Reproductive Empowerment Research Articles

Does Women’s Reproductive Health and Empowerment Affect Female Labor Participation in ASEAN?

This research aims to analyze the effect of women’s reproductive health and women’s empowerment on female labor force participation (FLFP) in ASEAN countries. This type of research is quantitative research with panel data types from 9 (nine) ASEAN countries during the period 2010-2017. The resultsshow that countries with high levels of women’s reproductive health and women’s empowerment also have high levels of female labor participation.

Using online technologies to improve diversity and inclusion in cognitive interviews with young people

BackgroundWe aimed to assess the feasibility of using multiple technologies to recruit and conduct cognitive interviews among young people across the United States to test items measuring sexual and reproductive empowerment. We sought to understand whether these methods could achieve a diverse sample of participants. With more researchers turning to approaches that maintain social distancing in the context of COVID-19, it has become more pressing to refine these remote research methods.MethodsWe used several online sites to recruit for and conduct cognitive testing of survey items. To recruit potential participants we advertised the study on the free online bulletin board, Craigslist, and the free online social network, Reddit. Interested participants completed an online Qualtrics screening form. To maximize diversity, we purposefully selected individuals to invite for participation. We used the video meeting platform, Zoom, to conduct the cognitive interviews. The interviewer opened a document with the items to be tested, shared the screen with the participant, and gave them control of the mouse and keyboard. After the participant self-administered the survey, the interviewer asked about interpretation and comprehension. After completion of the interviews we sent participants a follow-up survey about their impressions of the research methods and technologies used. We describe the processes, the advantages and disadvantages, and offer recommendations for researchers.ResultsWe recruited and interviewed 30 young people from a range of regions, gender identities, sexual orientations, ages, education, and experiences with sexual activity. These methods allowed us to recruit a purposefully selected diverse sample in terms of race/ethnicity and region. It also may have offered potential participants a feeling of safety and anonymity leading to greater participation from gay, lesbian, and transgender people who would not have agreed to participate in-person. Conducting the interviews using video chat may also have facilitated the inclusion of individuals who would not volunteer for in-person meetings. Disadvantages of video interviewing included participant challenges to finding a private space for the interview and problems with electronic devices.ConclusionsOnline technologies can be used to achieve a diverse sample of research participants, contributing to research findings that better respond to young people’s unique identities and situations.

A sexual and reproductive empowerment framework to explore volitional sex in sub-Saharan Africa

Volitional sex is central to the sexual health and well-being of women and girls globally. To date, few studies have examined women’s empowerment and its application to sexual health outcomes, including volitional sex. The aim of this study was to explore the relevance of a sexual and reproductive empowerment framework to volitional sex across four geographically and culturally diverse contexts in sub-Saharan Africa. Qualitative data were collected between July and August 2017 in four sites: Ethiopia, Nigeria (Anambra and Kano states) and Uganda. A total of 352 women aged 15–49 and 88 men aged 18 and older were interviewed through 120 in-depth interviews and 38 focus group discussions (n = 440 total participants). Results describe the substantial barriers restraining women’s sexual choices, particularly norms that stigmatise women’s requests for sex, even within marriage. Results further highlight women’s internal sexual motivations, particularly related to the enjoyment of sex and the role of sex in strengthening partner relationships. Future empowerment research and measurement should focus not only on sexual constraints, but also integrate internal motivations, in order to fully understand the factors that shape women’s sexual health outcomes.

The Intersections of Women’s Economic and Reproductive Empowerment

ABSTRACTThis article examines the connections between women’s reproductive health, care responsibilities, and the quality of work. The research suggests that the economic empowerment of women, manifest in their choice of where and when to work, and of the terms and conditions of that work, is intimately linked to reproductive empowerment and reproductive outcomes. Simplistic discourse in development policy about educating girls and getting women into the labor force will not translate into goals being met unless attention is paid to women’s reproductive health and rights. This analysis highlights the data limitations inherent in existing surveys that frustrate a more-nuanced inquiry into employment and fertility outcomes. Analysts and statistical agencies responsible for household and labor force survey design could certainly apply some of the information they gain from questions that elicit retrospective histories of contraception and fertility to inform their interpretations of women’s employment history, job quality, and labor market intermittency.

