Abstract
Introduction
Agency is a salient individual resource in attaining reproductive choice, yet it remains insufficiently characterized among adolescents.
Methods
This study characterizes agency profiles among a state-representative sample of adolescents ages 15 to 19 in Uttar Pradesh, India, by sex and marital status using latent class analysis from a 2015–2016 cross-sectional survey. We identify agency profiles most at risk for loss of reproductive autonomy and explore predictors of agency group membership.
Results
Distinct three-class profiles were identified for girls and boys. Among girls, the classes were as follows: high agency (41.0% married, 16.9% unmarried), motivational autonomy, low actualization (71.9% married, 22.1% unmarried), and low agency (11.1% married, 36.9% unmarried). Among boys, the classes were as follows: high agency (51.5%), gender-conforming actors (42.1%), and moderate agency (6.2%). Greater education and household wealth increased odds of membership to belong to the highest agency class; experience of physical violence increased odds of low agency class membership. Findings were not consistent among married girls. High agency married girls were most at risk of violence, to have unmet family planning need, unwanted/mistimed pregnancy, or a birth, relative to those in lower agency classes.
Conclusions
Findings suggest that in some settings, high agency girls, are at greater risk for loss of reproductive choice, particularly in the context of marriage.
Policy Implications
Segmented adolescent programming paired with activities to address unequal gender dynamics and provide conflict resolution information in marriage is needed. These strategies can optimize interventions which seek to empower adolescents as a mechanism to improve reproductive health and well-being.
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Data Availability
Data are accessible through Harvard Dataverse. Population Council, 2017, “UDAYA Adolescent Survey, Uttar Pradesh, 2015–16,” https://doi.org/10.7910/DVN/RRXQNT.
Coding Availability
Analysis code in STATA and SAS are available on request from the first author.
References
Al Riyami, A., Afifi, M., & Mabry, R. M. (2004). Women’s autonomy, education and employment in Oman and their influence on contraceptive use. Reproductive Health Matters, 12(23), 144–154.
Alkire, S. (2005). Subjective quantitative studies of human agency. Social Indicators Research, 74(1), 217–260. https://doi.org/10.1007/s11205-005-6525-0
Alkire, S. (2008). Concepts and measures of agency. Oxford Poverty and Human Development Initiative (OPHI) Working Paper, 9, University of Oxford. https://ophi.org.uk/working-paper-number-09/
Bongaarts, J., Blanc, A. K., & McCarthy, K. J. (2019). The links between women’s employment and children at home: Variations in low- and middle-income countries by world region. Population Studies, 73(2), 149–163. https://doi.org/10.1080/00324728.2019.1581896
Collins, L., & Lanza, S. (2016). Latent class and latent transition analysis for applications in the social, behavioral, and health sciences. Wiley.
Das, M., Ghosh, S., Verma, R., O’Connor, B., Fewer, S., Virata, M. C., & Miller, E. (2014). Gender attitudes and violence among urban adolescent boys in India. 19(1), 99–112. https://mc.manuscriptcentral.com/Rady, https://doi.org/10.1080/02673843.2012.716762
Desai, S., & Andrist, L. (2010). Gender scripts and age at marriage in India. Demography, 47(3), 667. https://doi.org/10.1353/DEM.0.0118
Do, M., & Kurimoto, N. (2012). Women’s empowerment and choice of contraceptive methods in selected African countries. International Perspectives on Sexual and Reproductive Health, 38(01), 023–033. https://doi.org/10.1363/3802312
Donald, A., Koolwal, G., Annan, J., Falb, K., & Goldstein, M. (2017). Measuring women’s agency. The World Bank. https://doi.org/10.1596/1813-9450-8148
Filmer, D., & Pritchett, L. (1999). The effect of household wealth on educational attainment: Evidence from 35 countries. Population and Development Review, 25(1), 85–120. https://doi.org/10.1111/j.1728-4457.1999.00085.x
Govindasamy, P., & Malhotra, A. (1996). Women’s position and family planning in Egypt. Studies in Family Planning, 27(6), 328–340.
