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MGH4006 Critical Appraisal *Methodology and Statistics II* of 2020/2021 graded with a 8
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A critical appraisal based on “Utilization of Maternal Health Services in Nepal” by Paudel and Pitakmanaket (2010)
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A critical appraisal based on “Utilization of Maternal HealthServices in Nepal” by Paudel and Pitakmanaket (2010)
Written by
Juweriya J. Salah – i6245651
Faculty of Health, Medicine and Life Sciences at Maastricht University
MGH4006 Methodology and Statistics II
Professor: Dr. Valéria Lima Passos
March 14th, 2021
, Executive summary:
Maternal mortality is recognized as a major health problem in Nepal. The country is faced
with one of the highest maternal mortality rates in South Asia. A contributing factor could be
the under-utilization of maternal health services which is notably understood to play a pivotal
role in reducing maternal mortality. However, service utilization can be influenced by several
factors including a women’s autonomy. Yet, limited studies have examined women's
autonomy and its impact on the utilization of maternal health services. The purpose of this
study was therefore to examine the independent association between women’s autonomy and
the utilization of maternal health services. Data of this cross-sectional study was derived from
the Nepal Demographic Health Survey conducted in 2001. The analysis included 3119
married women aged 15-49, who had given birth three years preceding the survey.
Multivariate logistic regression was carried out to analyze the covariates (women's autonomy,
sociodemographic factors, and perceived problems in accessing health services) on the three
dependent variables (utilization of antennal care, birth attendants, and healthcare facilities) of
maternal health services. Women’s autonomy was measured by decision-making,
employment status, control over the use of their earnings, control over the livestock, and
spousal communication. The study findings showed some positive associations between a
women’s autonomy and the utilization of maternal health services. When all variables except
age were taken into account, decision-making and spousal communication were mostly
associated with maternal health services. This study suggests the implementation of
awareness campaigns and educational programs to increase women's autonomy and
utilization of maternal services in Nepal.
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