Description
Background: Women's healthcare decision-making power is vital for well-being and has far-reaching implications for gender equality, human rights, sustainable development, economic productivity, social justice, and equity. This study compares the impact of women's healthcare decision-making power on the comprehensive utilization of maternal health services among left-behind women and their counterparts in rural Koch Bihar, West Bengal.
Method: Our fieldwork was conducted from October 2022 to February 2023 in rural Koch Bihar, West Bengal. We employed a mixed-methods approach involving surveys, interviews, and focus group discussions with left-behind women in the district. The study included 384 women aged 15-49 who had given birth to a live baby within the five years preceding the survey, with 192 having migrant husbands and 192 having resident husbands. We analyzed the data to explore the relationship between women's healthcare decision-making power and comprehensive maternal healthcare services.
Results: The results of the bivariate analysis demonstrated that women with migrant husbands had a significantly higher prevalence of healthcare decision-making power compared to women with non-migrant husbands. Further, multivariate analysis showed that women with migrant husbands who make healthcare decisions alone have higher odds of accessing comprehensive maternal healthcare services compared to those who make decisions jointly with their husbands (AOR=0.213; 95% CI: 0.077-0.584), decisions made by the husband alone (AOR=0.156; 95% CI: 0.044-0.547), and decisions made by in-laws or others (AOR=0.303; 95% CI: 0.092-0.995). Conversely, women with non-migrant husbands had the odds of accessing comprehensive maternal care services twice (AOR=2.098; 95% CI: 0.748-5.883) who make healthcare decisions jointly with their husbands compared to those who make healthcare decisions alone. Additionally, several factors, such as women's working status, husband's education, wealth quintile, and social group, played a role in women's comprehensive healthcare services.
Conclusion: Our findings suggest. that husband migration is a risk factor for unhealthy behaviours among women in rural Koch Bihar. Furthermore, these findings should guide policymakers and healthcare providers in developing tailored interventions to address the specific needs of left-behind mothers.
Keywords: Husband migration, Healthcare autonomy, Maternal health services, Koch Bihar.
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