Development and Validation of the Agency in Contraceptive Decisions Scale in Uganda and Nigeria

Bibliographic Data

ID10797393
AuthorsSneha Challa (0000-0001-5220-6834, Institute on Aging, corresponding author), Ushma D Upadhyay (0000-0002-2731-2157, Ibis Reproductive Health), Ronald Wasswa (0000-0003-1251-2460, Mulago Hospital), Sylvia Nanono (Mulago Hospital), Ivan Idiodi (Achieving Health Nigeria Initiative), Chioma Okoli (African Field Epidemiology Network), Phoebe Alitubeera (Makerere University), Dinah Amongin (0000-0002-1420-005X, Mulago Hospital), Ayobambo Jegede (Joseph Ayo Babalola University), Aminat Tijani (African Field Epidemiology Network), Catherine Birabwa (0000-0003-2916-9275, Mulago Hospital), Lynn Atuyambe (0000-0001-5886-5080, Makerere University), Shakede Dimowo (Ladoke Akintola University of Technology), Grace Nmadu, Awawu Grace Nmadu (0000-0001-7813-6723, Achieving Health Nigeria Initiative), Christine Dehlendorf (0000-0001-7303-5413, University of California, San Francisco), Elizabeth Omoluabi (0000-0003-1754-5384, College of Saint Elizabeth), Peter Waiswa (0000-0001-8221-902X, Mulago Hospital), Kelsey Holt (0000-0001-9093-4322, University of California, San Francisco)
Year2025
Volume56
Issue3
Pages655-675
Publication date2025-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueStudies in Family Planning (JOURNAL)
Journal identifiersISSN: 0039-3665 • E-ISSN: 1728-4465
PublisherWiley (PUBLISHER • GB)
DOI10.1111/sifp.70033
PMID40984665
OpenAlexW4414447491
LanguageEN
References cited44

To fill a gap in measures of empowered contraceptive decision‐making, we developed the Agency in Contraceptive Decisions Scale in Uganda and Nigeria. We developed an item pool drawing on the previously published Contraceptive Agency framework. We refined items through cognitive interviews ( N = 80) and expert feedback and piloted a reduced item pool via surveys ( N = 3002). Exploratory factor analysis using a random half of the sample suggested a 15‐item scale (Cronbach's α = 0.8) including four subscales: (1) Beliefs about Rights and Perceived Decision‐making Control (α = 0.8), (2) Decision‐making Self‐efficacy (α = 0.8), (3) Knowledge Aligned with Preferences (α = 0.8), and (4) Control over Use or Non‐use (α = 0.8). Confirmatory factor analysis with the other half of the sample supported this solution. Agency in Contraceptive Decisions Scale scores were significantly associated with scores on the contraceptive existence of choice and contraceptive exercise of choice subscales of the Women's and Girls Empowerment in Sexual and Reproductive Health Index, supporting construct validity. The 15‐item Agency in Contraceptive Decisions Scale and individual subscales are valid and reliable for use in Nigeria and Uganda. This measure offers an innovative alternative for gauging the success of contraceptive programs and policies in advancing the right to empowered choices

Agency (philosophy · Confirmatory factor analysis · Empowerment · Exploratory factor analysis · Family planning · Population · Sample (material · Scale (ratio · Adolescent Sexual and Reproductive Health · Global Maternal and Child Health · Reproductive Health and Contraception

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