Percentage of currently married women who usually make a decision about their own health care either by themselves or jointly with their husbands (HIV-O11)

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Percentage of currently married women who usually make a decision about their own health care either by themselves or jointly with their husbands (HIV-O11)
What it measures

This indicator of women’s roles in decision-making about their own health care helps to evaluate women’s control over their lives and environment. Further, since it measures decisionmaking about health, it provides direct insight into women’s ability to access healthcare, potentially including care of HIV related needs.

Rationale

The ability to make decisions about their own life is important to women’s empowerment. After marriage, gender restrictions and social norms (including limited mobility and decision making), in addition to an unsupportive environment for young women’s reproductive health, may prevent women from accessing RH care and family planning services. Gender inequality is often cited as a barrier to improving maternal health, and several studies have found that women's autonomy is associated with lower fertility and greater contraceptive use (Gage 1995; Morgan and Niraula 1995; Govindasamy and Malhotra 1996), especially in marriage. These results suggest that women who enjoy greater mobility, decision making power, and control over resources are better able to allocate resources to benefit their children, to make use of health-care and family planning services, and to engage in healthier practices in general.

Numerator

Number of currently-married women who usually make a decision about own health care either by themselves or jointly with their husbands

Denominator

Number of currently-married women surveyed

Calculation

Numerator/Denominator

Method of measurement

Through Population-based surveys, such as DHS

Measurement frequency

Every 4-5 years

Disaggregation
Explanation of the numerator
Explanation of the denominator
Strengths and weaknesses

The indicator has been measured using a standard question since late 1990s. The question used is easy to implement and understand. Use of standardized data collection and analysis methods, which allow for cross-country comparisons, enhance the usefulness of the indicator for measuring variations across countries and changes over time.
This indicator assesses progress in changing gender norms about women’s roles, and provides an indication of the level of gender equality. This means that an increase in women’s direct participation in decisions about their own health care is reflective of a decline in gender inequality—which is one of the structural factors driving the HIV epidemic. Due to the fact that this indicator monitors change in norms, it can be expected to change only slowly over time, and would not be directly linked to level of programming. It should be analyzed together with other indicators looking at changes in unequal gender norms, gender relations at the household and community level, women’s legal and customary rights, gender inequalities in access to health care, education, and economic and social resources, and male involvement in reproductive and child health.
This indicator is based on a question put to respondents in a survey, which means it is self- reported. Further, since the question is asked only to currently married women, it is more directly a manifestation of norms within marriage; however, such norms are likely to be reflective of gender inequality in the society as a whole.

Further information