Women’s Autonomy, Maternal child healthcare Practices and Child Mortality in the Upper East Region of Ghana

Abstract

Eight years to the deadline for the 2030 SDGs, child survival remains high and a major health challenge in Ghana and much of the sub-Saharan region. Child’s survival is greatly dependent on household circumstances and the mother’s healthcare choices before, during, and after birth. In Ghana, several policies and programmes have been implemented to facilitate women’s empowerment in all aspects of life. However, there is a paucity of literature on how this translates to improved child health in impoverished and male-dominated settings. Guided by a critical realist’s paradigm, the study used mixed research methods to examine the effects and context of women’s autonomy on maternal child healthcare practices and child mortality in the Upper East Region of Ghana. It found that women’s autonomy was not a strong predictor of antenatal care attendance and facility delivery. However, women’s autonomy was positively associated with the initiation of breastfeeding but negatively associated with exclusive breastfeeding and age-appropriate vaccination. Also, women’s autonomy was not protective of child mortality. Narratives by mothers and mother/father-in-laws revealed that women’s autonomy is a fluid concept and needs to be interpreted in context, because of the socially embedded context of family life and the role of significant others in child health in the study setting. The study concludes that the relationship between women’s autonomy and maternal healthcare practices and child mortality is inconsistent. It recommends the empowerment of women through formal education and small-scale livelihood enterprises alongside efforts to increase utilization of essential early childhood interventions towards the attainment of SGD 3& 5 in the Upper East region of Ghana and similar settings.