Abstract / Summary
Women’s household decision-making autonomy is a fundamental dimension of empowerment and an important determinant of maternal health, reproductive agency, and household welfare. In fragile and conflict-affected settings such as Somalia, persistent gender inequalities, insecurity, and sociocultural norms continue to limit women’s participation in household decisions. Despite growing global attention to women’s empowerment, nationally representative evidence on regional and socioeconomic inequalities in women’s autonomy in Somalia remains scarce. This study analyzed data from the 2020 Somali Demographic and Health Survey (SDHS), including a weighted sample of 8,436 ever-married women aged 15–49 years. Household decision-making autonomy was defined as women’s participation, either alone or jointly with their husbands, in decisions regarding personal healthcare, major household purchases, and visits to family or relatives. Descriptive statistics and multivariable logistic regression analyses were conducted while accounting for the complex survey design and sampling weights. Overall, 60.6% (95% CI: 57.9–63.2) of married women reported household decision-making autonomy. Autonomy increased significantly with age, with women aged 45–49 years demonstrating higher odds of autonomy compared with those aged 15–19 years (AOR = 1.69; 95% CI: 1.27–2.26). Substantial regional inequalities were observed. Women residing in Woqooyi Galbeed (AOR = 1.59; 95% CI: 1.22–2.08) and Sanaag (AOR = 1.37; 95% CI: 1.05–1.79) had significantly higher odds of autonomy, whereas markedly lower autonomy was observed among women living in conflict-affected regions including Hiraan, Middle Shabelle, Bay, Bakool, Gedo, and Lower Juba. Urban residence, educational attainment, and household wealth were also positively associated with women’s autonomy. Household decision-making autonomy among married women in Somalia remains suboptimal and is characterized by pronounced regional and socioeconomic inequalities. Greater autonomy was associated with older age, higher household wealth, employment, husbands’ fertility preferences, and media exposure, while nomadic residence and residence in several regions were associated with lower autonomy. These findings support targeted interventions that expand women’s economic opportunities and access to information, with particular attention to younger women, nomadic populations, and women living in disadvantaged regions.