Peer-reviewed article
Her Health Behavior, Her Choice? Decision-Making Power Over Key Health and Nutrition Behaviors Among Pregnant and Lactating Women in Jordan.
Miller LC, Brown R, Safadi R, Ren Y, Alghanmi A et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined decision-making power among pregnant and lactating women in Jordan who participated in a community health and nutrition program. The research surveyed 3,518 women across three governates to understand who makes choices about maternal and infant nutrition practices and contraceptive use. Women's autonomy to make these decisions varied significantly by location and number of children, with those outside Amman and those with fewer children having less decision-making power. The findings suggest that decision-making autonomy is an important factor in whether women can adopt recommended health behaviours.
Key points
- 78% of pregnant and lactating women changed at least one practice after receiving program messages about maternal, infant and young child nutrition and contraception
- Between 52.8% and 90.3% of women had decision-making power over the six targeted health and nutrition behaviours
- Women living in Zarqa had significantly less decision-making power over dietary diversity and early breastfeeding initiation compared to those in Amman
- Women in Karak had less decision-making power over modern contraceptive use compared to Amman
- Number of children was positively associated with decision-making power over exclusive breastfeeding, while nationality, age, and wealth showed no significant association
Limitations
This is a cross-sectional study, so it cannot establish causation or determine whether decision-making power caused behaviour change or vice versa. The study only measures women's reported decision-making and does not capture the perspectives of husbands, mothers, or mothers-in-law who were identified as co-decision-makers.
Abstract
Women's participation in family diet and health decisions is strongly associated with better family outcomes. We examined decision-making power among participants in a Community Health and Nutrition Program in Jordan, which sought to improve maternal, infant, and young child nutrition (MIYCN) and modern contraception through service-provider training and media campaigns. Cross-sectional surveys in Amman, Karak, and Zarqa governates enrolled 3518 pregnant/lactating women (PLW) in the program (2021-23). PLW respondents indicated whether receiving messages about MIYCN and contraceptive use changed their practices, and whether their decision-making was total, shared with other family members (husbands, mothers, mothers-in-law), or not possible for these choices. Results were analyzed using chi-square tests and multiple linear regressions. After receiving program messages, 78% of PLW changed ≥ 1 practice. Between 52.8% and 90.3% of PLW had decision-making power to accept or reject recommendations for the six targeted behaviors. Compared to Amman, Zarqa residence was negatively associated with decision-making power over women's dietary diversity (OR = 0.418, p < 0.05) and early initiation of breastfeeding (OR = 0.493, p < 0.05), while Karak residence was negatively associated with decision-making power over modern contraceptive use (OR = 0.419, SE = 0.116, p < 0.01). Number of children was positively associated with decision-making power over exclusive breastfeeding (OR = 1.18, p < 0.01). Nationality, age, and wealth were not associated with decision-making power over these practices. Decision-making power varied among PLW in the program: PLW living outside Amman and those with fewer children had less autonomy to change practices. Further research is needed to understand how to best support decision-making power among these populations. Trial Registration: Registered at clinicaltrials.gov (NCT05365698).
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Community Health and Nutrition Program including service-provider training and media campaigns delivering messages about maternal, infant, and young child nutrition and modern contraception
- Population
- 3,518 pregnant and lactating women in Amman, Karak, and Zarqa governates, Jordan (2021-23)
Key finding
78% of women reported changing at least one practice after receiving program messages
LC et al. · Europe PMC · 1 Apr 2026