title: Women at risk: Gender inequality and maternal health.
abstract: Gender inequality has been documented as a key driver of negative health outcomes, especially among women. However, studies have not clearly examined the role of gender inequality in maternal health in an African setting. Therefore, the authors of this study examined the role of gender inequality, indicated by lack of female autonomy, in exposing women to maternal health risk. Data were obtained from the 2007 Zambia Demographic and Health Survey on a weighted sample of 3,906 married or partnered women aged 15-49 years. Multivariable analyses revealed that low autonomy in household decision power was associated with maternal health risk (Odds Ratio (OR) = 1.52, p < .001). Autonomy interacted with household wealth showed that respondents who were in the wealthier households and had low autonomy in household decision power (OR = 2.03, p < .05) were more likely to be exposed to maternal health risk than their counterparts who had more autonomy. Efforts to lower women's exposure to maternal mortality and morbidity in Zambia should involve interventions to alter prevailing gender norms that limit women's active participation in decisions about their own health during pregnancy and delivery.
authors.affiliation: a Demography and Population Studies Programme , Schools of Public Health and Social Sciences, University of the Witwatersrand , Johannesburg , South Africa.|b Provincial Education Offices, Ministry of Education , Lusaka , Zambia.
authors.forename: Pamela C
authors.initials: PC
authors.lastname: Banda
authors.affiliation: a Demography and Population Studies Programme , Schools of Public Health and Social Sciences, University of the Witwatersrand , Johannesburg , South Africa.
authors.forename: Clifford O
authors.initials: CO
authors.lastname: Odimegwu
authors.affiliation: a Demography and Population Studies Programme , Schools of Public Health and Social Sciences, University of the Witwatersrand , Johannesburg , South Africa.|c Department of Demography and Social Statistics , Federal University Oye-Ekiti , Ekiti State , Nigeria.
authors.forename: Lorretta F C
authors.initials: LF
authors.lastname: Ntoimo
authors.affiliation: a Demography and Population Studies Programme , Schools of Public Health and Social Sciences, University of the Witwatersrand , Johannesburg , South Africa.
authors.forename: Evans
authors.initials: E
authors.lastname: Muchiri
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D000068097:Maternal Health; D008427:Maternal Health Services; D008428:Maternal Mortality; D008875:Middle Aged; D026684:Personal Autonomy; D011247:Pregnancy; D012959:Socioeconomic Factors; D055815:Young Adult; D015024:Zambia
keywords: Female autonomy; Zambia; gender inequality; maternal health