Exploring the relationship between women’s health autonomy and mental health in Senegal

Public Health. 2025 May 3;244:105746. doi: 10.1016/j.puhe.2025.105746. Online ahead of print.

ABSTRACT

OBJECTIVES: This study explores the relationship between women’s healthcare autonomy and mental health in Senegal, where cultural and societal norms often marginalize women’s autonomy. Recognizing autonomy as a crucial determinant of well-being, the study aims to evaluate how autonomy in health-related decision-making correlates with mental health.

STUDY DESIGN: Cross-sectional study.

METHODS: A sample of 10,983 women (15-49 years) was drawn from the 2023 Senegal Continuous Demographic and Health Survey data. The outcome variable (mental health status) was assessed through three self-reported indicators, including depression symptoms, loss of interest, and suicidal thoughts. The main independent variable, women’s health autonomy, was categorized into those with and without autonomy over healthcare decisions. Multivariable logistic regression models were applied to evaluate the relationship between women’s health autonomy and their mental health status.

RESULTS: Overall, 34.33 % of the women reported feeling sad/depressed, 27.68 % reported losing interest in anything and 21.55 % reported having suicidal thoughts. Also, only 10.73 % had autonomy over their healthcare decisions. Women with health autonomy were less likely to feel sad/depressed (AOR = 0.81, 95 % CI = 0.67-0.98), lose interest in anything (AOR = 0.78, 95 % CI = 0.65-0.94), and have suicidal thoughts (AOR = 0.69, 95 % CI = 0.52-0.91) compared to women without autonomy.

CONCLUSIONS: Women’s healthcare autonomy is a significant protective factor against mental health challenges. Policies enhancing women’s autonomy could improve mental health outcomes, highlighting a critical need for gender-responsive healthcare reforms in Senegal and similar contexts.

PMID:40319701 | DOI:10.1016/j.puhe.2025.105746