WOMEN'S AUTONOMY AND PARTNER INFLUENCE IN REPRODUCTIVE HEALTH DECISION MAKING AMONG CLIENTS SEEKING FAMILY PLANNING AND SAFE ABORTION SERVICES AT SAINT PAUL'S HOSPITAL MILLENNIUM MEDICAL COLLEGE MICHU CLINIC

Abstract

Abstract Background: Maternal health outcomes in Ethiopia are influenced by women's autonomy and the role of partners in reproductive health decision-making. Despite improved access to family planning and safe abortion services, disparities persist in decision-making power due to sociocultural, economic, and relational factors. Objectives: To assess the level of autonomy among women seeking reproductive health services, the degree of partner influence, and identify factors associated with reproductive decision-making at Michu Clinic, St. Paul’s Hospital Millennium Medical College. Methods: A facility-based cross-sectional study was conducted among 176 women aged 15-49 years using systematic random sampling. Data were collected through structured interviewer-administered questionnaires and analyzed with SPSS version 26. Descriptive statistics summarized key variables, while bivariate and multivariable logistic regression identified predictors of autonomy and partner influence. Qualitative responses were analyzed thematically. Results: From a total of 176 women who participated in the study, the majority (44.3%) were aged 15–24 years. Most respondents (92.0%) currently use family planning methods, with oral contraceptives (27.7%) and implants (26.5%) being the most common. Abortion experience was reported by 81.3% of participants. The mean autonomy score was 3.58, and 71.0% of women demonstrated high autonomy. The mean partner influence score was 3.6, with 67.1% reporting constructive partner influence. Multivariable logistic regression showed that urban residence (AOR = 8.12, p = 0.01) and tertiary education (AOR = 15.34, p = 0.01) were significant predictors of high autonomy. While urban residence (AOR = 8.56, p = 0.01) and history of induced abortion (AOR = 8.61, p = 0.01) were the primary predictors of constructive partner influence. Conclusions: Women’s autonomy in reproductive health decision-making remains limited in rural and less-educated women, and partner influence plays a decisive role. Interventions should prioritize women’s empowerment through education, counseling, and economic support, while promoting constructive partner engagement to improve uptake of family planning and safe abortion.