Women empowerment in reproductive health: a systematic review of measurement properties – BMC Women’s Health – BMC Blogs Network

Study characteristics

The search strategy yielded 5234 relevant records. Finally, 62 full texts were reviewed, of which 15 separate scales were identified (Fig. 1).

Fig. 1

PRISMA flow diagram of study process

Ambiguous scales that measured the components, dimensions, or subscales of women empowerment but did not fit in our framework and original search strategy were excluded to consistently adhere to our conceptual framework (n = 46). Another full text aimed at the psychometric analysis of Reproductive Agency Scale 17 (RAS-17), composing pregnancy-specific and non-pregnancy-specific agency items among Qatari and non-Qatari women with a normal pregnancy [20], was excluded to achieve the maximum homogeneity of the results. Some scales such as the Survey-Based Women’s Empowerment (SWPER) Index and Composite Women’s Empowerment Index (CWEI) have been developed to measure women empowerment [21, 22]; however, they did not include in this review because they were not applicable in sexual or reproductive health.

A detailed description of the included scales is shown in Table 1. The results revealed that included articles did not represent diverse geographical areas. The majority of studies (8/15) were conducted in the United States [5,6,7,8, 23,24,25,26]. 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, 29,30,31]. The sample size varied from 235 to 4674 in primary studies and 111,368 in one study using the Demographic and Health Surveys (DHS). The age of participants ranged between 16 and 71. The items of each scale ranged from 8 to 23. The target population in studies were as following: three studies (3/15) included adolescents and young adults (15–24 years) [11, 29, 30], three (3/15) were carried out on young women aged 16–29 [7, 8, 25]; one conducted in young women 20–35 years [12]; six studies (6/15) aimed to assess women in reproductive age defined as those aged 15 to 49 years [5, 6, 13, 26, 27, 31]. Two studies extended the age group of participants beyond 45 years; in one study, women at the ages of 15 to 60 [24]; and in another, women ages 18 to 71 were included [32].

Table 1 Characteristics of included studies

The most common domains of women empowerment in reproductive health that had been measured were: freedom from coercion, decision-making, communication with the partner, choice, control, autonomy, and ability to negotiate. “Kabeer’s framework of empowerment” was applied as the empowerment framework in two studies (2/15) [11, 31]; “The theory of gender and power” developed by Connell in four studies (4/15) [6, 24, 29, 30]; and “Sex scripts” (gender-stereotypical expectations to engage in sexual behavior) was used in two studies (2/15) [7, 8]. Moreover, the “Reproductive empowerment framework” developed by Edmeades et al. (2018) and “General conceptualization of assertiveness based on human rights to autonomy”, each one was used in one study [12]. The “World Bank’s Empowerment Framework” and “The sexual and health empowerment framework” developed by the authors were used in a study conducted by Moreau et al. [13]; whereas the rest of the studies …….

Source: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01566-0