Despite widespread assumptions about women’s empowerment and agency in the Arab Middle East, psychometric research of these constructs is limited. Using national data from 6214 married women ages 16–49 who took part in the 2006 Egypt Labor Market Panel Survey, we applied factor analysis to explore and then to test the factor structure of women’s agency. We then used multiple indicator multiple cause structural equations models to test for differential item functioning (DIF) by women’s age at first marriage, a potential resource for women’s agency. Our results confirm that women’s agency in Egypt is multi-dimensional and comprised of their (1) influence in family decisions, including those reserved for men, (2) freedom of movement in public spaces, and (3) attitudes about gender, specifically violence against wives. These dimensions confirm those explored previously in selected rural areas of Egypt and South Asia. Yet, three items showed significant uniform DIF by women’s categorical age at first marriage, with and without a control for women’s age in years. Models adjusting for DIF and women’s age in years showed that women’s older age at first marriage was positively associated with the factor means for family decision-making and gender-violence attitudes, but not freedom of movement. Our findings reveal the value of our analytical strategy for research on the dimensions and determinants of women’s agency. Our approach offers a promising model to discern “hierarchies of evidence” for social policies and programs to enhance women’s empowerment.

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World Health Organization and the US Centers for Disease Control and Prevention.

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Research shows a positive relationship between women's empowerment and reproductive health. Yet we know little about the quantitative relationship between women's agency and contraceptive use. We conducted a systematic review of peer-reviewed literature assessing the link between women's decision-making and freedom of movement with their contraceptive use in lower- and middle-income countries. Of 102 articles that met the initial screening criteria, 12 met all inclusion and exclusion criteria. Of the 12 included studies, consistently positive associations with contraceptive use were found in those that measured decision-making and freedom of movement as separate constructs. Composite measures had a less clear relationship with contraceptive use. In conclusion, women's agency is associated with women's contraceptive use in lower- and middle-income countries. However, the relationship is sensitive to how agency and its components are measured. Our review suggests the need for consistent validation of scales for women's agency as well as more rigorous research using standardised and validated scales, when possible. Longitudinal and intervention studies in lower- and middle-income countries will be useful for understanding the causal impact of women's agency on contraceptive use, and will help to inform policies and programmes to increase contraceptive use in these settings.