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In western Guatemala, the more involved a woman feels in making household decisions, the greater her likelihood of reporting that in preparing for a recent birth, she and her husband developed a plan for addressing problems during the pregnancy, delivery and postpartum period.
A woman's sense of involvement in decision making is not, however, associated with two other behaviors that can ensure maternal and infant health.
However, they also contend that inadequate knowledge of the importance of skilled health care, documented in an earlier study, may prevent women in western Guatemala from obtaining appropriate care.
In the analysts' view, their findings yield important lessons about the role of men in decision making and in couples' health behavior.
Men's reports suggest a very different relationship between women's decision-making role and preventive behavior.
Each one-point increase in the score reflecting a man's perception of his wife's participation in household decisions was associated with a 12% decline in the odds that she had given birth in a health facility.
Possible responses were woman only, man only, couple, father-in-law, mother-in-law, father, mother and other.
Thirty-five percent had had no schooling, 44% a primary education and 20% a secondary or higher level of schooling; 22% worked for pay, and 53% reported a Mayan mother tongue.
In three of the four specified situations, the proportion of couples in which both spouses reported that the wife participated in decision making increased with the woman's level of education and was higher if both partners were educated than if only one had been to school; in all four instances, it was greater among couples in which the wife was employed than among those in which she did not work outside the home.
On average, both women and their husbands said that women were involved in two of the four types of decisions.
The survey, undertaken to measure the impact of the national Maternal and Neonatal Health Program, was conducted in three departments of western Guatemala.
Interviewers surveyed all women aged 15–49 in selected households who were pregnant or had given birth in the previous 12 months, as well as the husbands of female respondents in every other household.
The building of the capital city, Belmopan, in the late 1960s was a crowning achievement of the nationalist movement, radically transforming the settlement pattern.