The Impact of Women’s Agency on Accessing and Using Maternal Healthcare Services: A Systematic Review and Meta-Analysis

Maryam Vizheh (), Frances Rapport, Jeffrey Braithwaite and Yvonne Zurynski
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Maryam Vizheh: Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
Frances Rapport: Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
Jeffrey Braithwaite: Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia
Yvonne Zurynski: Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW 2109, Australia

IJERPH, 2023, vol. 20, issue 5, 1-17

Abstract: Agency, defined as the ability to identify one’s goals and act upon them, has been recognized as a prominent strategy to access maternal healthcare services (MHS). The purpose of this study was to synthesize evidence of the association between women’s agency and MHS utilization. A systematic review was performed on five academic databases, comprising Scopus, PubMed, Web of Science, Embase, and ProQuest. Meta-analysis was performed with a random-effects method using the STATA™ Version 17 software. A total of 82 studies were selected following the PRISMA guidelines. The meta-analysis demonstrated that an increase in women’s agency was associated with a 34% increase in the odds of receiving skilled antenatal care (ANC) (OR = 1.34, 95% CI = 1.18–1.52); 7% increase in the odds of initiating the first ANC visit during the first trimester of pregnancy (OR = 1.07, 95% CI = 1.01–1.12); 20% increase in the odds of receiving at least one ANC visit (OR = 1.20, 95% CI = 1.04–1.4); 16% increase in the odds of receiving more than four ANC visits during pregnancy (OR = 1.16, 95% CI = 1.12–1.21); 17% increase in the odds of receiving more than eight ANC visits (OR = 1.17, 95% CI = 1.04–1.32); 13% increase in the odds of facility-based delivery (OR = 1.13, 95% CI = 1.09–1.17); 16% increase in the odds of using skilled birth attendants (OR = 1.16, 95% CI = 1.13–1.19); and 13% increase in the odds of receiving postnatal care (OR = 1.13, 95% CI = 1.08–1.19) compared to low level of agency. Any efforts to improve MHS utilization and reduce maternal morbidity and mortality should include the promotion of women’s agency.

Keywords: maternal health services; health services; women’s agency; empowerment; systematic review; meta-analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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