Gender-equitable Attitudes Research Articles

An Athletic Coach–Delivered Middle School Gender Violence Prevention Program

Adolescent relationship abuse (ARA) and sexual violence (SV) reported among adolescents point to the need for prevention among middle school-age youths. To test an athletic coach-delivered relationship abuse and sexual violence prevention program among middle school male athletes. An unblinded cluster randomized clinical trial from spring 2015 to fall 2017 at 41 middle schools (38 clusters). The study included 973 male middle school athletes (ages 11-14 years; grades 6-8; participation rate 50%) followed up for 1 year (retention 86%). Coaching Boys Into Men (CBIM) is a prevention program that trains athletic coaches to talk to male athletes about (1) respectful relationship behaviors, (2) promoting more gender-equitable attitudes, and (3) positive bystander intervention when harmful behaviors among peers are witnessed. The primary outcome was change in positive bystander behaviors (ie, intervening in peers' disrespectful or harmful behaviors); secondary outcomes were changes in recognition of what constitutes abusive behavior, intentions to intervene, gender-equitable attitudes, and reduction in recent ARA/SV perpetration (at end of sports season and 1-year follow up). Of the 973 participants, 530 were white (54.5%), 282 were black (29.0%), 14 were Hispanic (1.4%), and the remainder were multiracial, other race/ethnicity, or not reported. Positive bystander behaviors increased at end of sports season and at 1-year follow-up (relative risk, 1.51; 95% CI, 1.06-2.16 and 1.53; 95% CI, 1.10-2.12, respectively) as did recognition of abuse (mean risk difference, 0.14; 95% CI, 0.01-0.27 and 0.14; 95% CI, 0.00-0.28, respectively). At 1-year follow-up, among those who ever dated, athletes on teams receiving CBIM had lower odds of reporting recent ARA/SV perpetration (odds ratio, 0.24; 95% CI, 0.09-0.65). Gender attitudes and intentions to intervene did not differ between study arms. In exploratory intensity-adjusted and per protocol analyses, athletes on teams receiving CBIM were more likely to report positive bystander behaviors and to endorse equitable gender attitudes and less likely to report ARA and sexual harassment perpetration 1 year later. An athletic coach-delivered program for middle school male athletes is an effective strategy for reducing relationship abuse among younger adolescents. ClinicalTrials.gov Identifier: NCT02331238.

289. Adolescent Relationship Abuse, Gender Equitable Attitudes and Sexual Health Among Minority Young Women

289. Adolescent Relationship Abuse, Gender Equitable Attitudes and Sexual Health Among Minority Young Women

Engaging men to promote resilient communities among Syrian refugees in Lebanon

Engaging Men programmes seek to challenge the social norms, attitudes and practices that increase the risk of gender-based violence against girls and women while also harnessing positive male power to prevent violence and promote safety. This paper examines the impact of an Engaging Men intervention that engaged 1028 Syrian refugee and 440 Lebanese men in a 12-week training course structure. There were four core objectives: promoting peaceful interactions with others, reducing violence and gender-based violence, child protection and caregiving, and increasing community safety and harmony through a community project. Focus group discussions were conducted with 130 men, 28 wives, and 17 children of male participants, 10 family visits and 20 individual interviews by peer researchers.The findings were that programmes facilitated a safe emotional space for men to meet collectively to talk about their problems, to become more attuned and reflective about their relationships with their wives and children, which resulted in improved patterns of interaction and communication, increased openness and greater tolerance by men of changing gender roles in families as a result of displacement.The discussion calls for greater integration of psychosocial programming with other forms of programming from livelihoods to political advocacy and that programmes incorporate clear guidance on perpetrator accountability. Key implications for practice An intervention engaging with 1500 Syrian and Lebanese men reduced stress and improved family relations. Changes to gender-equitable attitudes were less clear. Interventions to engage refugee men should address refugee men's psychosocial needs in addition to viewing men's engagement as a means to protecting women and children. Findings highlight the importance of clearly defining the focus, aims and scope of interventions engaging with men, and that programmes incorporate clear guidance on perpetrator accountability.

