Investigating Pathways Linking Women's Status and Decision-Making Power to the Use of Skilled Birth Attendants at Childbirth in Senegal and Tanzania

Kyoko Shimamoto, University of California, Los Angeles
Jessica D. Gipson, University of California, Los Angeles

The progress in reducing maternal mortality and increasing Skilled Birth Attendant (SBA) use has stagnated in sub-Saharan Africa. This study assesses the pathways linking women’s status and decision-making power to SBA use, using the 2010 Demographic and Health survey in Senegal (weighted n=7,137) and Tanzania (n=4,516). The result of regression and mediation analyses shows the positive relationship of women’s education and decision-making power with SBA use, net of sociodemographics in Tanzania. It also shows the evidence of the pathways from education, through decision-making power, and to SBA use, specifically among women with no formal education in Tanzania (Sobel test=-1.95, p<0.05). However, the relationship of education and decision-making power with SBA use is not significant, net of sociodemographics in Senegal. Maternal health programs may potentially accelerate SBA use by focusing on women’s empowerment, yet the contextual nature of women’s status and empowerment should be carefully considered.