5.6.1 Women (15-49) Making 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
Goal 5: Achieve gender equality and empower all women and girls
Custodian Organization: United Nations Population Fund (UNFPA)
Tier Classification: Tier II
To facilitate the implementation of the global indicator framework, all indicators are classified by the IAEG-SDGs (Inter-Agency and Expert Group on Sustainable Development Goals Indicators) into three tiers on the basis of their level of methodological development and the availability of data at the global level, as follows:
Tier I: Indicator is conceptually clear, has an internationally established methodology and standards are available, and data are regularly produced by countries for at least 50 per cent of countries and of the population in every region where the indicator is relevant.
Tier II: Indicator is conceptually clear, has an internationally established methodology and standards are available, but data are not regularly produced by countries.
Tier III: No internationally established methodology or standards are yet available for the indicator, but methodology/standards are being (or will be) developed or tested.
Definition: Proportion of women aged 15-49 years (married or in union) who make their own decision on all three selected areas i.e. can say no to sexual intercourse with their husband or partner if they do not want; decide on use of contraception; and decide on their own health care. Only women who provide a “yes” answer to all three components are considered as women who “make her own decisions regarding sexual and reproductive”.
Whilst the aspiration of the indicator is to measure, among the three components, women’s decision – making on reproductive health care, current data provides information on women’s decision- making on health care in general. Expert group consultations recommended a specific, scenario-based question that speaks directly to decision-making about reproductive health care as follows:
“Who takes the decision on when you can go to seek reproductive health care, for example, if you experience a painful or burning sensation when urinating?” -Mainly respondent -Mainly husband/ partner -Joint decision -Other (specify)
Efforts are under way to pilot and refine the question for inclusion in future national surveys including in DHS and MICS. Whilst the process to collect data on women’s decision on reproductive health care are under way, data on Indicator 5.6.1 will be based on available information on women’s decision-making on “health care”.
Women’s autonomy in decision-making and exercise of their reproductive rights is assessed from responses to the following three questions:
1. Can you say no to your (husband/partner) if you do not want to have sexual intercourse?
- DEPENDS/NOT SURE
2. Would you say that using contraception is mainly your decision, mainly your (husband’s/ partner’s) decision, or did you both decide together?
Last updated: 08 August 2017
- MAINLY RESPONDENT
- MAINLY HUSBAND/PARTNER
- JOINT DECISION
- OTHER SPECIFY
3. Who usually makes decisions about health care for yourself?
- YOUR (HUSBAND/PARTNER)
- YOU AND YOUR (HUSBAND/PARTNER) JOINTLY
- SOMEONE ELSE
A woman is considered to have autonomy in reproductive health decision making and to be empowered to exercise their reproductive rights if they (1) can say “NO’ to sex with their husband/partner if they do not want to, (2) decide on use/ non-use of contraception and (3) decide on health care for themselves.
Concepts: A union involves a man and a woman regularly cohabiting in a married-like relationship.
Rationale: Women’s and girls’ autonomy in decision making over consensual sexual relations, contraceptive use and access to sexual and reproductive health services is key to their empowerment and the full exercise of their reproductive rights.
A woman’s ability to say “no” to her husband/partner if she does not want to have sexual intercourse is well aligned with the concept of sexual autonomy and women’s empowerment.
Regarding decision-making on use of contraception, the expert views as well as the initial data charts for several countries indicated that a clearer understanding of women empowerment is obtained by looking at the indicator from the perspective of decisions being made “mainly by the partner”, as opposed to decision being made “by the woman alone” or “by the woman jointly with the partner”. Depending in the type of contraceptive method being used, a decision by the woman “alone” or “jointly with the partner” does not always entail that the woman is empowered or has bargaining skills. Conversely, it is safe to assume that a woman that does not participate, at all, in making contraceptive choices is disempowered as far as sexual and reproductive decisions are concerned.
Women who make their own decision regarding seeking healthcare for themselves are considered empowered to exercise their reproductive rights.
Limitations: A key limitation is that current estimates of the indicator are based on currently married or in union women of reproductive age (15-49 years old) who are using any type of contraception. In the current DHS, the question on decision-making on use of contraception is only asked to women who are currently using contraception. Because the questions on decision- making on sexual relations and health care are restricted to women (15-49) currently married or in union, the denominator for Indicator 5.6.1 is women 15-49, who are currently married or in union and currently using contraception.
However, agreement has been reached with Macro/ICF for upcoming DHS surveys to ask the question on decision on use of contraception to all married/ in union women aged 15-49 years, whether they are currently using any contraception or not. The DHS model questionnaire for Phase 7 already includes the question on decision-making for women who are not currently using any contraception (DHS7 Woman’s Questionnaire, 17 May 2016 version, Q820.)
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.
Data Source: Data for this indicator was primarily collected from the United Nations Statistics Division’s Open SDG Data Hub. National level data is provided to the United Nations Statistics Division by the respective nation, unless otherwise noted. To learn more about the data used in this portal, visit the about page.
Data is accurate as of October 31, 2018.
5.6.1 Women (15-49) Making their own Informed Decisions Regarding Sexual Relations, Contraceptive use and Reproductive Health Care in the Sustainable Development Goals
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5. Achieve gender equality and empower all women and girls
While the world has achieved progress towards gender equality and women’s empowerment under the Millennium Development Goals (including equal access to primary education between girls and boys), women and girls continue to suffer discrimination and violence in every part of the world.
Gender equality is not only a fundamental human right, but a necessary foundation for a peaceful, prosperous and sustainable world.
Providing women and girls with equal access to education, health care, decent work, and representation in political and economic decision-making processes will fuel sustainable economies and benefit societies and humanity at large.
Related 5.6.1 Women (15-49) Making their own Informed Decisions Regarding Sexual Relations, Contraceptive use and Reproductive Health Care Targets
Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate