Social determinants of health present significant barriers to utilization of maternal
health services in transitional countries. This dissertation study examined associations
between household autonomy and utilization of prenatal services among women of
reproductive age in Armenia and Azerbaijan. Using nationally representative survey data,
this study explored if household autonomy of women positively influenced the timing of
the first prenatal visit, the number of prenatal care visits, and the content of care during
visits. Results showed that household autonomy was positively associated with the timing
of the first visit for prenatal care, but the number of prenatal care visits and the content of
care were negatively associated with the autonomy of women. Findings also pointed to an
endogenous influence of a woman's position in the household structure. Additionally, this
study analyzed associations between women's reproductive history and utilization, and
economic disparities in utilization of prenatal care. The findings demonstrated that a
history of complications during pregnancy and stillbirths were positively associated with
utilization of prenatal care. Economic disparities in utilization of care were identified.
Future interventions to increase utilization of maternal health services should account for
traditional household structures in transitional countries. Women from poor families
should receive support from social assistance and the health sector in accessing services
pertaining to their health and well-being.