Adapting and Validating the G‐NORM (Gender Norms Scale) in Nepal: An Examination of How Gender Norms Are Associated with Agency and Reproductive Health Outcomes

Abstract

Research calls for the sexual and reproductive rights field to prioritize gender norms to ensure that women can act on their reproductive rights. However, there is a gap in accepted measures. We addressed this by including important theoretical components of gender norms: differentiating between descriptive and injunctive norms and adding a referent group. Our team originally developed and validated the G‐NORM, a gender norms scale, in India. In this paper, we describe how we subsequently adapted and validated it in Nepal. We administered items to women of reproductive age, conducted exploratory and confirmatory factor analysis, and examined associations between the subscales and reproductive health outcomes. Like the original G‐NORM, our factor analyses showed that descriptive norms and injunctive norms comprise two distinct scales which fit the data well and had Cronbach alphas of 0.92 and 0.89. More equitable descriptive gender norms were associated with higher decision‐making scores, increased odds of intending to use family planning, disagreeing that it is wrong to use family planning, and older ideal age at marriage. Injunctive gender norms were only associated with disagreeing that it is wrong to use family planning. Findings offer an improved measure of gender norms in Nepal and provide evidence that gender norms are critical for agency and reproductive health outcomes.

Support for sexual and reproductive health and rights in Sub-Saharan Africa: a new index based on World Values Survey data

“…While the SRHR Support Index overlaps conceptually with existing indices and scales that capture attitudes towards specific dimensions of SRHR – such as gender equality and women’s empowerment (e.g., SWPER Index [ 23 ], Women and Girls Sexual and Reproductive Empowerment Index (WGE-SRH) [ 26 ], Women’s Agency Scale [ 27 ], the Gender-Equitable Men Scale [ 28 ], the G-NORM scale [ 29 ]) or fertility (e.g., the Fertility Norms Scale [ 30 ]) – its comprehensive approach can help to further improve the understanding and tracking of countries’ progress towards realizing SRHR for all. This Index can in particular be useful to understand and advance SRHR in light of global backlashes and resistance towards sexual and reproductive rights (e.g., abortion and the rights and freedoms of sexual minorities).…”

Introduction to the Special Issue: Indicators in Sexual and Reproductive Health and Rights

“…Bhan and colleagues (2023) present a newly developed 15‐item fertility norms scale and examine its association with several reproductive health outcomes in India. Similarly, Sedlander and colleagues (2023) evaluate measures of gender norms in Nepal and document their association with sexual and reproductive health‐related behavioral outcomes.…”

“…Several of the contributions discussed the strengths and limitations of the operationalization of this construct (Bradley and Casterline, 2014; Cleland, Harbison, and Shah, 2014). More recently, Bell and Bishai (2017) suggested that unmet need as currently operationalized may exaggerate the extent of need by failing to account fully for variations in coital frequency; Rominsky and Stephenson (2019) suggested incorporating method dissatisfaction into the operationalization of unmet need; Rothschild, Brown, and Drake (2021) explored implication of doing so; and Karra (2022) suggested a radically different approach to operationalizing unmet need. The limitations of unmet need also served as a key motivation for Senderowicz's (2020) introduction of contraceptive autonomy as a new indicator for family planning programs.…”