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The Association Between Women's Empowerment and Reproductive Health Care Utilization in Cameroon.

BACKGROUND
The context related to maternal mortality has improved over the past decade in Cameroon. However, the demand for reproductive health care use remains insufficient with regard to public health policy targets, and women's empowerment is identified as a catalyst with a great potential. This study aims to analyse the association between the dimensions of women's empowerment and the utilization of adequate reproductive health care.


METHOD
The data comes from the fifth demographic and health survey of Cameroon carried out in 2018. Women's empowerment is measured through two indices: The economic status index and the decision-making index. Given the dichotomous nature of reproductive health outcomes, namely the use of at least four antenatal visits during pregnancy, the timing from the first antenatal visit and the place of delivery, a logistic regression model is adopted.


RESULTS
The results suggest that an increase in the decision-making index was significantly associated with higher chances of having at least four antenatal visits during pregnancy (OR: 1.25; 95% CI: 1.20, 1.29), of making the first prenatal visit during the first three months of pregnancy (OR: 1.03; 95% CI: 1.01, 1.07) and delivery in a hospital (OR: 1.34; 95% CI: 1.29, 1.39). However, a better economic status of the woman in the household was associated with lower chances of making the first prenatal visit during the first three months of pregnancy (OR: 0.65; 95% CI: 0.60, 0.71) and giving birth in a hospital (OR: 0.92; 95% CI: 0.83, 1.01); but no significant association was found with the number of antenatal visits. These different associations do not remain the same when mother and household characteristics are controlled. In addition, the results illustrate the key role that education, household wealth and media exposure played in the use of reproductive health care.


CONCLUSION
One of the strategic objectives of the Health Sector Strategy 2016-2027, the framework document for the public health policy in force, is to reduce maternal mortality rates by improving access to reproductive health care. To achieve this objective, this study suggests that policymakers should emphasize social policies favourable to women's empowerment in Cameroon, by pointing out access to income-generating activities and decision-making within the household.