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

Abstract

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.

Association between sexual and reproductive health knowledge and protective sexual behaviors among young women in Nigeria

“…When young people are empowered with information on sexual and reproductive health, they are more likely to embrace protective sexual behaviors and make healthy choices about their reproductive health [25,31]. Even though there is limited evidence on the association between sexual and reproductive knowledge and protective sexual behavior, our finding is consistent with previous studies reporting a positive association between measures of empowerment or agency and contraceptive use [32][33][34]. Our finding is consistent with studies that have reported the association between sexuality education and young people's sexual behavior [14,35].…”

Role of women's empowerment in determining fertility and reproductive health in Bangladesh: a systematic literature review

“… 5 , 38 , 49 , 51 Although social and health factors directly influence fertility control, it is hypothesized that women's empowerment is also linked to FRH. 5 , 15 , 49 , 51 , 58 , 59 , 60 , 61 Understanding current and total fertility is essential for monitoring population growth and developing policies and programs. The fundamental drivers of population growth, namely human FRH outcomes, are influenced by various individual, household, community, national, and regional characteristics.…”

Thematic Analysis and Mapping of Reproductive Empowerment Scales: A Tool for Family Planning Self-Care Programming and Research

“…Similar to our findings, a recent systematic review investigating the measurement properties of women empowerment scales in sexual and reproductive health found the most common domains explored were decision making, freedom of coercion, and communication with a partner. 19 …”