Male Adolescents’ Gender Attitudes and Violence: Implications for Youth Violence Prevention

This study analyzed the associations among male adolescents' gender attitudes, intentions to intervene, witnessing peers' abusive behaviors, and multiple forms of adolescent violence perpetration. This community-based evaluation aims to inform future youth violence prevention efforts through the identification of potential predictors of interpersonal violence perpetration. Cross-sectional data were from baseline surveys conducted with 866 male adolescents, aged 13-19 years, from community settings in 20 lower-resource neighborhoods in Pittsburgh, PA (August 2015 - June 2017), as part of a cluster RCT to evaluate a sexual violence prevention program. Participants completed in-person, anonymous electronic surveys about gender attitudes, bystander intentions, witnessing peers' abusive behaviors, violence perpetration, and demographics. The analysis was conducted between 2018 and 2019. The youth identified mostly as African American (70%) or Hispanic, multiracial, or other (21%). Most (88%) were born in the U.S., and 85% were in school. Youth with more equitable gender attitudes had lower odds of self-reported violence perpetration across multiple domains, including dating abuse (AOR=0.46, 95% CI=0.29, 0.72) and sexual harassment (AOR=0.50, 95% CI=0.37, 0.67). The relationship between intentions to intervene and violence perpetration was inconclusive. Witnessing peers engaged in abusive behaviors was associated with increased odds of multiple types of violence perpetration, such as dating abuse (witnessed 3 or more behaviors, AOR=2.41, 95% CI=1.31, 4.44). This is the first U.S.-based study to elicit information from male adolescents in community-based settings (rather than schools or clinics) about multiple types of interpersonal violence perpetration. Findings support violence prevention strategies that challenge harmful gender and social norms while simultaneously increasing youths' skills in interrupting peers' disrespectful and harmful behaviors.

'Small small quarrels bring about happiness or love in the relationships': Exploring community perceptions and gendered norms contributing to male perpetrated intimate partner violence in the Central Region of Ghana.

In this paper, we explore gender norms held by men and women that might contribute to male perpetration of intimate partner violence (IPV) in Ghana. This qualitative research was conducted at the pre-intervention stage of a cluster randomized controlled trial. Our intervention uses community-based action teams to change social norms on gender and violence. Focus group discussions and in-depth interviews were conducted within communities. We found that male perpetrated IPV is a common phenomenon within the study communities, yet it is complex and experienced differently depending on the context. A woman’s non-compliance with gender norms provided context for the male partner to enforce societal conformity through IPV. Also, male partners’ misbehavior (e.g. alcohol abuse) may exacerbate IPV. Whereas the former is socially acceptable, the latter may be contested. Victims may challenge/counteract IPV using varying tactics (e.g. threats), which were mainly directed toward male partners’ immoral behavior. We conclude that there is a need to assess IPV with key considerations for female agency, as some victims may respond with violence. Moreover, some communities have the tendency to demonstrate more gender-equitable attitudes regarding male perpetration of IPV, as indicated by laws instituted by some traditional leaders to deter perpetrators. These are key learnings that can inform the design and delivery of various interventions that seek to address IPV.

Factors associated with young people's attendance at an IPV prevention intervention in informal settlements in South Africa: A prospective analysis

ABSTRACTUnderstanding factors shaping attendance at behavioural interventions is critical for programmatic planning. Through the Stepping Stones and Creating Futures intervention trial amongst young (18-30) women and men to reduce intimate partner violence and strengthen livelihoods, we prospectively assessed factors associated with intervention attendance. Baseline data were collected between September 2015 and September 2016 among 677 women and 675 men. For women, in multinomial models, compared to high attenders, medium (β = −0.04, p = 0.001) and low (β = −0.05, p = 0.003) attenders had lived less time in the community, medium attenders were more likely to have children (β = 0.97, p = 0.001), and low attenders had less gender-equitable attitudes (β = −0.57, p = 0.035). For men, in multinomial models, compared to high attenders, medium attenders were more likely to have completed secondary school (β = 1.48, p = 0.011) and to have worked in the past three months (β = 0.64, p = 0.021). Low attenders had lived for a shorter period in the community (β = −0.06, p = 0.005), and were more likely to have worked in the past three months (β = 0.66, p = 0.041) compared to high attenders. Attendance was shaped by structural factors, and gender-specific factors, and these need to be incorporated into future interventions.

