Empowerment as an Outcome and a Process: Longitudinal Validation of a Reproductive Empowerment Scale in Plateau State, Nigeria.

Abstract

Measurement of reproductive empowerment (RE) is necessary to understand and address barriers to RE and to evaluate the impact of policies and practices that increase RE as a pathway to improving reproductive health. This study validated an existing RE scale, developed in 2016 for sub-Saharan African (SSA) contexts, using longitudinal survey data from a cohort of women in Plateau State, Nigeria. Psychometric properties were assessed through confirmatory factor analysis, and invariance tests evaluated the scale's consistency across baseline and endline. Longitudinal logistic regression models examined whether changes in RE levels predicted family planning outcomes. The results demonstrate the final RE scale is a valid and predictive tool, comprising 24 items across five subscales that measure empowerment at individual, immediate relational, and distant relational levels. The RE scale also predicts the use of family planning and intention to use modern contraception in the future. This is one of the few RE scales designed specifically for SSA contexts and the only one known to be validated longitudinally. The RE scale provides a robust framework for measuring RE across levels and over time and can be used in SSA contexts to measure RE as a dynamic process and as an outcome.