What is it about?
Women’s empowerment and use of antenatal care (ANC) services remain important in the Association of Southeast Asian Nations (ASEAN). This study assessed the association between women’s empowerment and ANC use in five member states of the Association of Southeast Asian Nations (ASEAN) using data from Demographic Health Surveys. The number of ANC visits was positively associated with labor-force participation in Cambodia, the Philippines, and Timor-Leste; with disagreement with justification for wife beating and women’s knowledge level in Cambodia, Indonesia, Myanmar; and with women’s decision-making power in Cambodia and Indonesia. The association of women’s empowerment variables with timing of the first ANC visit was not as evident as that for number of ANC visits. Adolescent mothers had poorer access to ANC compared to adult mothers, especially for adolescent mothers with medium knowledge level that had less odds of attending ≥4 ANC in Cambodia, and adolescent mothers with the poorest labor-force participation that had lower odds of attending the first ANC early in Myanmar. Tailored policy on women’s improved access to labor force and health information in each country may be needed to improve ANC use.
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Why is it important?
Improving outcomes for reproductive, maternal, neonatal, and child health remains a challenge in most of the developing world, including Southeast Asia. Of six Southeast Asian (ASEAN) countries joining the Countdown to 2015,1 only two (Cambodia and Indonesia) achieved the Millennium Development Goals (MDG) 4 target to reduce child mortality, while two (Cambodia and Lao Republic) achieved the MDG 5 target to reduce maternal mortality (Victora et al. 2016). Inadequate ANC is potentially life-threatening for newborns (Doku and Neupane 2017). In Cambodia, the neonatal death rate among women who did not attend any ANC visits was more than six times greater than among women who attended four or more visits (Hong et al. 2017). However, the number of women attending four or more ANC visits in ASEAN varied, ranging from 55 to 87.8 percent, and the proportion of women attending the first ANC in the first trimester ranged from 40 to 80.4 percent. Women’s empowerment should be considered as an important element in attaining the minimum number of ANC visits, as it has been demonstrated to be positively associated with indicators of maternal health (Osamor and Grady 2016; Sado, Spaho, and Hotchkiss 2014) and health services (Pratley 2016). Too little attention, however, has been paid in ASEAN countries to find evidence of the relation of women’s empowerment to maternal and child health.
Perspectives
I hope this article makes policy makers understand that the issue of women's health is not merely the issue of health. It calls for innovative multisectoral efforts. This study shows that the use of antenatal care needs multisectoral approaches to improve women’s access to the labor force, such as creating job opportunities, providing microfinance and incentives on women entrepreneurship, and providing specific policies to support women at work, especially in Cambodia, Philippines, and Timor-Leste; and developing community-based women’s group and improving women’s access to health information through the media, especially in Cambodia, Indonesia, and Myanmar.
Susy Sebayang
Universitas Airlangga
Read the Original
This page is a summary of: Women’s empowerment and the use of antenatal care services: analysis of demographic health surveys in five Southeast Asian countries, Women & Health, April 2019, Taylor & Francis,
DOI: 10.1080/03630242.2019.1593282.
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