Empowering Women through Maternal Health Education: Impacts on Decision-Making and Health Outcomes
DOI:
https://doi.org/10.37899/mjdh.v2i1.242Keywords:
Antenatal Care, Decision-Making Autonomy, Maternal Health Education, Maternal Healthcare Utilization, Women’s EmpowermentAbstract
The effects of maternal health education on women's decision making autonomy and maternal health outcomes in Indonesia are explored. Data were obtained from 305 women of reproductive age by structured questionnaires in a quantitative cross sectional design and analyzed by descriptive statistics, regression analysis and mediation analysis. The results show that maternal health education has a significant effect on increasing women's autonomy in decision making regarding health services and utilization of antenatal, facility-based delivery and postnatal health services. The study also indicates that the relationship between maternal health education and maternal healthcare utilisation is partially mediated by women's decision making autonomy. The novelty of the research is the incorporation of an education intervention and empowerment approach in analyzing maternal health care. The results suggest that maternal health programs need to go beyond informing to include strategies that empower women, thereby enhancing their agency and access to healthcare. This study is a step towards more inclusive and sustainable policies for maternal health care in the context of a developing country.
References
Aikpitanyi, J., Yacin, F., & Tubeuf, S. (2024). Effectiveness of behavioural change interventions to influence maternal and child healthcare-seeking behaviour in low and lower-middle-income countries. African Journal of Reproductive Health/La Revue Africaine de la Santé Reproductive, 28(4), 127-148. https://doi.org/10.29063/ajrh2024/v28i4.12
Alam, C. E., Abou-Abbas, L., Ramadan, M. S., & Asmar, M. K. (2025). Exploring the barriers to accessing antenatal care at the primary health care center level of a tertiary hospital in Lebanon: a qualitative study. BMC health services research, 25(1), 304. https://doi.org/10.1186/s12913-025-12444-y
Besnier, E. (2023). Women’s political empowerment and child health in the sustainable development era: A global empirical analysis (1990–2016). Global Public Health, 18(1), 1849348. https://doi.org/10.1080/17441692.2020.1849348
Bohren, M. A., Iyer, A., Barros, A. J., Williams, C. R., Hazfiarini, A., Arroyave, L., ... & Oladapo, O. T. (2024). Towards a better tomorrow: addressing intersectional gender power relations to eradicate inequities in maternal health. EClinicalMedicine, 67. https://doi.org/10.1016/j.eclinm.2023.102180
Chowdhury, J., & Ravi, R. P. (2022). Healthcare accessibility in developing countries: A global healthcare challenge. J Clin Biomed Res, 4(152), 2-5. https://doi.org/10.47363/JCBR/2022(4)152
Cresswell, J. A., Alexander, M., Chong, M. Y., Link, H. M., Pejchinovska, M., Gazeley, U., ... & Say, L. (2025). Global and regional causes of maternal deaths 2009–20: a WHO systematic analysis. The Lancet Global Health, 13(4), e626-e634. https://doi.org/10.1016/s2214-109x(24)00560-6
Damayanti, N. A., Wulandari, R. D., & Ridlo, I. A. (2023). Maternal health care utilization behavior, local wisdom, and associated factors among women in urban and rural areas, Indonesia. International Journal of Women's Health, 665-677. https://doi.org/10.2147/ijwh.s379749
Gebeyehu, N. A., Gelaw, K. A., Lake, E. A., Adela, G. A., Tegegne, K. D., & Shewangashaw, N. E. (2022). Women decision-making autonomy on maternal health service and associated factors in low-and middle-income countries: Systematic review and meta-analysis. Women's Health, 18, 17455057221122618. https://doi.org/10.1177/17455057221122618
Geremew, A. B., Roberts, C. T., Kassa, B. G., Ullah, S., & Stephens, J. H. (2025). Exploring evidence of healthcare-seeking pathways for maternal complications in Sub-Saharan Africa: a scoping review. BMC Pregnancy and Childbirth, 25(1), 634. https://doi.org/10.1186/s12884-025-07745-3
Hashim, S. H., Erfina, E., Abdul-Mumin, K. H., Sharbini, S., Safari, K., & East, C. (2025). Healthcare-seeking behaviours among women with hypertensive disorders of pregnancy in Asia: A scoping review. Midwifery, 104541. https://doi.org/10.1016/j.midw.2025.104541
Herwansyah, H., Czabanowska, K., Kalaitzi, S., & Schröder-Bäck, P. (2022). The utilization of maternal health services at primary healthcare setting in Southeast Asian Countries: A systematic review of the literature. Sexual & Reproductive Healthcare, 32, 100726. https://doi.org/10.1016/j.srhc.2022.100726
Huang, J., Man, Y., Shi, Z., Fu, X., Shi, W., & Liang, X. (2025). Global, regional, and national burden of maternal disorders, 1990–2021: a systematic analysis from the global burden of disease study 2021. BMC public health, 25(1), 2576. https://doi.org/10.1186/s12889-025-23814-w
Hung, C. H., Lee, Y. H., Lee, D. C., Chang, Y. P., & Chow, C. C. (2022). The mediating and moderating effects of shared decision making and medical autonomy on improving medical service satisfaction in emergency observation units. International Emergency Nursing, 60, 101101. https://doi.org/10.1016/j.ienj.2021.101101