Hebert, L. E., Bansal, S., Lee, S. Y., Yan, S., Akinola, M., Rhyne, M., Menendez, A., & Gilliam, M. (2020). Understanding young women’s experiences of gender inequality in Lucknow, Uttar Pradesh through story circles. International Journal of Adolescence and Youth, 25(1), 1. https://doi.org/10.1080/02673843.2019.1568888
International Institute for Population Sciences, IIPS/India, & ICF Macro. (2017). India Demographic Health Survey 2015–16. https://dhsprogram.com/publications/publication-fr339-dhs-final-reports.cfm. Accessed 10 November 2020.
James-Hawkins, L., Peters, C., VanderEnde, K., Bardin, L., & Yount, K. M. (2016). Women’s agency and its relationship to current contraceptive use in lower- and middle-income countries: A systematic review of the literature. Global Public Health, 1–16. https://doi.org/10.1080/17441692.2016.1239270
Jejeebhoy, S., Acharya, R., Alexander, M., Garda, L., & Kanade, S. (2010). Measuring agency among unmarried young women and men. In Economic and political weekly (vol. 45, pp. 56–64). Economic and Political Weekly. https://doi.org/10.2307/20764338
Lanza, S., & Rhoades, B. (2013). Latent class analysis: An alternative perspective on subgroup analysis in prevention and treatment. Prevention Science, 14(2), 157–168. https://doi.org/10.1007/s11121-011-0201-1.Latent
Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling : A Multidisciplinary Journal, 14(4), 671–694.
Lanza, S. T., Lemmon, D. R., Dziak, J. J., Huang, L., Schafer, J. L., & Collins, L. M. (2014). Proc LCA & Proc LTA users’ guide version 1.2.5 beta. The Methodology Center, 1–43.
Lanza, S. T., & Bray, B. (2013). Transitions in drug use among high-risk women: An application of latent class and latent transition analysis. Advances and Applications in Statistical Sciences, 31(9), 1713–1723. https://doi.org/10.1109/TMI.2012.2196707.Separate
Lanza, S. T., Bray, B., & Collins, L. (2013). An introduction to latent class and latent transition analysis. In Handbook of psychology (2nd ed., vol. 2, pp. 291–716). Wiley.
McBurney, P. (1988). On transferring statistical techniques across cultures: The Kish grid. Current Anthropology, 29(2), 323–325. https://doi.org/10.1086/203642
McCarthy, K. J., Mehta, R., & Haberland, N. A. (2018). Gender, power, and violence: A systematic review of measures and their association with male perpetration of IPV. PLoS ONE, 13(11), e0207091. https://doi.org/10.1371/journal.pone.0207091
McNay, K. (2005). The implications of the demographic transition for women, girls and gender equality: A review of developing country evidence. Progress in Development Studies, 5(2), 115–134. https://doi.org/10.1191/1464993405ps109oa
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007). Deciding on the number of classes in latent class analysis and growth mixture modeling: A Monte Carlo simulation study. Structural Equation Modeling, 14(4), 535–569. https://doi.org/10.1080/10705510701575396
Paul, M., Essén, B., Sariola, S., Iyengar, S., Soni, S., & Klingberg Allvin, M. (2017). Negotiating collective and individual agency. Qualitative Health Research, 27(3), 311–324. https://doi.org/10.1177/1049732315613038
Raj, A., Saggurti, N., Balaiah, D., & Silverman, J. G. (2009). Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: A cross-sectional, observational study. Lancet, 373(9678), 1883–1889. https://doi.org/10.1016/S0140-6736(09)60246-4
Reed, E., Silverman, J. G., Raj, A., Decker, M. R., & Miller, E. (2011). Male perpetration of teen dating violence: Associations with neighborhood violence involvement, gender attitudes, and perceived peer and neighborhood norms. Journal of Urban Health, 88(2), 226–239. https://doi.org/10.1007/s11524-011-9545-x
Sabarwal, S., Santhya, K. G., & Jejeebhoy, S. J. (2014). Women’s autonomy and experience of physical violence within marriage in rural India. Journal of Interpersonal Violence, 29(2), 332–347. https://doi.org/10.1177/0886260513505144
Santhya, K., Acharya, R., Pandey, N., Kumar Gupta, A., Rampal, S., Kumar Singh, S., & Francis Zavier, A. (2017). Understanding the lives of adolescents and young adults (UDAYA) in Uttar Pradesh. New Delhi: Population Council.
