Women’s Empowerment and Antenatal Care Utilization: A Multilevel Analysis of the Philippines Demographic and Health Survey Data 2022
1
Department of Clinical Epidemiology, College of Medicine, University of the Philippines - Manila, Manila, Philippines
2
JC School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
Popul. Med. 2026;8(Supplement Supplement 1):A2319
ABSTRACT
INTRODUCTION:
Antenatal care (ANC) plays a critical role in reducing maternal and child morbidity and mortality. Women’s empowerment, defined as the process by which women gain the capacity to act on their own free will, has been associated with ANC utilization. However, the influence of empowerment at sub-national levels remains underexplored. This study aimed to examine the association of individual- and municipality-level women’s empowerment with ANC utilization in the Philippines.
METHODS:
Multilevel logistic regression analyses were performed using secondary cross-sectional data from 3,619 women aged 15–49 years who participated in the 2022 Philippine Demographic and Health Survey. Women’s empowerment was measured using the Survey-based Women’s emPowERment (SWPER) index, comprising three domains: attitudes toward violence, decision-making power, and social independence. ANC utilization was defined as completion of at least four ANC visits and receipt of WHO-recommended maternal health services.
RESULTS:
About 86.0% of women reported at least four ANC visits, and 85.3% achieved complete ANC utilization. Inadequate ANC utilization was more prevalent among younger women, those with higher parity, lower socioeconomic status, no or low educational attainment, unintended pregnancies, and rural residence. At the individual level, greater decision-making power was associated with higher ANC utilization (medium empowerment: OR = 1.59, 95% CI: 0.82–3.08; high empowerment: OR = 1.90, 95% CI: 1.02–3.51). Higher social independence was also associated with increased ANC utilization, although estimates for high empowerment were borderline significant (medium empowerment: OR = 1.43, 95% CI: 1.02–2.01; high empowerment: OR = 1.43, 95% CI: 0.99–2.05). No significant associations were observed between municipality-level women’s empowerment and ANC utilization across SWPER domains.
CONCLUSIONS:
Greater decision-making power and social independence among women were associated with higher ANC utilization in the Philippines. These findings highlight the importance of strengthening policies and programs that foster women’s empowerment over time to improve maternal health outcomes.
Antenatal care (ANC) plays a critical role in reducing maternal and child morbidity and mortality. Women’s empowerment, defined as the process by which women gain the capacity to act on their own free will, has been associated with ANC utilization. However, the influence of empowerment at sub-national levels remains underexplored. This study aimed to examine the association of individual- and municipality-level women’s empowerment with ANC utilization in the Philippines.
METHODS:
Multilevel logistic regression analyses were performed using secondary cross-sectional data from 3,619 women aged 15–49 years who participated in the 2022 Philippine Demographic and Health Survey. Women’s empowerment was measured using the Survey-based Women’s emPowERment (SWPER) index, comprising three domains: attitudes toward violence, decision-making power, and social independence. ANC utilization was defined as completion of at least four ANC visits and receipt of WHO-recommended maternal health services.
RESULTS:
About 86.0% of women reported at least four ANC visits, and 85.3% achieved complete ANC utilization. Inadequate ANC utilization was more prevalent among younger women, those with higher parity, lower socioeconomic status, no or low educational attainment, unintended pregnancies, and rural residence. At the individual level, greater decision-making power was associated with higher ANC utilization (medium empowerment: OR = 1.59, 95% CI: 0.82–3.08; high empowerment: OR = 1.90, 95% CI: 1.02–3.51). Higher social independence was also associated with increased ANC utilization, although estimates for high empowerment were borderline significant (medium empowerment: OR = 1.43, 95% CI: 1.02–2.01; high empowerment: OR = 1.43, 95% CI: 0.99–2.05). No significant associations were observed between municipality-level women’s empowerment and ANC utilization across SWPER domains.
CONCLUSIONS:
Greater decision-making power and social independence among women were associated with higher ANC utilization in the Philippines. These findings highlight the importance of strengthening policies and programs that foster women’s empowerment over time to improve maternal health outcomes.
| eISSN: | 2654-1459 |
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