Is reproductive agency associated with subjective well-being? A population-based cross-sectional study among men and women in four sub-Saharan African countries using the World Values Survey

We investigated the association between reproductive agency (RA) and subjective well-being (SWB) in Ethiopia, Kenya, Nigeria, and Zimbabwe using cross-sectional research design. We used nationally representative data from the World Values Survey from 2017 to 2021 (N = 4948). SWB used four items on perceived: (i) life satisfaction (range 1-10), overall life agency (range 1-10), health status (range 1-5), and happiness (range 1-4). RA used one item on perceived freedom of choice and control over whether, when, and how many children to have (range 1-10). We compared SWB between 4302 respondents of high vs. low RA (cutoff based on the median) using bivariate and multivariable logistic regression, stratified by country and sex. 55% rated their RA as high (median, 8; interquartile range (IQR, 5-10). 66% rated their life satisfaction as high (median, 5; IQR, 4-8), and 51% rated their overall life agency as high (median, 8; IQR, 5-10). 75% reported themselves as healthy and happy. High RA was associated with higher life satisfaction (aOR 1.27, 95% CI 1.11-1.46) and overall life agency (aOR 3.70, 95% CI 3.24-4.24), particularly for women and respondents in Nigeria and Zimbabwe. Women's RA and wellbeing are linked, relevant when fertility becomes politicized globally.