(P10-095-24) Decision-Making Autonomy Among Pregnant and Lactating Jordanian Women Relating to Reproductive Health, Breast-Feeding, and Mother and Infant Diet

Objectives: Women’s empowerment is integral to achieving positive outcomes for women themselves, their families, and society at large. Female autonomy is strongly associated with higher social status, translating into better nutrition, health, and well-being, especially in societies with high levels of gender discrimination. Despite comparatively high levels of female education and recent women's empowerment initiatives, Jordan exhibits notably low indicators for gender equality. This study assessed the decision-making autonomy among Jordanian pregnant and lactating women (PLW).

Methods: A cross-sectional survey of socio-demographic characteristics and practices, knowledge, and decision-making related to reproductive health, breast-feeding, and diet in PLW (n=1079; 7 excluded from analysis) was conducted in Amman, Karak, and Zarqa in 2022. PLWs were asked whether “receiving information” about contraception (UC), breastfeeding initiation/continuation (BF), and diet choices (self/infant) (DC) influenced their decisions, and if the decisions were made by their husband and/or mother/mother-in-law (M/MIL). Results were dichotomized based on whether the PLW’s husband and/or M/MIL decided on at least one practice. Descriptive statistics and bivariate and multivariate analyses were performed to assess demographic characteristics and PLW’s decision-making autonomy.

Results: PLW made UC, BF, and DC decisions autonomously. However, 23% reported that their husband and/or M/MIL made at least one important decision in these areas. Husbands of 11% of PLW made decisions (range 1-5) (especially UC) and M/MIL of 15% of PLW made decisions (range 1-4) (especially BF, DC). In fully adjusted models, women with an educational level of grade 11 or more were 3.56 times more likely to make decisions for themselves (p < 0.01), confirming the key importance of girls’ education if impacts are desired on later health and nutrition.

Conclusions: Jordanian PLWs (77%) made their own decisions on UC, BF, and DC. However, for 23%, the husband and/or M/MIL made at least one important decision in these areas. The lack of autonomy in PLW’s decision-making related to reproductive health, diets, and nutrition represents one possible barrier to optimizing maternal and infant nutrition and health in Jordan.

Funding Sources: United States Agency for International Development