Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling
BackgroundSkilled birth attendants (SBA) facilitate identifying and overcoming labor problems and saving lives. With one of the highest maternal death rates in the Asia-Pacific area, SBA utilization during childbirth among Papua New Guinea (PNG) women remains low. Women’s status and empowerment are...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1192966/full |
| _version_ | 1797361387180130304 |
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| author | Hao Shen Hao Shen Hang Zhao Hang Zhao Baoqin Wang Baoqin Wang Yi Jiang Yi Jiang |
| author_facet | Hao Shen Hao Shen Hang Zhao Hang Zhao Baoqin Wang Baoqin Wang Yi Jiang Yi Jiang |
| author_sort | Hao Shen |
| collection | DOAJ |
| description | BackgroundSkilled birth attendants (SBA) facilitate identifying and overcoming labor problems and saving lives. With one of the highest maternal death rates in the Asia-Pacific area, SBA utilization during childbirth among Papua New Guinea (PNG) women remains low. Women’s status and empowerment are important factors in maternal and child health services and critical to maternal and child health development. This study is intended to apply structural equation modeling based on data from the Demographic and Health Survey (DHS) to evaluate the causal relationship between women’s status, empowerment, and SBA utilization in PNG and the mechanisms of their influence.MethodsThis study employed data from the 2016–2018 Papua New Guinea Demographic Health Survey (PNG DHS), which recruited 18,175 women aged 15–49 years. A multi-stage sample and a structured questionnaire were used to collect information on maternal health, women’s empowerment, and related topics. STATA 17.0 was used to describe the data, while MPLUS 8.2 was employed for structural equation modeling and pathway analysis.ResultsThe two empowerment dimensions of household decision-making (standardized path coefficient, β = 0.049, p < 0.05) and access to health services (β = 0.069, p < 0.01) were positively associated with SBA utilization, while the association between attitudes toward partner violence and SBA utilization was not statistically significant. In addition, mediation analysis revealed that education indirectly influenced SBA utilization through access to health services (β = 0.011, 95% CI: 0.002, 0.022).ConclusionThe findings confirmed the direct and indirect effects of women’s status and empowerment on SBA utilization in PNG. Therefore, a call for further evidence-based interventions in PNG and possibly Pacific Small Island Developing States (PSIDS) is needed to improve women’s educational attainment, household decision-making, and access to health services to enhance maternal and newborn health and well-being. |
| first_indexed | 2024-03-08T15:52:58Z |
| format | Article |
| id | doaj.art-ba763171fd394bbcbe2755fb256ea30f |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-08T15:52:58Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-ba763171fd394bbcbe2755fb256ea30f2024-01-09T04:14:47ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-01-011110.3389/fpubh.2023.11929661192966Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modelingHao Shen0Hao Shen1Hang Zhao2Hang Zhao3Baoqin Wang4Baoqin Wang5Yi Jiang6Yi Jiang7School of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaSchool of Public Health, Chongqing Medical University, Chongqing, ChinaBackgroundSkilled birth attendants (SBA) facilitate identifying and overcoming labor problems and saving lives. With one of the highest maternal death rates in the Asia-Pacific area, SBA utilization during childbirth among Papua New Guinea (PNG) women remains low. Women’s status and empowerment are important factors in maternal and child health services and critical to maternal and child health development. This study is intended to apply structural equation modeling based on data from the Demographic and Health Survey (DHS) to evaluate the causal relationship between women’s status, empowerment, and SBA utilization in PNG and the mechanisms of their influence.MethodsThis study employed data from the 2016–2018 Papua New Guinea Demographic Health Survey (PNG DHS), which recruited 18,175 women aged 15–49 years. A multi-stage sample and a structured questionnaire were used to collect information on maternal health, women’s empowerment, and related topics. STATA 17.0 was used to describe the data, while MPLUS 8.2 was employed for structural equation modeling and pathway analysis.ResultsThe two empowerment dimensions of household decision-making (standardized path coefficient, β = 0.049, p < 0.05) and access to health services (β = 0.069, p < 0.01) were positively associated with SBA utilization, while the association between attitudes toward partner violence and SBA utilization was not statistically significant. In addition, mediation analysis revealed that education indirectly influenced SBA utilization through access to health services (β = 0.011, 95% CI: 0.002, 0.022).ConclusionThe findings confirmed the direct and indirect effects of women’s status and empowerment on SBA utilization in PNG. Therefore, a call for further evidence-based interventions in PNG and possibly Pacific Small Island Developing States (PSIDS) is needed to improve women’s educational attainment, household decision-making, and access to health services to enhance maternal and newborn health and well-being.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1192966/fullPapua New Guineawomen’s empowermentstatus of womenskilled birth attendantsstructural equation modeling |
| spellingShingle | Hao Shen Hao Shen Hang Zhao Hang Zhao Baoqin Wang Baoqin Wang Yi Jiang Yi Jiang Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling Frontiers in Public Health Papua New Guinea women’s empowerment status of women skilled birth attendants structural equation modeling |
| title | Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling |
| title_full | Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling |
| title_fullStr | Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling |
| title_full_unstemmed | Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling |
| title_short | Women’s status, empowerment, and utilization of skilled delivery services in Papua New Guinea: an empirical analysis based on structural equation modeling |
| title_sort | women s status empowerment and utilization of skilled delivery services in papua new guinea an empirical analysis based on structural equation modeling |
| topic | Papua New Guinea women’s empowerment status of women skilled birth attendants structural equation modeling |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1192966/full |
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