Fostering gender equality and alternatives to violence: perspectives on a gender-transformative community mobilisation programme in rural South Africa

Gender-based violence and violence against children are significant problems in South Africa. Community mobilisation and gender-transformative programming are promising approaches to address and reduce violence. A quantitative evaluation of One Man Can, a gender-transformative community mobilisation programme in South Africa, found mixed results in increasing gender-equitable behaviours and reducing violence. To better understand these findings, we analyse longitudinal qualitative data from community mobilisers, community members and community action teams, exploring individual and community-level factors that facilitate and hinder change. Interviews and focus groups were transcribed and analysed. Participants self-reported changes in their gender-equitable attitudes and use of violence as a result of participation in the programme, although some participants also reported opposition to shifting to a more gender-equitable culture. Facilitators to change included the internalisation of gender-transformative messaging and supportive social networks, which was buoyed by a shared vocabulary in their community generated by One Man Can. Because the programme targeted a critical mass of community members with gender-transformative programming, mobilisers and community action teams were held accountable by community members to model non-violent behaviour. Results reinforce the importance of addressing facilitators and barriers to change at both individual and community levels.

What works to prevent violence against children in Afghanistan? Findings of an interrupted time series evaluation of a school-based peace education and community social norms change intervention in Afghanistan.

BackgroundAgainst a backdrop of more than four decades of war, conflict and insecurity, Afghanistan is recognised as suffering from endemic violence and children are exposed to multiple forms of violence, including at the family and school levels. This paper presents the results of an evaluation of school-based peace education and a community-based intervention to change harmful social norms and practices related to gender and the use of violence in conflict resolution, implemented in Afghanistan with the aim of reducing violence against and between children.MethodsThe evaluation consisted of a cross-sectional, interrupted time series design with three data collection points over 12 months. Data was collected from students in 11 secondary schools (seven girls’ and four boys’ schools) in Jawzjan province of Afghanistan, with a total of 361 boys and 373 girls sampled at endline. All children were interviewed with a questionnaire developed for the study. Key outcomes included children’s experience of peer violence (both perpetration and victimization) at school, corporal punishment both at home and at school, and observation of family violence. Other outcomes included children’s gender equitable attitudes, attitudes towards child punishment, depression and school performance.ResultsBetween baseline and endline evaluation points, there were significant reductions in various forms of violence at the school level, including both boys’ and girls’ past month experience of peer violence victimization, peer violence perpetration, and corporal punishment by teachers. There were also significant reductions in boys’ and girls’ experience of corporal punishment at home and observation of family violence, with a particularly strong effect observed among girls. Both boys and girls had significantly more equitable gender attitudes and significantly less violence-supportive attitudes in relation to children’s punishment, and significantly fewer symptoms of depression. Girls’ school attendance was also significantly higher at endline.DiscussionTo our knowledge this is the first time that a peace education program has been evaluated in Afghanistan, with or without a community intervention to change harmful social norms and practices related to gender and the use of violence for conflict resolution. The evaluation suggests that the intervention may have led to a reduction in various forms of violence, including children’s peer violence, corporal punishment of children both at school and at home, and in children’s reports of domestic violence against women at the household level.

The Association Between Exposure to Violent Pornography and Teen Dating Violence in Grade 10 High School Students

Exposure to pornography in general has been linked with adolescent dating violence and sexual aggression, but less is known about exposure to violent pornography specifically. The current study examined the association of violent pornography exposure with different forms of teen dating violence (TDV) using baseline survey data from a sample of Grade 10 high school students who reported being in a dating relationship in the past year (n = 1694). Gender-stratified logistic regression models generated odds ratios adjusted for demographics, substance use, history of suspension/expulsion, gender equitable attitudes, and tolerance of rape myths to identify significant associations between violent pornography exposure and self-reported physical, sexual, and threatening TDV perpetration and victimization. Violent pornography exposure was associated with all types of TDV, though patterns differed by gender. Boys exposed to violent pornography were 2-3 times more likely to report sexual TDV perpetration and victimization and physical TDV victimization, while girls exposed to violent pornography were over 1.5 times more likely to be perpetrate threatening TDV compared to their non-exposed counterparts. Comprehensive prevention strategies for TDV may consider the potential risks associated with exposure to violent pornography, particularly for boys, and provide an alternative source of education about healthy sexual behavior and relationships.

