Women’s Autonomy and Male Involvement in Antenatal Care in Katmandu, Nepal: Associations and Tensions

Britta C. Beenhakker, Johns Hopkins University
Stan Becker, Johns Hopkins University

Women’s empowerment programs focus primarily on increasing the decision-making power of women, while male involvement/couple friendly programs emphasize communication and negotiation between couples in making decisions. A survey focusing on the role of husbands during pregnancy and household decision-making was administered to 592 pregnant women receiving antenatal services at the largest maternity hospital in Katmandu, Nepal. In-depth-interviews and focus group discussions were also conducted. Multivariate regression techniques were used to compare male involvement behaviors across different levels of women’s autonomy. Higher women’s autonomy, as measured by sole final decision-making power, was associated with less male involvement in pregnancy health. Conversely, joint decision-making between the husband and wife was associated with higher levels of male involvement. These qualitative and quantitative data illustrate the inherent tensions between women’s empowerment and male involvement goals by assessing how different decision-making patterns within couples influence the degree of male spousal involvement in pregnancy health.