Background

Pervious evidences attempted to explore the barriers of healthcare service utilization, from demographic and economic, sociocultural and behavioral perspectives. Several studies emphasizing the role of women decisions-making power on health service utilization. Some studies showed the importance of independency of women on decision making. USAID Transform: Primary Health Care project, funded by the United States Agency for International Development, recognizes the importance of gender as a key social determinate of health by addressing gender gaps and opportunities to improve healthcare service utilization. The aim of this study is to describe the association between women’s decision-making power and utilization of healthcare service among women in project target areas. The result will be used for project planning

Method

A cross sectional multistage simple random sampling technique was used. A sample of 3,433 households were randomly selected.  Wife’s in selected households asked about their decision-making power on their own health care. It is assumed that if a wife has ability to decide on their own health she can also decide for family members, for her children. Data on family planning use for women of age 15-49 years, place of delivery for women with children under two years and health seeking behavior for children who were sick in the last two weeks before the data of data collection were collected that can be used to measure household level service utilization practices. Data collection was conducted from October 01- December 31, 2017 as part of project follow up visit activities. Household questionnaire/ checklist was used to collect the required data.

Results

Family planning use, institutional delivery and health seeking behavior for sick child were 48.4%, 71.3% and 62.6%, respectively, while Wife’s decision making power for  own health care is 82.8%. Modern family planning use, institutional delivery and health seeking behavior are 50.6%, 75% and 65.5%, respectively, among married women who are found in households with wife’s decision-making power, versus 37.9%, 53.6% and 50.4%, in the same order, among women who are found in households without wife’s decision-making power. The odds rations are (OR=1.3, 95% CI:1.01-1.69), (OR=2.4, 95% CI:1.74-3.43) and (OR=1.7, 95% CI [0.99-2.77]), in the same order, which is statistically significant except health seeking behavior for sick children.

Conclusion

This study showed that improved women’s perception towards own health decision making improves households service uptake. In line with this, the project is advised to implement intervention that can improve women’s decision-making power which in turn increase service uptake in project areas.