Empowerment at the Core: Decoding the Determinants of Skilled Birth Attendance in Pakistan
AI Summary
Women's empowerment is essential for skilled birth attendance; education, mobile and internet access and rejecting domestic violence norms significantly increase SBA likelihood.
Empowerment effects are comparable to household wealth and parity; socioeconomic and geographic disparities, notably in Baluchistan and larger families, reduce SBA.
Policy and maternal health interventions must prioritise women's resources, agency and relational autonomy to reduce childbirth biological risks and improve SBA coverage.
Am J Hum Biol. 2026 May;38(5):e70272. doi: 10.1002/ajhb.70272.
ABSTRACT
BACKGROUND: The maintenance of hygienic conditions and the provision of appropriate medical care during childbirth are essential to reduce the complications and infections that pose health risks to both expectant mothers and their newborn babies. Although skilled birth attendance (SBA) has been very much helpful in reducing the biological risks linked to childbirth, it is pertinent to mention that more than 34% of deliveries in Pakistan continue to take place at home without the proper medical care and supervision.
OBJECTIVE: The main objective of this proposed work is to explore the correlation between women’s empowerment characterized by resources, agency, and relational autonomy and access to skilled birth attendance within the reproductive and sociocultural context of Pakistan. This study also considers the influence of various socioeconomic and demographic factors on this correlation.
DATA AND METHODS: The present study utilizes the logistic regression models to estimate average marginal effects, using nationally representative data from currently married women aged 15-49 as mentioned in the Pakistan Demographic and Health Survey 2017-18. This analysis aims to evaluate the relative contributions of different empowerment dimensions, while simultaneously controlling for household and demographic characteristics.
RESULTS: Women empowerment is a very important part of skilled birth attendance. The relationship between educational empowerment, digital access, specifically ownership of mobile phones and internet usage, and the rejection of norms related to domestic violence substantially enhances the probability of skilled birth attendance. This phenomenon exhibits effects that are comparable to those of conventional determinants, including household wealth and parity. Significant disparities persist in geographic and socio-economic contexts, adversely affecting mothers in Baluchistan, particularly those with larger families.
CONCLUSION: This study demonstrates that the empowerment of women within the context of Pakistan’s reproductive ecology is essential, rather than ancillary, for reducing biological risks associated with childbirth. It provides comparative insights that are pertinent to the fields of human biology and maternal health research.
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