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Women's Autonomy in Health Care Decision-Making in Somalia: Evidence from a Multinomial Logistic Regression Analysis of the 2020 National Survey.

Created on 05 Jul 2026

Authors

Hamda Jama Yousuf, Abdiasis Aden Omer, Suhur A Ahmed

Published in

BMC women's health. Jul 04, 2026. Epub Jul 04, 2026.

Abstract

Women's autonomy in healthcare decision-making is a key determinant of maternal and reproductive health outcomes in Somalia. This study examined the level of women's autonomy and its associated factors using nationally representative data.
A cross-sectional study was conducted using data from the 2020 Somalia Demographic and Health Survey, including 32,272 women aged 15-49 years. Data were analyzed using STATA version 17, accounting for sampling weights. Multinomial logistic regression was used, and results were reported as Relative Risk Ratios (RRRs) with 95% Confidence Intervals (CIs).
Overall, 15.3% of women made healthcare decisions independently, 32.9% made decisions jointly, and 51.8% had decisions made by others. Older women aged 45-49 years were more likely to make independent decisions compared to those aged 15-19 (RRR = 1.93; 95% CI: 1.42-2.62). Urban residence was associated with higher autonomy (RRR = 1.17; 95% CI: 1.07-1.28). Women in the highest wealth quintile had a higher likelihood of independent decision-making compared to the lowest quintile (RRR = 2.68; 95% CI: 2.36-3.03). Higher maternal education was also significantly associated with increased autonomy.
Women's autonomy in healthcare decision-making in Somalia remains limited and is associated with socio-demographic and economic factors. Interventions focusing on improving women's education, economic empowerment, and access to healthcare services may enhance autonomy and improve health outcomes.

PMID:
42401836
Bibliographic data and abstract were imported from PubMed on 05 Jul 2026.

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