Determinants of healthcare decision-making autonomy among Bangladeshi women: mixed-effect logistic regression analysis.

Background: Women's healthcare decision-making autonomy is observed to play a significant role in improving maternal and child health outcomes. However, there is a dearth of research that addressed this issue in the Bangladeshi context. Therefore, this study aimed to estimate the prevalence of healthcare decision-making autonomy and its determinants among Bangladeshi women.

Methods: Data on 18,890 (weighted) women's healthcare autonomy were driven from the Bangladesh Demographic and Health Survey (BDHS) 2017-18. A multilevel (mixed-effect) logistic regression model was applied to explore the determinants of healthcare autonomy.

Results: Overall weighted prevalence of healthcare autonomy was 76.5% (95% CI: 75.85-77.06). The odds of having healthcare autonomy were higher among women belonging to 25-34 years (aOR: 1.69, 95% CI: 1.52-1.87), and 35-49 years (aOR: 1.89, 95% CI: 1.65-2.17) age group, attaining secondary (aOR: 1.31, 95% CI: 1.14-1.50), and higher education (aOR: 1.61, 95% CI: 1.33-1.94), who were employed (aOR: 1.37, 95% CI: 1.26-1.50), who read newspaper/magazine at least once a week (aOR: 1.45, 95% CI: 1.13-1.84), having 1-2 (aOR: 1.91, 95% CI: 1.67-2.17), and 3 or more (aOR: 1.94, 95% CI: 1.65-2.27) living children, gave no birth in the last 3 years (aOR: 1.17, 95% CI: 1.06-1.29), and from urban areas (aOR: 1.43, 95% CI: 1.25-1.63).

Conclusion: Around one-quarter of the women were not autonomous regarding their healthcare decision-making. So, it is necessary to implement strategies and policies that can enable and empower women in the healthcare aspects of their lives.