Social Values and Determinants of Health; Social determinants; Gender equality assessments / strategies; Health Service Delivery; PHC/MNCH/RH/Nutrition/W&S; Reproductive Health / Maternal health / newborn health; Social Values and Determinants of Health; Equity, Equality, Access, Inclusion; Rights based approaches
Women’s ability to make choices on SRHR is key factor influencing women’s sexual and reproductive health outcomes. Women are often not able to access SRHR services due to harmful and discriminatory social norms and practices and their lack of agency and financial resources. In the past, monitoring has focused on access to services; neglecting dimensions related to women’s ability to make choices about their SRHR. In the context of the Sustainable Development Goals (SDG), UNFPA has taken up the role as a custodian of the indicators 5.6.1. which focuses on women’s ability to make autonomous choices. SDG indicator 5.6.1 is a composite indicator providing data on whether a woman can refuse sexual intercourse to her husband or partner; whether using or not using contraception is mainly the woman’s decision or a joint decision; and whether a woman can make her own decision about reproductive health care.
The hera led research project was commissioned by the UNFPA to bring attention to new information and data on what factors determine women’s ability to decide on their SRHR; to explore and identify interventions that correlate with the changes in SDG 5.6.1 and, to propose areas where further research is needed.
You can read more about the study results and the UNFPA report here.
A consultant team from hera conducted the research which includes a systematic review on factors associated with women’s SRHR decision-making, including peer-reviewed literature covering low- and middle income countries published between 2005 and March 2019; a quantitative trend analysis covering 22 countries for which more than two data points on indicator 5.6.1 were available, to identify those where significant change had been observed and to understand what factors contributed to those changes; a qualitative study involving four case studies (on Ghana, Rwanda, Senegal and Uganda) and eight key informant interviews to further explore what factors impacted on the 5.6.1 outcomes in those countries and what programme approaches and strategies have shown to influence the outcomes.
The research used triangulated data from different sources, including 98 quantitative datasets from the DHS of 22 countries, 345 peer reviewed articles out of more than 13000 initially identified records, grey literature and 8 national and global key informants with relevant SRHR background.