Women's Autonomy in Decision Making for Health Care in South Asia

TLDR

The study examines determinants of women’s autonomy in health‑care decision making across three South Asian countries using nationally representative surveys. Autonomy was measured by whether women participated alone or jointly in household health‑care decisions, with data drawn from the surveys. Results show that in Nepal, Bangladesh, and India, 72.7%, 54.3%, and 48.5% of households made health‑care decisions without women, whereas 79.7% of Sri Lankan households jointly decided on contraceptive use; participation increased with age, education, number of children, employment, and income, and was lower among rural and poor women.

Abstract

This article aims to discuss women's autonomy in decision making on health care, and its determinants in 3 South Asian countries, using nationally representative surveys. Women's participation either alone or jointly in household decisions on their own health care was considered as an indicator of women's autonomy in decision making. The results revealed that decisions of women's health care were made without their participation in the majority of Nepal (72.7%) and approximately half of Bangladesh (54.3%) and Indian (48.5%) households. In Sri Lanka, decision making for contraceptive use was a collective responsibility in the majority (79.7%). Women's participation in decision making significantly increased with age, education, and number of children. Women who were employed and earned cash had a stronger say in household decision making than women who did not work or worked not for cash. Rural and poor women were less likely to be involved in decision making than urban or rich women.