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

Conceptual ambiguity in how we define reproductive empowerment has left the field with inconclusive evidence of its relationship to key reproductive outcomes. Our study aimed to develop and test a measure of reproductive decision-making agency, which is a critical component of reproductive empowerment, in a sample of married women from two Nepalese districts. Initial measures were developed based on theory and previous literature. Next, we used cognitive interviewing techniques to explore local meanings of reproductive empowerment and decision making through eight focus group discussions and 24 in-depth interviews. This process resulted in four core questions used to assess decision making across three domains of reproductive behavior: when to have children, whether to use family planning, and which family planning method to use. We combined these questions to develop an overall assessment of decision-making agency. These measures were included in a quantitative survey conducted with 1000 women, split evenly between the two districts. The combined measure of overall reproductive decision-making agency was internally consistent across the three domains examined (Cronbach's alpha = 0.6416), performed well across a range of validity assessments, including those aimed at assessing construct and criterion validity, and was predictive of a range of reproductive outcomes, particularly those related to feelings of reproductive control. The results suggest that the measures developed here provide insight into the nuances of joint versus sole decision making beyond those provided by standard measures. With better measures of reproductive agency, we can better design interventions for men and women, to meet their reproductive needs.

Quality of Contraceptive Use and Women’s Paid Work and Earnings in Peri-Urban Ethiopia

Economic and reproductive empowerment mutually reinforce each other. However, while many studies have examined the importance of economic empowerment for reproductive empowerment, few have investigated the reverse relationship, especially in Sub-Saharan Africa. This study uses retrospective contraceptive-use history and panel data from two time points from a peri-urban community in Ethiopia to explore the impact of quality of contraceptive use as measured by duration of use and type of method on a woman’s ability to participate in the labor force, receive payment for work, and contribute to family income. Multivariate regression models were implemented based on the nature of the outcome variable. Women who reported more consistent use had statistically significant higher odds of working in the labor force and receiving cash payments. The findings illustrate the critical role of contraceptive use in enabling women to participate in the labor force and receive payment for their work.

Women’s Reproductive Empowerment: A Comparative Study of Urban and Rural Females in Iran

Objectives: Women’s reproductive empowerment is an essential issue for good reproductive health which is affected by various socioeconomic and cultural factors. This study was designed to compare women’s reproductive empowerment in urban and rural areas. Materials and Methods: In this descriptive-analytical and correlational-type study, 810 women referring to health care centers in Sari were recruited through proportional cluster sampling method. Data were collected using a questionnaire on women’s reproductive empowerment including cultural, individual-family, social, and family planning domains. Finally, the obtained data were analyzed using descriptive and analytical tests. Results: The mean (standard deviation) of women’s reproductive empowerment score was 91.46±13.14 (a 95% CIof 90.55-92.36) and no statistical difference was observed between the urban and rural women in this respect (P = 0.59). In addition, cultural and family planning domains obtained the highest 29.12 (5.80) and the lowest 17.55 (4.25) scores concerning reproductive empowerment, respectively. Therefore, women’s reproductive empowerment score was significantly correlated with the females’ employment status (P = 0.006) and their husbands’ levels of education (P < 0.001). Conclusions: Overall, the finding contributes to the discourse on women’s reproductive empowerment based on their residential area and thus adds to the limited literature on this issue in developing countries and Iran, in particular. Therefore, appropriate planning is required for women with various employment statuses and their spouses with different educational levels in order to improve their empowerment in terms of reproductive issues.

Reproductive Life Planning: Raising the Questions.

Introduction Unintended pregnancy has been a concerning public health problem for decades. As we begin to understand the complexities of pregnancy intention and how women experience these pregnancies, reproductive life planning offers a paradigm shift. Methods Reproductive life planning is a patient-centered approach that places a patient's reproductive preferences-whether concrete or ambivalent-at the forefront of her clinical care. ResultsThis process grants women and men the opportunity to consider how reproduction fits within the context of their broader lives. Within a clinical encounter, reproductive life planning allows counseling and care to be tailored to patient preferences. Discussion Although there is great potential for positive public health impacts in unintended pregnancy, contraceptive use and improved preconception health, the true benefit lies within reinforcing reproductive empowerment. Despite recommendations for universal adoption, many questions remain regarding implementation, equity and outcomes.

