Couples’ Reports of Household Decision-Making and the Utilization of Maternal Health Services in Bangladesh

William T. Story, University of Michigan

This study examines the association between maternal health service utilization and household decision-making in Bangladesh. Most studies of the predictors of reproductive health service use focus on the woman’s report of her own characteristics. This may be a limitation because, in many societies, decisions to use antenatal care or to deliver in a health facility are strongly influenced by family members, including the husband. We use matched husband and wife reports about who makes common household decisions to predict use of antenatal and delivery care, using data from the 2007 Bangladesh Demographic and Health Survey. Results from regression analyses suggest that it is important to consider whether husbands and wives agree about who makes household decisions since disagreeing about who makes these decisions is negatively associated with reproductive health care use. In addition, compared to joint decision-making, husband-only decision-making is negatively associated with antenatal care use and facility-based deliveries.