Adolescents’ development of gender equity attitudes in India

ABSTRACT Gender-equitable attitudes are often constructed during adolescence making this a critical time to alter gender perceptions. However, there is little research on gender attitudes and gender equity in early adolescence, especially in India. This study is a cross-sectional sample of 1,691 participants 8–18 years from three Northern India states. Surveys were collected on mobile tablets and assessed gender perceptions and attitudes. Gender-equitable scores were categorized into low, medium and high. Gender-equitable attitudes and gender vary by grade (p < .001). Gender-equitable attitudes improved with grade, but boys were 46% less likely to be in the moderate category compared to the low category as grade increased (p < .01). Compared to girls, boys were 56% less likely to be in the high category compared to the low category as grade increased (p < .001). Early adolescence is a unique opportunity to address gender attitudes before they become more solidified.

Gender norms and modern contraceptive use in urban Nigeria: a multilevel longitudinal study

BackgroundEvidence suggests that gender equality positively influences family planning. However, the evidence from urban Africa is sparse. This study aimed to examine the association between changes in gender norms and modern contraceptive use over time among women in urban Nigeria.MethodsData were collected in 2010/2011 from 16,118 women aged 15–49 living in six cities in Nigeria (Abuja, Benin, Ibadan, Ilorin, Kaduna, and Zaria) and again in 2014 from 10,672 of the same women (34% attrition rate). The analytical sample included 9933 women living in 480 neighborhoods. A four-category outcome variable measured their change in modern contraceptive use within the study period. The exposure variables measured the changes in the level of gender-equitable attitudes towards: a) wife beating; b) household decision-making; c) couples’ family planning decisions; and d) family planning self-efficacy. Multilevel multinomial logistic regression models estimated the associations between the exposure variables at the individual and neighborhood levels and modern contraceptive use controlling for the women’s age, education, marital status, religion, parity, household wealth, and city of residence.ResultsThe proportion of women who reported current use of modern contraceptive methods increased from 21 to 32% during the four-year study period. At both surveys, 58% of the women did not report using modern contraceptives while 11% reported using modern contraceptives; 21% did not use in 2010/2011 but started using by 2014 while 10% used in 2010/2011 but discontinued use by 2014. A positive change in the gender-equitable attitudes towards household decision-making, couples’ family planning decisions, and family planning self-efficacy at the individual and neighborhood levels were associated with increased relative probability of modern contraceptive use (adoption and continued use) and decreased relative probability of modern contraceptive discontinuation by 2014. No such associations were found between the individual and neighborhood attitudes towards wife beating and modern contraceptive use. Accounting for the individual and neighborhood gender-equitable attitudes and controlling for the women’s demographic characteristics accounted for 55–61% of the variation between neighborhoods in the change in modern contraceptive use during the study period.ConclusionInterventions that promote gender equality have the potential to increase modern contraceptive use in Nigerian cities.

Associations between poverty, mental health and substance use, gender power, and intimate partner violence amongst young (18-30) women and men in urban informal settlements in South Africa: A cross-sectional study and structural equation model.

Research suggests that poverty is a key driver of intimate partner violence (IPV), however detailed analysis suggests that this relationship is not clear, either for women’s experience or men’s perpetration of IPV. We explored associations between poverty and IPV using cross-sectional data from the Stepping Stones and Creating Futures cluster randomized control trial, in urban informal settlements in Durban, South Africa, with young (18–30) people. Using logistic regression and structural equation modelling we assess associations between poverty and women’s experience and men’s perpetration of physical and/or sexual IPV in the past 12 months. 680 women and 677 men were recruited into the study between September 2015 and September 2016. The analyses highlight how specific forms or measures of poverty intersecting with gender identities shape IPV. For men we found indicators of economic provision were associated with IPV perpetration, while for women food-insecurity was key to IPV experience. We also found similarities between women and men. First, food-insecurity and childhood traumas shaped pathways to substance misuse and poor mental health that increased IPV. Second, there was a resilience pathway in both models, whereby those with more education had increased gender equitable attitudes and fewer controlling behaviours, which reduced IPV. Interventions to reduce IPV need to work to reduce household food insecurity, but these need to be combined with gender transformative interventions. Interventions should also focus on reducing the impact of mental health and substance misuse. Finally, working to increase educational attainment is a long-term critical intervention to reduce IPV.Trial registration: NCT03022370. Registered 13 January 2017, retrospectively registered.

