author(s)
Nnamdi Nneka J, Okoronkwo Ijeoma L, Okorocha Nnenaya A, Udoinyang Florence O, Nwachukwu Norah N, Eluwa Chidinma N

abstract
The study explored the association between women's status and their utilization of maternal health care services provided at primary health care centers in Nando, a town in Anambra East Local Government Area of Anambra State. This study was anchored on three core objectives. The first was to assess the extent to which women utilize maternal health care services provided by primary health care centers. The second objective explored the association between women's autonomy in decision-making and their utilization of these services. The third aimed to examine how women's economic status—specifically their wealth index—affects their use of maternal health services in Nando. A descriptive cross-sectional survey design was employed. The target population comprised women aged 15 to 49 years who had given birth within the preceding five years. Using a finite population sampling formula, a total of 500 women were selected for the study. Of these, 482 respondents completed and returned the structured questionnaire, resulting in a response rate of 96.4%. The instrument was developed by the researcher following an extensive review of relevant literature. Data analysis was conducted using SPSS version 18. The findings showed that 71.5% of respondents accessed antenatal care (ANC), while 44.4% utilized health facility services during childbirth. In relation to decision-making on ANC utilization, 40.2% of women reported making joint decisions with their spouses, whereas 32.4% made such decisions independently. For delivery care, 39% made decisions independently, and 36.5% made them jointly with their partners. The analysis revealed a statistically significant relationship between women’s decision-making autonomy and their utilization of maternal health services. A similarly significant association was found between economic status and maternal health service use, with higher utilization observed among women with greater economic means. The study concluded that both women’s autonomy and socio-economic status are key determinants of maternal health service utilization. It recommended concerted efforts to promote women's empowerment, as enhancing their decision-making capacity is likely to improve the uptake of maternal health services.