L’autonomie décisionnelle des femmes permettrait elle de réduire les taux d’accouchements à domicile au Sénégal ? une analyse par appariement de score de propension

NDEYE MAREME SOUGOU; Bassoum  Oumar; Diouf Jean Baptiste Niokhor; Seck Ibrahima

doi:10.4314/rasp.v6i2.6

Authors

NDEYE MAREME SOUGOU Service Médecine Préventive et Santé Publique, Université Cheikh Anta Diop , Dakar
Bassoum Oumar
Diouf Jean Baptiste Niokhor
Seck Ibrahima

DOI:

https://doi.org/10.4314/rasp.v6i2.6

Keywords:

Autonomy of decision-making for health, childbirth in the home, Senegal

Abstract

In West Africa, studies have shown that maternal deaths are higher in rural areas, where 80% of deliveries are performed at home without skilled attendants. This study examines the effect of women's autonomy for their health on home deliveries in Senegal. We applied the propensity score matching (PSM) approach to explore the relationship between women's autonomy in healthcare decisions and home birth. PSM is a strategy for reducing sampling bias by balancing sample characteristics and miming randomization on cross-sectional data. Data were collected from Senegal DHS surveys conducted in 2017. Women's decision-making autonomy was the primary explanatory variable of interest for home birth. Analyses were done with STATA.15 software. Eight thousand eight hundred and sixty-five (8865) women between the ages of 15 and 49 were surveyed in the DHS 2017. Women who have the latitude to decide on their health represent 6.26%. Women giving birth at home accounted for 21.67%. There was a decrease in home births of 31.64% from 53.33% to 21.15% among women who were autonomous in deciding about their health. Autonomy in healthcare decision-making would reduce home births. These results show the importance of gender mainstreaming for accessing maternity services in Senegal.

References

Ag Ahmed MA, Hamelin-Brabant L, Gagnon MP. Sociocultural determinants of nomadic women’s utilization of assisted childbirth in Gossi, Mali: a qualitative study. BMC Pregnancy Childbirth. 2018;18(1):388

Alkema L, Chou D, Hogan D, Zhang S, Moller A-B, Gemmill A, et al. Global, regional, and national levels and trends in maternal mortality between 1990 and 2015, with scenario-based projections to 2030: a systematic analysis by the UN Maternal Mortality Estimation Inter-Agency Group. The Lancet. 2016;387(10017):462‑74.

Ali M, Farron M, Ouedraogo L, Mahaini RK, Miller K, Kabra R. Research gaps and emerging priorities in sexual and reproductive health in Africa and the eastern Mediterranean regions. Reprod Health. 2018;15(1):39

Ameyaw EK, Tanle A, Kissah-Korsah K, Amo-Adjei J. Women’s Health Decision-Making Autonomy and Skilled Birth Attendance in Ghana. Int J Reprod Med. 2016; 6569514.

Austin PC, Grootendorst P, Anderson GM. A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study. Statist Med. 2007;26(4):734‑53.

Berhe R, Nigusie A. Magnitude of home delivery and associated factors among child bearing age mothers in Sherkole District, Benishangul Gumuz regional state-Western-Ethiopia. BMC Public Health. 2020;20(1):796.

Chol C, Negin J, Agho KE, Cumming RG. Women’s autonomy and utilisation of maternal healthcare services in 31 Sub-Saharan African countries: results from the demographic and health surveys, 2010-2016. BMJ Open. 2019;9(3):e023128.

Darteh EKM, Dickson KS, Doku DT. Women’s reproductive health decision-making: A multi-country analysis of demographic and health surveys in sub-Saharan Africa. PLoS One. 2019 ;14(1):e0209985

Eshete T, Legesse M, Ayana M. Utilization of institutional delivery and associated factors among mothers in rural community of Pawe Woreda northwest Ethiopia, 2018. BMC Res Notes. 2019;12(1):395.

Exavery A, Kanté AM, Njozi M, Tani K, Doctor HV, Hingora A, et al. Access to institutional delivery care and reasons for home delivery in three districts of Tanzania. Int J Equity Health. 2014; 13:48.

Fapohunda BM, Orobaton NG. When women deliver with no one present in Nigeria: who, what, where and so what? PLoS ONE. 2013;8(7):e69569

Faye A, Wone I, Samb OM, Tal-Dia A. Étude des facteurs contributifs de l’accouchement à domicile (Sénégal). Bull Soc Pathol Exot. 2010;103(4):246‑51.

Faye A, Niane M, Ba I. Home birth in women who have given birth at least once in a health facility: contributory factors in a developing country. Acta Obstet Gynecol Scand. 2011;90(11):1239‑43.

Kifle MM, Kesete HF, Gaim HT, Angosom GS, Araya MB. Health facility or home delivery? Factors influencing the choice of delivery place among mothers living in rural communities of Eritrea. J Health Popul Nutr. 2018; 37(1):22

Leuven E, Sianesi B. PSMATCH2: Stata module to perform full Mahalanobis and propensity score matching, common support graphing, and covariate imbalance testing [Internet]. 2018 [cité 13 sept 2019]. (Statistical Software Components). Disponible sur: https://econpapers.repec.org/software/bocbocode/S432001.htm

Morgan R, Tetui M, Muhumuza Kananura R, Ekirapa-Kiracho E, George AS. Gender dynamics affecting maternal health and health care access and use in Uganda. Health Policy Plan. 2017; 32(suppl_5):v13‑21.

Osamor PE, Grady C. Autonomy and couples’ joint decision-making in healthcare. BMC Med Ethics. 2018;19(1):3.

Rapport Final EDS 2017.pdf [Internet]. [cité 9 sept 2019]. Disponible sur: http://www.ansd.sn/ressources/rapports/Rapport%20Final%20EDS%202017.pdf

Ronsmans C, Etard JF, Walraven G, Høj L, Dumont A, de Bernis L, et al. Maternal mortality and access to obstetric services in West Africa. Trop Med Int Health. 2003;8(10):940‑8.

Sougou NM, Bassoum O, Faye A, Leye MMM. Women’s autonomy in health decision-making and its effect on access to family planning services in Senegal in 2017: a propensity score analysis. BMC Public Health. 2020;20(1):872.

Sougou NM, Sougou AS, Bassoum O, Leye MMMb, Faye A, Seck I. (sous presse) Facteurs associés à l’autonomie de décision des femmes pour leur santé au Sénégal en 2017. Santé Publique. 2020;1‑8.