Reproductive Agency: Validation of a Measure for Women's Autonomy in Family Planning and Sexual Intercourse in Burkina Faso

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Résumé

The links between women's empowerment and their reproductive health remain complex due to persistent challenges in defining empowerment and its various components, as well as the factors shaping it in different contexts. These difficulties also stem from the inability to conceptualize reproductive empowerment as an independent process that both reflects and shapes broader empowerment dynamics. This study, based on data from the Performance Monitoring for Action (PMA) research platform in Burkina Faso, aims to assess the validity of a multidimensional measure of agency specifically adapted to reproductive health in the Burkinabe context. This measure consists of two key dimensions: motivation—the ability to define reproductive goals—and self-efficacy—the ability to act on them. It explores women's decision-making autonomy in two key areas of reproductive health: family planning and sexual intercourse. The findings indicate that the three multi-item subdimensions of this measure demonstrate acceptable psychometric properties for use in Burkina Faso, while the two-item contraceptive self-efficacy index should be treated as preliminary. Moreover, external validity analyses reveal that, across each domain of agency, the motivation dimension was more consistently associated with reproductive outcomes than self-efficacy. Finally, the results highlight that social expectations regarding fertility, fear of infertility, stigma surrounding female sexuality, perceptions of men's sexual rights, and fear of relational sanctions contribute to limiting women's autonomy in reproductive decision-making.

Mots-clés

Reproductive Agency; Women's empowerment; Measurement validation; Family planning; Sexual autonomy; Burkina Faso