserved.