Gender norms in sexual and reproductive health and rights: insights from young Angolan women and the development of a context-specific questionnaire (2021–2022)

Restrictive gender norms and persistent inequalities continue to constrain women’s lives globally, particularly in relation to sexual and reproductive health and rights (SRHR). In Angola, despite international and national commitments, young women face enduring SRHR challenges, including high rates of adolescent pregnancy and limited access to contraception and maternal healthcare. These reflect systemic health constraints and the normative structures shaping expectations, behaviours, and entitlements. Addressing SRHR thus requires attention to both service provision and the gendered norms that sustain inequality. Yet, measuring gender norms remains methodologically complex: many instruments conflate individual attitudes with collective expectations or rely on indirect proxies, reducing conceptual precision. To address this gap, a mixed-methods study incorporating Rash analysis was undertaken. Drawing on a literature review and qualitative approaches, contextually salient SRHR topics were identified, and an eleven-item gender norms questionnaire was developed. The questionnaire was embedded in a larger cross-sectional survey of 2,081 young women aged 18–24 in urban and rural areas across three provinces. Descriptive statistics were applied to socio-demographic variables and gender norm items. Provincial contrasts emerged: participants in better-resourced provinces reported lower rates of adolescent pregnancy and intimate partner violence, alongside stronger normative support for SRHR. Endorsement was most consistent for education and bodily autonomy, while norms relating to reproductive rights and equality within relationships were more contested. Rasch analysis indicated sound psychometric properties and adequate coverage of the latent construct, although some provincial variation in item functioning was observed. Psychometric techniques identified minor tensions within and between SRHR topics; yet overall, the questionnaire demonstrated suitability as a composite measure. Thematic and geographical variations in perceived normative support highlighted how gender norms intersect with broader inequalities. Integrating the socio-demographic analysis, and an aggregate gender norms index, and item-level differentiation provides a strong basis for intervention design. Such integration can support contextually grounded, gender-empowering initiatives that strengthen young women’s SRHR within their specific socio-economic realities.