Women’s Empowerment and Community Norms Association on Women’s Access to Health Facility Delivery in Ethiopia. A Multilevel Analysis.

Women’s Empowerment and Community Norms Association on Women’s Access to Health Facility Delivery in Ethiopia. A Multilevel Analysis. | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Women’s Empowerment and Community Norms Association on Women’s Access to Health Facility Delivery in Ethiopia. A Multilevel Analysis. Daniel Bekele This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-574394/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Health-care facility delivery was the most critical in ensuring the provision of high-quality care and a distribution location that was ready in the case of an emergency for reproductive women. However, maternal mortality remains high in African nations, and the majority of women were still giving birth at home. This study was aimed to determine whether women's empowerment and community norms, plus other proximate factors, are related to the health facility delivery utilization of women in Ethiopia. Methods The data for this study was taken from the Performance Monitoring for Action (PMA) in Ethiopia of the 2019 cross-sectional survey. A weighted sample of 4864 women with at least one birth history, clustered within 264 clusters was used for this study. The impact of women's empowerment, cultural norms, and other proximate factors on the use of health facility deliveries among reproductive-age women across clusters in Ethiopia was studied using a two-level multilevel logistic regression. Results In Ethiopia, around 51 % of women were delivered their most recent child at the health facility. The use of a health facility delivery was more common among empowered women and those living in where the most people encourage a health facility delivery. Older women were less likely to deliver at a health facility and women from the highest wealth quantile more likely to have a facility delivery. Those women with higher education and living in an urban area were more likely to have a health facility delivery. Women’s chances of giving birth in health facilities vary significantly across the 264 clusters of Ethiopia ( σ_uo^2 =2.49,p.value<0.001). Conclusions This study emphasizes the importance of women's empowerment and cultural norms in enhancing maternal health outcomes of women in Ethiopia. It is more important than ever that the government and development agency should invest more in women's empowerment and raising community consciousness about the benefits of using health facility delivery as part of a strategic intervention to improve maternal health outcomes. Health Economics & Outcomes Research Health-care facility cross-sectional survey empowered women health facility delivery Full Text Due to technical limitations, full-text HTML conversion of this manuscript could not be completed. However, the manuscript can be downloaded and accessed as a PDF. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-574394","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":30479006,"identity":"63de74c4-b66b-4d73-a94c-7c956f9dd657","order_by":0,"name":"Daniel Bekele","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA90lEQVRIiWNgGAWjYDCCAyDEBmIxNj74AKTY2InWwsbcbDgDTBOhhQGihb1NmgfEIaSF7/jZgwd+lB2WM5dvbJC2+bVNno+ZgfHDxxzcWiTP5CUc7Dl32NiyjbHBOLfvtmEbMwOz5MxtuLUYHMgxOMDblpa44RhjQ3Juz21GoBY2Zl58Ws6/MTj4ty2tHqTlsGXPbXvCWm7kGBzmbbNJMDjG2NjM8ON2IkEtkjfeGByWOWdjuOFYYjNjb8Pt5DZmxma8fuE7n2P88U2ZhLzB4ePPf/z4c9t2fnvzwQ8f8WhBBYxtYLKBWPUg8IcUxaNgFIyCUTBSAABPSFg1hkW/6gAAAABJRU5ErkJggg==","orcid":"","institution":"Dire Dawa University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Daniel","middleName":"","lastName":"Bekele","suffix":""}],"badges":[],"createdAt":"2021-05-30 14:44:01","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-574394/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-574394/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":13640017,"identity":"9e915939-6650-49aa-bf33-90d2922fd320","added_by":"auto","created_at":"2021-09-17 08:58:12","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":253124,"visible":true,"origin":"","legend":"","description":"","filename":"Fullmanuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-574394/v1_covered.pdf"},{"id":9994706,"identity":"fd43c806-5ee2-413c-9c5b-26ae2467ba29","added_by":"auto","created_at":"2021-06-04 17:19:27","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":249519,"visible":true,"origin":"","legend":"","description":"","filename":"Fullmanuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-574394/v1_covered.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eWomen’s Empowerment and Community Norms Association on Women’s Access to Health Facility Delivery in Ethiopia. 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However, maternal mortality remains high in African nations, and the majority of women were still giving birth at home. This study was aimed to determine whether women's empowerment and community norms, plus other proximate factors, are related to the health facility delivery utilization of women in Ethiopia. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eThe data for this study was taken from the Performance Monitoring for Action (PMA) in Ethiopia of the 2019 cross-sectional survey. A weighted sample of 4864 women with at least one birth history, clustered within 264 clusters was used for this study. The impact of women's empowerment, cultural norms, and other proximate factors on the use of health facility deliveries among reproductive-age women across clusters in Ethiopia was studied using a two-level multilevel logistic regression. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e \u003c/p\u003e\u003cp\u003eIn Ethiopia, around 51 % of women were delivered their most recent child at the health facility. The use of a health facility delivery was more common among empowered women and those living in where the most people encourage a health facility delivery. Older women were less likely to deliver at a health facility and women from the highest wealth quantile more likely to have a facility delivery. Those women with higher education and living in an urban area were more likely to have a health facility delivery. 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