Developing and testing measures of reproductive decision-making agency in Nepal

Hinson, Laura; Edmeades, Jeffrey; Murithi, Lydia; Puri, Mahesh

doi:10.1016/j.ssmph.2019.100473

Cited by 18 publications

(41 citation statements)

References 4 publications

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“…The majority of studies (8/15) were conducted in the United States [ 5 – 8 , 23 – 26 ]. Two were done in Nepal [ 12 , 27 ], one in Spain [ 28 ], and the rest of the studies (4/15) were carried out in African countries [ 13 , 29 – 31 ]. The sample size varied from 235 to 4674 in primary studies and 111,368 in one study using the Demographic and Health Surveys (DHS).…”

Section: Resultsmentioning

confidence: 99%

“…Kabeer's foundational work on women's empowerment in the early 2000s, and then developing a framework by World Bank [ 9 , 10 ], introduced decision-making and exercise of choice as the components of the agency. These concepts were used commonly to design scales of women empowerment measurements such as Sexual and reproductive empowerment [ 11 ], Reproductive Decision-making Agency [ 12 ], Women’s and Girls’ Empowerment in Sexual and Reproductive health (WGE-SRH) [ 13 ], aimed to assess women’s agency in decision making over vital sexual and reproductive health matters.…”

Section: Introductionmentioning

confidence: 99%

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Women empowerment in reproductive health: a systematic review of measurement properties

et al. 2021

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Introduction There is a considerable dearth of official metrics for women empowerment, which is pivotal to observe universal progress towards Sustainable Development Goals 5, targeting "achieve gender equality and empower all women and girls.” This study aimed to introduce, critically appraise, and summarize the measurement properties of women empowerment scales in sexual and reproductive health. Methods A comprehensive systematic literature search through several international electronic databases, including PubMed, Scopus, Embase, ProQuest, and Science Direct was performed on September 2020, without a time limit. All studies aimed to develop and validate a measurement of women empowerment in sexual and reproductive health were included. The quality assessment was performed through a rating scale addressing the six criteria, including: a priori explicit theoretical framework, evaluating content validity, internal consistency, and factor analysis to assess structural validity. Results Of 5234 identified studies, fifteen were included. The majority of the studies were conducted in the United States. All studies but one used a standardized measure. Total items of each scale ranged from 8 to 23. The most common domains investigated were decision-making, freedom of coercion, and communication with the partner. Four studies did not use any conceptual framework. The individual agency followed by immediate relational agency were the main focus of included studies. Of the included studies, seven applied either literature review, expert panels, or empirical methods to develop the item pool. Cronbach's alpha coefficient reported in nine studies ranged from α = 0.56 to 0.87. Most of the studies but three lack reporting test–retest reliability ranging r = 0.69–0.87. Nine studies proved content validity. Six criteria were applied to scoring the scales, by which nine of fifteen articles were rated as medium quality, two rated as poor quality, and four rated as high quality. Conclusion Most scales assessed various types of validity and Internal consistency for the reliability. Applying a theoretical framework, more rigorous validation of scales, and assessing the various dimensions of women empowerment in diverse contexts and different levels, namely structural agency, are needed to develop effective and representing scales.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Women empowerment in reproductive health: a systematic review of measurement properties

et al. 2021

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“…While it was exploratory, a low cell count limited our understanding of Concordant 2 group among those who do not intend to use contraceptives, and Concordant 2 and Discordant 2 groups among pill users in the multinomial analysis. Improved measurement of women’s decision-making involvement is needed to advance our understanding of this complex construct [ 34 ]. Finally, although we used the same measures for husbands and wives’, they may perceive and respond to them differently.…”

Section: Discussionmentioning

confidence: 99%

Male–female concordance in reported involvement of women in contraceptive decision-making and its association with modern contraceptive use among couples in rural Maharashtra, India

et al. 2021

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Objective Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study design We carried out a cross-sectional study using data from rural India (N = 961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR = 0.61, 95% CI 0.45–0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs. Trial registration ClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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“…While it was exploratory, a low cell count limited our understanding of Concordant 2 group among those who do not intend to use contraceptives, and Concordant 2 and Discordant 2 groups among pill users in the multinomial analysis. Improved measurement of women's decision-making involvement is needed to advance our understanding of this complex construct (34).…”

Section: Discussionmentioning

confidence: 99%

Male-Female Concordance in Reported Involvement of Women in Contraceptive Decision-Making and Its Association With Modern Contraceptive Use Among Couples in Rural Maharashtra, India.

Dixit

Johns

Ghule

et al. 2021

Preprint

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Objective: Women’s involvement in contraceptive decision-making increases contraceptive use and reduces unmet need, but study of this has been limited to women’s self-reports. Less research is available examining couple concordance and women’s involvement in contraceptive decision-making as reported by both men and women. Study Design: We carried out a cross-sectional study using data from rural India (N=961 young married couples). Using multivariable regression we examined the association between concordance or discordance in spousal reports of wife’s involvement in contraceptive decision-making and modern contraceptive use, adjusting for demographics, intimate partner violence, and contraceptive use discussion. Results: More than one third (38.3%) of women reported current modern contraceptive use. Report of women’s involvement in contraceptive decision-making showed 70.3% of couples agreed that women were involved, jointly or alone (categorized as Concordant 1), 4.2% agreed women were not involved (categorized at Concordant 2), 13.2% had women report involvement but men report women were uninvolved (categorized as Discordant 1), and 12.2% had women report uninvolvement but men report that women were involved (categorized as Discordant 2). Discordant 2 couples had lower odds of modern contraceptive use relative to Concordant 1 couples (adjusted RR=0.61, 95% CI 0.45-0.83). No other significant differences between Concordant 1 couples and other categories were observed. Conclusion: One in four couples indicated discordance on women’s involvement in contraceptive decision making, with Discordant 2 category having lower odds of contraceptive use. Couples’ concordance in women’s involvement in contraceptive decision-making offers a target for family planning research and interventions to better meet their needs.Trial registrationClinicalTrial.gov, NCT03514914. https://clinicaltrials.gov/ct2/show/NCT03514914

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Developing and testing measures of reproductive decision-making agency in Nepal

Cited by 18 publications

References 4 publications

Women empowerment in reproductive health: a systematic review of measurement properties

Women empowerment in reproductive health: a systematic review of measurement properties

Male–female concordance in reported involvement of women in contraceptive decision-making and its association with modern contraceptive use among couples in rural Maharashtra, India

Male-Female Concordance in Reported Involvement of Women in Contraceptive Decision-Making and Its Association With Modern Contraceptive Use Among Couples in Rural Maharashtra, India.

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