Voices Unheard: Exploring women's struggles for reproductive health autonomy in Ogbomoso, Nigeria

To achieve Sustainable Development Goal 3.7, which aims for universal access to reproductive healthcare, it is crucial to understand the social and structural barriers that hinder women's reproductive health decisions. This study examines women's reproductive autonomy and their use of reproductive health services in Ogbomoso, Nigeria. A cross-sectional survey was conducted involving 385 women aged 15-55, utilising a semi-structured self-administered questionnaire. The survey focused on reproductive health autonomy, spousal decision-making, and socio-economic factors. Data analysis was conducted using descriptive statistics and binary logistic regression. Women reported a moderate level of confidence in discussing reproductive health issues with their partners (mean=3.33) and in participating in family size decisions (mean=3.42). However, their ability to make independent choices about contraceptive use (mean=2.58) and visiting health facilities (mean=2.74) was notably limited. Evidence of spousal dominance emerged, with a high mean score (3.68) indicating male control over pregnancy timing. Logistic regression analysis indicated that employed women were significantly more likely (OR=1.9, 95% CI: 1.035-3.714, P=0.039) to access reproductive health services compared to unemployed women. Additionally, married women had greater odds (OR=2.217, 95% CI: 1.096-4.486, P=0.027) of utilising these services than their single counterparts. The findings highlight the constrained reproductive autonomy of women in Ogbomoso, influenced by patriarchal norms, economic dependency, and spousal control. Interventions should aim to enhance women's economic empowerment, challenge prevailing gender norms, and increase access to reproductive health services, particularly for unmarried and unemployed women.