Gender norms in sexual and reproductive health and rights: Insights from young Angolan women and the development of a context-specific questionnaire

Background Sexual and reproductive health and rights (SRHR) are fundamental to human dignity, well-being, and sustainable development. Despite strong international and national commitments, young women in Angola continue to face critical SRHR challenges, including high rates of adolescent pregnancy and limited access to contraception and maternal healthcare. These challenges are understood to be shaped, in part, by gender norms that influence social expectations, behaviours, and access to services. Addressing SRHR thus requires not only expanded healthcare provision but also strengthened normative support and attention to the power dynamics that underpin gender inequality. Measuring gender norms, however, remains methodologically complex. Existing tools often conflate personal attitudes with perceived social expectations or rely on indirect proxies, limiting their capacity to reflect the social and context-specific nature of norms. Results To address this gap, a mixed-methods study was conducted. Contextually relevant SRHR-topics were identified through a literature review, key informant interviews, and participatory workshops, resulting in the development of an eleven-item gender norms questionnaire. The questionnaire was used in a cross-sectional study including 2,081 young women aged 16–24 across urban and rural settings in three Angolan provinces and evaluated using Rasch analysis. Quantitative data revealed regional and socio-economic disparities, with early pregnancy and intimate partner violence more prevalent in less resourced settings. Perceived normative support was stronger for issues related to education and bodily autonomy than for reproductive maturity and equality within intimate relationships. While some provincial variation in item functioning was noted, the questionnaire demonstrated sound psychometric properties overall. Conclusions Gender norms remain central to SRHR experiences, marked by notable thematic and geographical variations. Divergent levels of normative support across SRHR domains reflect underlying tensions between entrenched social expectations and evolving values related to gender equality. Socio-economic disparities appear to intersect with these normative dynamics, potentially compounding structural disadvantage. The integration of both summary and item-level measures enables a more comprehensive understanding of the complex, layered nature of gender norms and the environments in which they operate. Continued research is essential to refine measurement and support the development of gender-responsive programmes that meaningfully support young women in realising their SRHR.