Support for sexual and reproductive health and rights in Sub-Saharan Africa: a new index based on World Values Survey data.

IF 3.6 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Signe Svallfors, Karin Båge, Anna Mia Ekström, Yadeta Dessie, Yohannes Dibaba Wado, Mariam Fagbemi, Elin C Larsson, Helena Litorp, Bi Puranen, Jesper Sundewall, Olalekan A Uthman, Anna E Kågesten
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引用次数: 0

Abstract

Background: Addressing attitudes is central to achieving sexual and reproductive health and rights (SRHR) and Agenda 2030. We aimed to develop a comprehensive index to measure attitudinal support for SRHR, expanding opportunities for global trend analyses and tailored interventions.

Methods: We designed a new module capturing attitudes towards different dimensions of SRHR, collected via the nationally representative World Values Survey in Ethiopia, Kenya, and Zimbabwe during 2020-2021 (n = 3,711). We used exploratory factor analysis of 58 items to identify sub-scales and an overall index. Adjusted regression models were used to evaluate the index according to sociodemographic characteristics, stratified by country and sex.

Results: A 23-item, five-factor solution was identified and used to construct sub-indices reflecting support for: (1) sexual and reproductive rights, (2) neighborhood sexual safety, (3) gender-equitable relationships, (4) equitable masculinity norms, and (5) SRHR interventions. These five sub-indices performed well across countries and socioeconomic subgroups and were combined into a comprehensive "SRHR Support Index", standardized on a 1-100 scale (mean = 39.19, SD = 15.27, Cronbach's alpha = 0.80) with higher values indicating more support for SRHR. Mean values were highest in Kenya (45.48, SD = 16.78) followed by Ethiopia (40.2, SD = 13.63), and lowest in Zimbabwe (32.65, SD = 13.77), with no differences by sex. Higher education and being single were associated with more support, except in Ethiopia. Younger age and urban residence correlated with more support among males only.

Conclusion: The SRHR Support Index has the potential to broaden SRHR attitude research from a comprehensive perspective - addressing the need for a common measure to track progress over time.

撒哈拉以南非洲对性健康和生殖健康及权利的支持:基于世界价值观调查数据的新指数。
背景:端正态度是实现性与生殖健康及权利(SRHR)和《2030 年议程》的核心。我们旨在开发一个综合指数来衡量对性与生殖健康和权利的态度支持,从而为全球趋势分析和有针对性的干预措施提供更多机会:我们设计了一个新模块,通过 2020-2021 年期间在埃塞俄比亚、肯尼亚和津巴布韦开展的具有全国代表性的世界价值观调查(n = 3,711)收集对性健康和生殖健康及权利不同方面的态度。我们对 58 个项目进行了探索性因子分析,以确定子量表和总指数。我们使用调整回归模型,按照国家和性别分层,根据社会人口特征对指数进行评估:结果:确定了一个 23 个项目的五因素解决方案,并用于构建反映以下方面支持情况的分指数:(1) 性权利和生殖权利,(2) 邻里性安全,(3) 性别平等关系,(4) 公平的男性规范,(5) 性健康和生殖健康及权利干预。这五个分指数在不同国家和社会经济亚群中表现良好,并被合并成一个综合的 "性健康和生殖健康及权利支持指数",以 1-100 标度进行标准化(平均值 = 39.19,标准差 = 15.27,Cronbach's alpha = 0.80),数值越高表示对性健康和生殖健康及权利的支持越多。肯尼亚的平均值最高(45.48,SD = 16.78),其次是埃塞俄比亚(40.2,SD = 13.63),津巴布韦最低(32.65,SD = 13.77),没有性别差异。除埃塞俄比亚外,受教育程度越高和单身的人得到的支持越多。结论:性健康和生殖健康及权利支持指数具有潜在的潜力,可用于衡量女性在性健康和生殖健康及权利方面所获得的支持:性健康和生殖健康及权利支持指数有可能从一个全面的角度扩大对性健康和生殖健康及权利态度的研究--满足对一个共同衡量标准的需求,以跟踪随时间推移取得的进展。
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来源期刊
Reproductive Health
Reproductive Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.00
自引率
5.90%
发文量
220
审稿时长
>12 weeks
期刊介绍: Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access. Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.
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