Gender Inequality Index Appropriateness for Measuring Inequality

ABSTRACTIntroduction: Gender inequality means unequal distribution of wealth, power, and benefits among women and men. The gender inequality index (GII) measures the lost human development in three important dimensions: reproductive health, political empowerment, and economic status. The first purpose of this study was to calculate the index for provinces of Iran, and the second purpose was to survey the appropriateness of that, for comparing different regions, through regression estimations. Methodology: In this study, GII has been calculated for Iran between the years 2006–2011 and provinces have been ranked based on it. Then, a panel composed of 30 sections was estimated for five years to determine the most important factor affecting level of index. Some changes have been made to analyze values of the index and the ranking of provinces. Results: Based on panel model, share of parliamentary seats was the most effective factor for determination of the index. After applying adjustments, some differences were seen in the ranking of provinces and general level of index. Conclusion: Weighing of dimensions of the index and considering an overall variable, such as life expectancy in the field of health, will give a more accurate comparison of the GII among different regions though concurrent attention to non-discriminatory cultural dimensions of political participation of women; therefore, making more analyses possible for a more correct comparison of the extensive geographical regions, such as countries.

Altruism or obligation? The motivations and experience of women who donate oocytes to known recipients in assisted conception treatment: an interpretative phenomenological analysis study

Introduction: This qualitative study was conducted to explore the motivations and experience of oocyte donors donating to women known to them.Methods: Three women who donated oocytes to a close relative were interviewed and data were analysed using an Interpretative Phenomenological Analysis approach.Results: The two key elements noted were “motivations for donation” and “coping with the consequences of oocyte donation”. The motivation for donation was influenced by the familial bond that was strengthened by the donation process in some cases. The concept of altruistic oocyte donation stemmed from the narratives of giving the gift of motherhood and gaining a positive self-image and respect from others. Coping with the consequences of oocyte donation tests the donor identity, their wishes for a positive outcome, concerns regarding disclosure of biological motherhood and detachment from the egg and potential child.Discussion: Motivation is influenced by a combination of factors including the rewards of altruistic behaviour, the existence and potential strengthening of the relationship between donor and recipient, but possibly also, a sense of obligation and societal expectations. Oocyte donation can be variously viewed by donors as a unique way of reproductive empowerment or an example of acceding to subtle coercion and thus disempowerment. The study also highlights the clinical as well as ethical importance of providing support services for oocyte donors and recipients.

Making the Most of the Affordable Care Act's Contraceptive Coverage Mandate for Privately-Insured Women

Under the Patient Protection and Affordable Care Act of 2010 (ACA), most women of reproductive age with private health insurance have, or will soon have, first-dollar coverage of contraception and contraceptive counseling. The need for contraceptive coverage is great, because most American families want two children, resulting in the average woman spending three decades of her reproductive life trying to avoid pregnancy (Guttmacher Institute, 2012; Finer & Philbin, 2014). Contraceptive coverage without cost sharing is a sea change in women’s health insurance. This policy change has the potential to dramatically shift contraceptive use patterns, to reduce the U.S. unintended pregnancy ratedwhich stands at approximately half of all pregnancies (Finer & Zolna, 2014)dand to improve the health of women and families. In this commentary, we argue that realizing the potential of this policy change requires more action on the part of public health practitioners, insurers, health care providers, and researchers than is currently evident, andwe offer some suggestions for making the most of first-dollar contraceptive coverage.

Abstract P187: Gender Equality and female-to-male Smoking Ratio: Trends in Spain Over the Last 50 Years (1960-2010)