Izulla, P., Muriuki, A., Kiragu, M., Yahner, M., Fonner, V., Nitu, S. N. A., ... & de Graft-Johnson, J. (2023). Proximate and distant determinants of maternal and neonatal mortality in the postnatal period: A scoping review of data from low-and middle-income countries. PLoS One, 18(11), e0293479. https://doi.org/10.1371/journal.pone.0293479
Kang, B. A., Rimal, R. N., Lakew, Y., & Tamene, H. (2025). Improving maternal health service use among underserved pregnant women through social mechanisms: Evaluation of a quasi-experimental study in rural Ethiopia. VeriXiv, 2(284), 284. https://doi.org/10.12688/verixiv.2037.1
Kruk, M. E., Lewis, T. P., Arsenault, C., Bhutta, Z. A., Irimu, G., Jeong, J., ... & Yousafzai, A. K. (2022). Improving health and social systems for all children in LMICs: structural innovations to deliver high-quality services. The Lancet, 399(10337), 1830-1844. https://doi.org/10.1016/s0140-6736(21)02532-0
Lateef, M. A., Kuupiel, D., Mchunu, G. G., & Pillay, J. D. (2024). Utilization of antenatal care and skilled birth delivery services in Sub-Saharan Africa: A systematic scoping review. International journal of environmental research and public health, 21(4), 440. https://doi.org/10.3390/ijerph21040440
Maganty, A., Byrnes, M. E., Hamm, M., Wasilko, R., Sabik, L. M., Davies, B. J., & Jacobs, B. L. (2023). Barriers to rural health care from the provider perspective. Rural and remote health, 23(2), 1-11. https://doi.org/10.22605/rrh7769
Malik, A., & Akram, M. (2025). Healthcare Disparities: Addressing Inequities In Global Health Systems. Multidisciplinary Research in Computing Information Systems, 5(5), 480-487. https://doi.org/10.59613/4b75gc54
McDonald, C. R., Weckman, A. M., Wright, J. K., Conroy, A. L., & Kain, K. C. (2022). Developmental origins of disease highlight the immediate need for expanded access to comprehensive prenatal care. Frontiers in Public Health, 10, 1021901. https://doi.org/10.3389/fpubh.2022.1021901
Mwangi, L. W., Abuga, J. A., Cottrell, E., Kariuki, S. M., Kinyanjui, S. M., & Newton, C. R. (2022). Barriers to access and utilization of healthcare by children with neurological impairments and disability in low-and middle-income countries: a systematic review. Wellcome Open Research, 6, 61. https://doi.org/10.12688/wellcomeopenres.16593.2
Oluyede, L., Cochran, A. L., Wolfe, M., Prunkl, L., & McDonald, N. (2022). Addressing transportation barriers to health care during the COVID-19 pandemic: Perspectives of care coordinators. Transportation Research Part A: Policy and Practice, 159, 157-168. https://doi.org/10.1016/j.tra.2022.03.010
Olwanda, E., Opondo, K., Oluoch, D., Croke, K., Maluni, J., Jepkosgei, J., & Nzinga, J. (2024). Women’s autonomy and maternal health decision making in Kenya: implications for service delivery reform-a qualitative study. BMC Women's Health, 24(1), 181. https://doi.org/10.1186/s12905-024-02965-9
Rickard, N. S., Chin, T. C., Cross, D., Hattie, J., & Vella-Brodrick, D. A. (2024). Effects of a positive education programme on secondary school students’ mental health and wellbeing; challenges of the school context. Oxford Review of Education, 50(3), 309-331. https://doi.org/10.1080/03054985.2023.2211254
Shartyanie, N. P., Hanifa, I. N., & Khan, N. (2025). Digital health interventions in emergency obstetric and newborn care services in low-and middle-income countries: scoping review. Journal of Medical Internet Research, 27, e75738. https://doi.org/10.2196/75738
Simona, S., Lumamba, C., Moyo, F., Ng’andu, E., & Phiri, M. (2022). The influence of contextual factors on maternal healthcare utilization in sub-Saharan Africa: a scoping review of multilevel models. MedRxiv, 2022-03. https://doi.org/10.1101/2022.03.15.22272437
Teixeira, D. S., Bastos, V., Andrade, A. J., Palmeira, A. L., & Ekkekakis, P. (2024). Individualized pleasure-oriented exercise sessions, exercise frequency, and affective outcomes: a pragmatic randomized controlled trial. International Journal of Behavioral Nutrition and Physical Activity, 21(1), 85. https://doi.org/10.1186/s12966-024-01636-0
Wafiq, A., & Haq, N. (2025). The Role of Women’s Empowerment Programs in Reducing Gender-Based. Moccasin Journal De Public Perspective, 2(3), 125-135. https://doi.org/10.37899/mjdpp.v2i3.241
Ward, Z. J., Atun, R., King, G., Sequeira Dmello, B., & Goldie, S. J. (2023). Simulation-based estimates and projections of global, regional and country-level maternal mortality by cause, 1990–2050. Nature medicine, 29(5), 1253-1261. https://doi.org/10.1038/s41591-023-02310-x
Wei, J., Yi, Y., Li, X., Xu, Y., Fan, L. S., & Huang, H. (2025). Global, regional, and national burden of maternal hemorrhage: a systematic analysis from the global burden of disease 2021 and projections to 2030. BMC Pregnancy and Childbirth, 25(1), 1-18. https://doi.org/10.1186/s12884-025-08353-x
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Magenta Journal De Healthymedi

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
This journal provides direct open access to it's content on the principle that research is freely available to the public supporting a greater global exchange of knowledge. All articles published by Open Access will soon and forever be free for everyone to read and download. The license options defined for this journal are Creative Commons Attribution-ShareAlike (CC BY-SA)










