Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe

We investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (n = 3096), we utilised the SRHR Support Index including f...

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Main Authors: Karin Båge, Anna Kågesten, Olalekan Uthman, Mariano Salazar, Bi Puranen, Signe Svallfors, Anna Mia Ekström, Helena Litorp
Format: Article
Language:English
Published: Taylor & Francis Group 2024-12-01
Series:Sexual and Reproductive Health Matters
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Online Access:https://www.tandfonline.com/doi/10.1080/26410397.2024.2444725
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author Karin Båge
Anna Kågesten
Olalekan Uthman
Mariano Salazar
Bi Puranen
Signe Svallfors
Anna Mia Ekström
Helena Litorp
author_facet Karin Båge
Anna Kågesten
Olalekan Uthman
Mariano Salazar
Bi Puranen
Signe Svallfors
Anna Mia Ekström
Helena Litorp
author_sort Karin Båge
collection DOAJ
description We investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (n = 3096), we utilised the SRHR Support Index including five subindices to gauge SRHR attitudes, the WVS Equality Index for gender equality values, and the perceived level of freedom of choice and control over whether, when, and how many children to have as a proxy for reproductive agency. Descriptive statistics, bivariate, and multivariable logistic regressions were used to analyse how values and attitudes differed between respondents of high vs low reproductive agency using the median as cut-off, stratified by country and sex. Country, education, subjective social class, and religion were associated with reproductive agency. Adjusted analyses indicated associations between supportive values and attitudes towards equitable masculinity norms, SRHR interventions and gender equality, with high reproductive agency. Associations varied more between countries than by sex. Findings suggest an association between SRHR and gender equality values and attitudes and the level of reproductive agency, and underscore the importance of addressing values and attitudes in context-specific interventions. Measures of SRHR progress should be critically reviewed and complemented with self-assessed – as opposed to researcher-ascribed – items to support the successful implementation of global SRHR agendas.
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spelling doaj-art-e6585826724a4b84bb0fcd5a568651a02025-08-20T03:05:35ZengTaylor & Francis GroupSexual and Reproductive Health Matters2641-03972024-12-0132110.1080/26410397.2024.2444725Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and ZimbabweKarin Båge0Anna Kågesten1Olalekan Uthman2Mariano Salazar3Bi Puranen4Signe Svallfors5Anna Mia Ekström6Helena Litorp7Phd Student, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.Associate Professor, Department of Global Public Health, Karolinska Institutet, Stockholm, SwedenProfessor, Warwick Centre for Global Health, Warwick Applied Health, Warwick Medical School, Warwick University, Warwick, UKAssociate Professor, Department of Global Public Health,  Karolinska Institutet, Stockholm, SwedenAssociate Professor, Senior Research Fellow, Institute for Future Studies, Stockholm, Sweden; Secretary General, World Values Survey, Stockholm, SwedenPost Doctoral Fellow, Department of Sociology, Stanford University, Stanford, CA, USA; Post Doctoral Fellow, Department of Sociology, Stockholm University, Stockholm, Sweden; Post Doctoral Fellow, Department of Global Public Health, Karolinska Institutet, Stockholm, SwedenProfessor, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Senior Physician, Department of Infectious Diseases/Venhälsan, South General Hospital, Stockholm, SwedenAssociate Professor, Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Associate Professor, Department of Women’s and Children’s Health, Uppsala University, Uppsala, SwedenWe investigated the association between values and attitudes toward sexual and reproductive health and rights (SRHR) and gender equality, with reproductive agency in Ethiopia, Kenya, and Zimbabwe. Using 2020-21 World Values Survey (WVS) data (n = 3096), we utilised the SRHR Support Index including five subindices to gauge SRHR attitudes, the WVS Equality Index for gender equality values, and the perceived level of freedom of choice and control over whether, when, and how many children to have as a proxy for reproductive agency. Descriptive statistics, bivariate, and multivariable logistic regressions were used to analyse how values and attitudes differed between respondents of high vs low reproductive agency using the median as cut-off, stratified by country and sex. Country, education, subjective social class, and religion were associated with reproductive agency. Adjusted analyses indicated associations between supportive values and attitudes towards equitable masculinity norms, SRHR interventions and gender equality, with high reproductive agency. Associations varied more between countries than by sex. Findings suggest an association between SRHR and gender equality values and attitudes and the level of reproductive agency, and underscore the importance of addressing values and attitudes in context-specific interventions. Measures of SRHR progress should be critically reviewed and complemented with self-assessed – as opposed to researcher-ascribed – items to support the successful implementation of global SRHR agendas.https://www.tandfonline.com/doi/10.1080/26410397.2024.2444725sexual and reproductive health and rightsattitudesreproductive agencyreproductive empowermentEthiopiaKenya
spellingShingle Karin Båge
Anna Kågesten
Olalekan Uthman
Mariano Salazar
Bi Puranen
Signe Svallfors
Anna Mia Ekström
Helena Litorp
Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe
Sexual and Reproductive Health Matters
sexual and reproductive health and rights
attitudes
reproductive agency
reproductive empowerment
Ethiopia
Kenya
title Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe
title_full Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe
title_fullStr Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe
title_full_unstemmed Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe
title_short Attitudes toward sexual and reproductive health and rights and their associations with reproductive agency: a population-based cross-sectional study in Ethiopia, Kenya, and Zimbabwe
title_sort attitudes toward sexual and reproductive health and rights and their associations with reproductive agency a population based cross sectional study in ethiopia kenya and zimbabwe
topic sexual and reproductive health and rights
attitudes
reproductive agency
reproductive empowerment
Ethiopia
Kenya
url https://www.tandfonline.com/doi/10.1080/26410397.2024.2444725
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