INTRODUCTION Gender empowerment has been associated with higher gender smoking ratio (GSR) and proved to be a strong predictor of the GSR. Our aim is to study how changes in gender equality may be associated with female-to-male smoking ratio trends in Spain over the last 50 years. HYPOTHESIS We hypothesize that greater gender equality will increase female-to-male gender smoking ratio. METHODS Values of the United Nations Development Programme’s Gender Inequality Index (GII) were calculated in 5-year intervals from 1960-2010, using data from the National Institute of Statistics. The GII ranges from 0-1 (1 meaning highest inequality) and contemplates 3 dimensions: reproductive health (measured by maternal mortality ratio and adolescent fertility rate), empowerment (share of parliamentary seats and % of each gender with at least secondary education), and female and male labor force participation rates. Female and male smoking prevalence and female-to-male smoking ratio were measured by retrospective reconstruction of National Health Surveys conducted in 2001, 2003, 2006, 2009 (n=20.426, n=21.358, n=29.478, n=22.188), attending to smoking initiation and cessation dates and birth cohorts. In order to test the association between the GII and GSR over the 5 decades we performed Pearson’s correlation. FINDINGS The GII decreased from 0.65 to 0.09 in Spain in the last 50 years. Higher women’s empowerment (parliamentary representation: from 0% to 36%; attainment of secondary education: from 5% to 63%), higher women’s participation in the labor force (from 19% to 68%), and lower maternal mortality ratio (from 45.36 to 4.11 deaths/100.000 live births), can account for most of the reduction in the GII. The smoking prevalence reconstruction reproduced the model of the epidemic in developed countries. Women born after 1951 had a smoking prevalence pattern similar to men’s, as opposed to women born prior to this date. GSR increased from 0.05 to 0.66, indicating that smoking prevalence of both genders converged in time. A gradient of the GSR by level of education was observed and women with higher education had equal smoking prevalence compared to men since 1990. The relation between the GII and GSR over time resulted inversely proportional (r=-0.99) with decreases in gender inequality relating to higher female-to-male smoking ratio. CONCLUSIONS We found a strong negative correlation between gender inequality and female-to-male smoking ratio. Gender equality has significantly improved in Spain over the last 50 years and this process has been accompanied of differential smoking prevalence patterns by genders, which eventually result in analogous female and male smoking prevalence. Gender sensitive tobacco control measures specifically targeted to women are necessary to prevent female smoking prevalence from rising, especially in the context of social transitions involving women’s development.

Development of a reproductive autonomy measure to predict contraceptive use

A broad body of research exists on women's empowerment and reproductive outcomes, but measures of women's empowerment rarely include dimensions of reproductive decision-making power. We aimed to develop a theory-based validated instrument to measure women's reproductive empowerment and to assess whether it predicts contraceptive use.

Reproductive empowerment: The main motivator and outcome of carrier testing

The aim of this Grounded Theory study was to assess the motivation and outcomes of carrier testing. Qualitative semi-structured interviews were conducted with participants who had undergone carrier testing for autosomal recessive, X-linked conditions and chromosome translocations. Reproductive empowerment emerged as the central phenomenon. A desire to manage risk was the main motivator for carrier testing, and information gathering the main facilitator. Participants were then able to make informed decisions, regain control over their reproductive risk and pass on information to family members. These findings support a patient-reported outcome measure of empowerment currently being developed for genetic services.

Khmer Girls in Action

Khmer Girls in Action (KGA) began in 1997 as HOPE for Girls, a Cambodian young women's reproductive health and empowerment project. Since KGA's inception, the organization has been successful in developing the leadership of Southeast Asian, predominantly Khmer girls and young women to work on issues of immigrants and refugee rights, reproductive justice and building the Khmer American identity. To ensure the organization remains grounded in the community as it expands, KGA hired its first Khmer American Executive Director, Suely Ngouy in 2006. KGA connects the Khmer American experience to the Asian & Pacific Islander (API) community on social justice values and the struggle to end all forms of discrimination along lines of age, gender, class, race, and sexuality. The following pieces are from the Tongues Afire Workshop.

Should prenatal sex selection be restricted? Ethical questions and their implications for research and policy

Sex-selective abortion following prenatal sex testing is so blatantly discriminatory that many observers have, understandably, called on governments to condemn and restrict the practice. Yet ethical questions that counterbalance these sentiments have been neglected. Restricting the practice would seem to interfere with reproductive freedoms and maternal empowerment, the twin goals adopted at the recent Cairo conference. The restrictions may also increase human suffering if sex discrimination is then shifted into the postnatal period. Consideration and empirical testing of this substitutive dynamic has been precluded by limitations in the comparative design of recent research and a lack of appropriate data. Nevertheless, this dynamic has always been presumed to exist by pro-choice advocates. Moreover, extending anti-discriminatory legislation to the prenatal realm may awaken and justify similar demands among other disadvantaged groups whose foetal counterparts have previously engendered less public sympathy, which may result in further restrictions on abortion.