Is Mother’s Education or Household Poverty a Better Predictor for Girl’s School Dropout? Evidence from Aggregated Community Effects in Rural India

Neighbourhoods and families are key social institutions instilled with development of early life course of adolescents. Limited research in India has examined exposure to community along with socioeconomic conditions for school-dropouts of girls. Multidimensional benefits of female education are increasingly recognized in recent years; hence, it becomes imperative to study the community components of school discontinuation particularly in rural area. This study aims to analyse effect of mother’s education, community poverty, and gender equitable attitudes associated with a girl’s school dropout. This study uses baseline survey data from an intervention program from poor-performing districts of India. Collinearity among individual predictors validated by variance inflation factor proceeded step-wise binary-logistic regression. Result suggests that communities with high concentrations of poverty and mother illiteracy are disadvantages with low gender perception and high levels of dropouts. Result suggests that girls living in poor communities are three times more likely to dropout and 70% more if belonged to communities with lower mother literacy. Girls who scored low on Gender Equitable Scale had less probability to dropout. The study concludes that girls from poor communities with low levels of mother literacy and non-egalitarian gender attitudes are at higher risk of school dropout.

Gender Norms, Violence in Childhood, and Men's Coercive Control in Marriage: A Multilevel Analysis of Young Men in Bangladesh.

Coercive control in marriage is common in patriarchal settings, but multilevel determinants are understudied. Using a probability sample of 570 junior men (married, 18-34 years) from the Bangladesh survey of the 2011 UN Multi-Country Study of Men and Violence, we examined how exposure to violence in childhood and community-level gender norms were related to men's attitudes about gender equity and use of controlling behavior. We tested whether community-level gender norms moderated the relationship between men's exposure to violence in childhood and our outcomes. According to results from multilevel Poisson regression models, as community gender norms become more equitable by 1 standard deviation, a junior married man's expected rate of controlling behavior is lower by 0.11, and his rate of agreement with gender equitable attitudes is higher by 0.27. More gender-equitable community norms were negatively related to a junior married man's use of controlling behavior. Childhood exposure to violence was not associated with use of controlling behavior. There was a significant cross-level interaction such that exposure to violence had a stronger negative impact on men's gender equitable attitudes in communities with lower overall gender equity than those with higher overall gender equity. The corresponding cross-level interaction effect was not significant for the controlling behavior outcome. More equitable community gender norms may encourage more gender-equitable attitudes and discourage use of controlling behavior among junior men, suggesting that interventions to change community gender norms may reduce coercive control of women in marriage.

Learning from our mothers: examining the role of intergenerational knowledge transfer in advancing gender equity among Sri Lankan youth

Abstract Background In a 2013 survey, over half of Sri Lankan men and women expressed gender-inequitable attitudes that equated masculinity with violence, and femininity with obedience to men. High rates of gender-inequitable attitudes are a community-level risk factor for gender-based violence including rape and intimate partner violence. In Sri Lanka, public health practitioners focused on reducing the health disparities resulting from gender inequity need to better understand the processes by which gender-inequitable attitudes develop and how to prevent them. The goal of this research was to identify potential points of intervention at which appropriate programmes and policies could most effectively cultivate gender-equitable attitudes among young people in Sri Lanka. Methods Over 9 months in 2016 and 2017, we interviewed more than 30 young adults in Sri Lanka to understand how their experiences helped them to develop their own gender identity, as well as to understand and respond to gender norms. Their responses were analysed using a grounded theory approach to explore which factors have most influenced the processes of gender norm learning, acceptance, or rejection throughout Sri Lankan young adults' lives. Findings Many interviews focused on the impact of elder family members on the interviewee's perception and acceptance of gender norms. Many young adults who did not agree with gender-inequitable norms reported receiving advice from their parents or other elder relatives to disregard norms and pursue their own non-conforming interests. In one example, many non-working mothers insisted on their daughters working and becoming financially independent. Interpretation Young people in Sri Lanka are repeatedly confronted by gender-inequitable attitudes in school, the media, politics, and society at large. However, family members can support youth to develop gender equitable attitudes and behaviours within this gender-inequitable society. Harnessing elders' positive wishes for their offspring's future may prove essential to advancing gender equity in the next generation of Sri Lankan adults. Even from gender-inequitable roles, parents may still support gender equity, and could be encouraged through public health interventions to support their children in realising their full potential. Elder family members are an untapped public health resource for advancing gender equity and reducing its related health disparities among Sri Lankan youth. Funding 2016 Fulbright US Student Grant.

Training university teachers and students in Sri Lanka on Gender Based Violence: testing of a participatory training program.

