Reproductive agency : Validation of a measure for women's autonomy in family planning and sexuality in Burkina Faso.

The links between women's empowerment and their reproductive health remains complex due to persistent challenges in defining empowerment and its various components, as well as the factors shaping it in different contexts. These difficulties also stem from the inability to conceptualize reproductive empowerment as an independent process that both reflects and shapes broader empowerment dynamics. This study, based on data from the Performance Monitoring for Action (PMA) research platform in Burkina Faso, aims to assess the validity of a multidimensional measure of agency specifically adapted to reproductive health in the Burkinabe context. This measure consists of two key dimensions: motivation —the ability to define reproductive goals—and self-efficacy —the ability to act on them. It explores women’s decision-making autonomy in two key areas of reproductive health: family planning and sexuality. The findings indicate that this measure demonstrates acceptable psychometric properties for use in Burkina Faso. Moreover, external validity analyses reveal that, across each domain of agency, the motivation dimension was more strongly associated with reproductive outcomes compared to self-efficacy. Finally, the results highlight that social expectations regarding fertility, fear of infertility, stigma surrounding female sexuality, perceptions of men's sexual rights, and fear of relational sanctions contribute to limiting women's autonomy in reproductive decision-making.