Indicator 5.6.1 Proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care

Indicator 5.6.1: Proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care

Target 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences

United Nations Population Fund (UNFPA)

Definition:

Proportion of women aged 15-49 years (married or in union) who make their own decision on all three selected areas i.e. decide on their own health care; decide on use of contraception; and can say no to sexual intercourse with their husband or partner if they do not want. Only women who provide a “yes” answer to all three components are considered as women who make their own decisions regarding sexual and reproductive health. A union involves a man and a woman regularly cohabiting in a marriage-like relationship.

Women’s autonomy in decision-making and exercise of their reproductive rights is assessed from responses to the following three questions:

1. Who usually makes decisions about health care for yourself?

– RESPONDENT

– HUSBAND/PARTNER

– RESPONDENT AND HUSBAND/PARTNER JOINTLY

– SOMEONE ELSE

– OTHER, SPECIFY

2. Who usually makes the decision on whether or not you should use contraception?

– RESPONDENT

– HUSBAND/PARTNER

– RESPONDENT AND HUSBAND/PARTNER JOINTLY

– SOMEONE ELSE

– OTHER, SPECIFY

3. Can you say no to your husband/partner if you do not want to have sexual intercourse?

– YES

– NO

– DEPENDS/NOT SURE

A woman is considered to have autonomy in reproductive health decision making and to be empowered to exercise their reproductive rights if they (1) decide on health care for themselves, either alone or jointly with their husbands or partners, (2) decide on use or non-use of contraception, either alone or jointly with their husbands or partners; and (3) can say no to sex with their husband/partner if they do not want to.

Percent (%)

Data are mainly derived from nationally representative Demographic and Health Surveys (DHS). Data sources increasingly include Multiple Indicator Cluster Surveys (MICS) and Generations and Gender Surveys (GGS), and other country-specific household surveys.

Agencies responsible for household surveys at national level.

Until recently, the indicator captured results for married and in-union women and adolescent girls of reproductive age (15–49 years old) who are using any type of contraception. In the phase of the national Demographic and Health Survey (DHS–7) and later rounds, as well as in other data collection instruments including the MICS and GGS, the questionnaire is extended to respondents whether they are using contraception or not. The measure does not cover women and girls that are not married or in a union, as they do not usually make “joint decisions” on their health care with their partners.

As of early 2022, a total of 64 countries, the majority in sub-Saharan Africa, have at least one survey with data on all three questions necessary for calculating Indicator 5.6.1. 28 countries have at least 2 data points between 2006 and 2020. Broader data sources are needed, and efforts to increase data coverage are underway.

In many national contexts, household surveys, which are the main data source for this indicator, exclude the homeless and are likely to under-enumerate linguistic or religious minority groups.

Numerator: Number of married or in union women and girls aged 15-49 years old:

– for whom decision on health care for themselves is not usually made by the husband/partner or someone else; and

– for whom the decision on contraception is not mainly made by the husband/partner; and

– who can say no to sex.

Only women who satisfy all three empowerment criteria are included in the numerator.

Denominator: Total number of women and girls aged 15-49 years old, who are married or in union.

Proportion = (Numerator/Denominator) * 100

2024-07-29

United Nations Population Fund (UNFPA)

Indicator 3.1.1: Maternal mortality ratio

Indicator 3.1.2: Proportion of births attended by skilled health personnel

Indicator 3.7.1: Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods

Indicator 3.7.2: Adolescent birth rate (aged 10–14 years; aged 15–19 years) per 1,000 women in that age group

Indicator 5.2.1: Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months, by form of violence and by age

Indicator 5.6.2: Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information and education

2