This article was migrated. The article was marked as recommended. In all societies, violence is a social problem and violation of human rights. Changing attitudes and behaviors, which accept violence at individual and societal levels are key components in prevention strategies. The aim of this study was to produce educational material on Gender Based Violence (GBV). A participatory study design including educators and university students was used to create four teaching modules. The teaching was evaluated by descriptive surveys before and after the training and focus group discussions followed the training session. The questionnaire covered attitudes to gender, violence and laws. One hundred eleven teachers and 25 students representing different faculties and universities participated in separate workshops in three Sri Lankan universities. The students lacked knowledge of the meaning of GBV, consequences and existing laws. Women held more gender-equitable attitudes. Both women and men favoured equal participation of work and decision in the households. Male undergraduates showed less accepting attitudes toward rape or blaming women for rape Three categories emerged after the FGDs; Make training module compulsory and teacher led; Mind your own business; What can be done. The newly prepared and context specific material was well-received by educators and students and they provided valuable inputs, which improved the educational modules.

Addressing harmful and unequal gender norms in early adolescence

Early adolescence (age 10–14) is an important window of opportunity to address gender socialization as the basis for health and social justice. This Comment explains why this is the case and provides illustrative examples of existing evidence on strategies to promote gender equitable attitudes in young adolescents.

122 - Exploring Gender Norms and Relation to Condom and Contraceptive Use Attitudes among Adolescent Girls in Low-Resource Neighborhoods

Purpose: A growing body of evidence supports an important role for promotion of gender equality in sexual and reproductive health education. Previous research has demonstrated that programs that address gender and power are far more likely to reduce STI or pregnancy than those that do not. However, there is a paucity of evidence regarding the correlation between gender equitable attitudes specifically and positive sexual and reproductive health outcomes. Additionally, research on gender norms and behaviors among boys and men is more extensive. Far less is known about the role of gender equitable attitudes among adolescent girls and the impact on sexual decision-making and behaviors. In this study, we hypothesize that gender equitable attitudes and positive attitudes toward women among adolescent girls are associated with greater condom and contraceptive self-efficacy and attitudes.

MenCare+ in South Africa: findings from a gender transformative young men’s group education on sexual and reproductive health and rights

This paper details findings from an evaluation of a gender-transformative sexual and reproductive health and rights group education programme facilitated with young men aged 15–24 years in South Africa. A total of 475 young men participated in the group education programme. A self-administered pre- and post-questionnaire survey was conducted with a sample of the participants, and focus group discussions were facilitated. A total of 265 young men completed both the pre and post-questionnaires. Findings from the surveys as well as the focus group discussions showed positive changes in gender equitable attitudes, contraception and condom use. Results indicate that the young men who participated in the group education learned to identify harmful gender norms and actively questioned these constructs both within their personal lives and in the broader community. The intervention enabled some participants to envision alternative versions of masculinity and femininity, thus enabling them to adopt a new way of being, with transformed attitudes concerning household and gender roles.

A review of measures of women\u2019s empowerment and related gender constructs in family planning and maternal health program evaluations in low- and middle-income countries

BackgroundEvidence suggests that gender-integrated interventions, which actively seek to identify and integrate activities that address the role of gender norms and dynamics, improve family planning (FP) and maternal health (MH). To understand the link between the gender components of interventions and FP and MH outcomes, it is critical to examine the gender measures used in evaluations.MethodsWe conducted a systematic review of evaluations of gender-integrated FP and MH interventions in low- and middle-income countries. We examine characteristics of the interventions and their evaluations, and summarize women’s empowerment and related gender measures.ResultsOut of 16 evaluation articles, five reported the theoretical or conceptual model that guided the intervention. Twelve described how gender was quantitatively measured and identified 13 women’s empowerment and related gender constructs. Gender scales or indexes were used in five evaluations, three of which noted that their scales had been validated. Less than one third of articles reported examining the effect of gender on FP or MH.ConclusionsEvaluations of gender-integrated FP and MH interventions do not consistently describe how gender influences FP and MH outcomes or include validated gender measures within their studies. As a result, examining the pathways through which interventions empower women and the manner in which women’s empowerment leads to changes in FP and MH outcomes remains a challenge. Valid measures of commonly reported women’s empowerment and gender constructs, such as gender-equitable attitudes and women’s decision-making power, must be adapted and used within evaluations to examine how empowerment and improvements in gender-related factors can produce positive FP and MH outcomes.