Evaluating Contraceptive Empowerment Among Women and Girls in Sub‐Saharan Africa: Validation of the Women's and Girls’ Empowerment in Sexual and Reproductive Health (WGE‐SRH) Index Contraceptive Empowerment Subscale

This study evaluates the contraceptive empowerment subscale of the Women's and Girls' Empowerment in Sexual and Reproductive Health (WGE-SRH) index across seven sub-Saharan African countries. Using structural equation modeling and logistic regression among population-based samples of women aged 15-49, we find evidence that the abbreviated eight-item subscale is a reliable measure of contraceptive empowerment (Cronbach's alpha range: 0.67-0.78), significantly associated with women's involvement in the decision to use contraception. Results show geographic variability, with the highest overall contraceptive empowerment in Kenya (mean = 4.26, range: 1-5) and lowest in Uganda (mean = 3.67), reflecting diverse fertility trends, contraceptive norms, and gendered power dynamics. The subscale's two-dimensional structure-distinguishing existence and exercise of choice-proves effective, with existence of choice being a stronger correlate of involvement in contraceptive use decisions than exercise in most settings. Despite some challenges, such as variable factor loadings, the subscale shows acceptable internal consistency and construct validity. This research underscores the need for multidimensional measures of reproductive empowerment to capture this nuanced process.