Construction and Validation of a Women’s Autonomy Measurement Scale with Reference to Utilization of Maternal Health Care Services in Nepal

Ganesh Dangal,P Shankara Sharma,Tulsi Ram Bhandari,V Raman Kutty

doi:10.31729/jnma.2718

Abstract

Women's autonomy is one of the predictors of maternal health care service utilization. This study aimed to construct and validate a scale for measuring women's autonomy with relevance to developing countries. We conducted a study for construction and validation of a scale in Rupandehi and further validated in Kapilvastu districts of Nepal. Initially, we administered a 24-item preliminary scale and finalized a 23-item scale using psychometric tests. After defining the construct of women's autonomy, we pooled 194 items and selected 24 items to develop a preliminary scale. The scale development process followed different steps i.e. definition of construct, generation of items pool, pretesting, analysis of psychometric test and further validation. The new scale was strongly supported by Cronbach's Alpha value (0.84), test-retest Pearson correlation (0.87), average content validity ratio (0.8) and overall agreement- Kappa value of the items (0.83) whereas all values were found satisfactory. From factor analysis, we selected 23 items for the final scale which show good convergent and discriminant validity. From preliminary draft, we removed one item; the remaining 23 items were loaded in five factors. All five factors had single loading items by suppressing absolute coefficient value less than 0.45 and average coefficient was more than 0.60 of each factor. Similarly, the factors and loaded items had good convergent and discriminant validity which further showed strong measurement capacity of the scale. The new scale is a reliable tool for assessing women's autonomy in developing countries. We recommend for further use and validation of the scale for ensuring the measurement capacity.

Highlights

Women’s autonomy is one of the predictors of maternal health care service utilization
The study was conducted in Ilaka number eleven of Rupandehi district which consists of four village development committees (VDC); out of four, we selected two VDCs randomly using lottery method
After testing psychometric characteristics of the scale, we concluded that the new scale is a reliable and valid tool for assessing women’s autonomy in developing countries

Summary

Introduction

Women’s autonomy is one of the predictors of maternal health care service utilization. This study aimed to construct and validate a scale for measuring women’s autonomy with relevance to developing countries. Autonomy is a multidimensional concept and difficult to quantify.[1] increasing women’s autonomy is a well-documented strategy for improving the utilization of maternal health care services in developing countries.[2] Women who have greater autonomy in decision-making, and in physical and financial resources are able to seek health care services for themselves and their children, and are able to make fertility decision independently.[3,4,5,6] socio-economic factors are Correspondence: Dr Tulsi Ram Bhandari, Achutha Menon. Bhandari et al Construction and Validation of a Women’s Autonomy Measurement Scale with Reference to Utilization of Maternal. Positively associated with their autonomy in decisionmaking and seeking maternal health care services.[2,7]. It further indicates that the poor women’s autonomy at household level where women still do not access of required maternal health care services without prior permission of either their husbands or senior members of their family

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Conclusion