Validation of Reproductive Autonomy and Contraceptive Autonomy Scales Among Egyptian Women in Assiut

In October 2011, the global population was estimated to be 7 billion. With a growth rate 1.05% per year, the world's population is expected to increase by 2 billion persons in the next 30 years, from 7.7 billion currently to 9.7 billion in 2050 and could peak at nearly 11 billion around 2100 (1). Nearly all of this growth is occurring in developing nations, where fertility rates remain relatively high(2) .

There is an inverse relationship between contraceptive use and fertility. Countries with high proportions of women using contraception generally have lower levels of fertility (3). Globally, 62 percent of married women ages 15 to 49 use a method of family planning and 56 percent use a modern method. These rates are twice as high among women living in high-income countries (67 percent and 60 percent, respectively) compared to women living in low-income countries (34 percent and 29 percent, respectively)(4).

Currently, many more women of reproductive age are using some form of contraception than in 1990. The growing use of contraceptive methods in recent decades has resulted not only in improvements in health-related outcomes such as reduced unintended pregnancies, high-risk pregnancies, maternal mortality, and infant mortality, but also in improvements in schooling and economic outcomes, especially for girls and women. Beyond the impacts of contraceptive use at the individual level, there are benefits at the population level. From a macroeconomic perspective, reductions in fertility enhance economic growth as a result of reduced youth dependency and an increased number of women participating in paid labour(3).

In recognition of the 25th anniversary of the International Conference on Population and Development (ICPD) in 1994, governments reaffirmed the importance of the Program of Action and its further implementation for achieving the Sustainable Development Goals (SDG). The emphasis on universal access to a full range of safe and reliable family planning methods, which help couples and individuals to realize their right to decide freely and responsibly on the number, spacing and timing of births, remains as critical today as it did in 1994(3).

The primary outcome of interest to the family planning community has been contraceptive use (often modern method use), which has traditionally been measured and interpreted in a fairly straightforward way. Generally, a person using a (modern) method is considered a positive outcome, while someone not using a (modern) method is considered a negative outcome (5). Most studies of individual determinants of contraceptive use focus on cognitive, demographic, and contextual variables. However, these models assume that individuals have personal control over their contraceptive behavior(6) .As with other sexual risk outcomes, a woman's capacity to act upon her intention to use contraception may be contingent upon the wishes and actions of her partner or other members of her family or community(7).