Santhya, K. G., Ram, U., Acharya, R., Jejeebhoy, S. J., Ram, F., & Singh, A. (2010). Associations between early marriage and young women’s marital and reproductive health outcomes: Evidence from India. International Perspectives on Sexual and Reproductive Health, 36(3), 132–139. https://doi.org/10.1363/ipsrh.36.132.10
Santhya, K. G., Zavier, A. J. F., & Jejeebhoy, S. J. (2015). School quality and its association with agency and academic achievements in girls and boys in secondary schools: Evidence from Bihar, India. International Journal of Educational Development, 41, 35–46. https://doi.org/10.1016/j.ijedudev.2014.12.002
Shekhar, C., Sundaram, A., Hussain, R., Pradhan, M. R., & Kalyanwala, S. (2018). Unintended pregnancy, abortion and postabortion care in Uttar Pradesh, India—2015. New York: Guttmacher Institute. https://doi.org/10.1363/2018.30163
Singh, S., Hussain, R., Shekhar, C., Acharya, R., Moore, A. M., Stillman, M., Pradhan, M. R., Frost, J. J., Sahoo, H., Alagarajan, M., Sundaram, A., Kalyanwala, S., & Ball, H. (2018a). Abortion and Unintended Pregnancy in Six Indian States: Findings and Implications for Policies and Programs. https://doi.org/10.1363/2018.30009
Singh, S., Shekhar, C., Acharya, R., Moore, A. M., Stillman, M., Pradhan, M. R., Frost, J. J., Sahoo, H., Alagarajan, M., Hussain, R., Sundaram, A., Vlassoff, M., Kalyanwala, S., & Browne, A. (2018b). The incidence of abortion and unintended pregnancy in India, 2015. Lancet Global Health, 6(1), e111–e120. https://doi.org/10.1016/S2214-109X(17)30453-9
UNFPA. (2018). India 2018. https://www.unfpa.org/sites/default/files/IN_UNFPA_Results_05_30.pdf. Accessed 10 November 2020.
UNICEF. (2016). Adolescent demographics. https://data.unicef.org/topic/adolescents/demographics/. Accessed 7 December 2020.
Upadhyay, U. D., Gipson, J. D., Withers, M., Lewis, S., Ciaraldi, E. J., Fraser, A., Huchko, M. J., & Prata, N. (2014). Women’s empowerment and fertility: A review of the literature. Social Science & Medicine, 115, 111–120. https://doi.org/10.1016/j.socscimed.2014.06.014
Upadhyay, U. D., & Karasek, D. (2012). Women’s empowerment and ideal family size: An examination of DHS empowerment measures in Sub-Saharan Africa. International Perspectives on Sexual and Reproductive Health, 38(2), 78–89. https://doi.org/10.1363/3807812
Van Eerdewijk, A., Wong, F., Vaast-Julie, C., Tyszler, N.-M., Pennington, -Amy, Vaast, C., Newton, J., Tyszler, M., Pennington, A., van Eerdewijk, A., Wong, F., Vaast, C., Newton, J., Tyszler, M., & Pennington, A. (2017). A conceptual model of women and girls’ empowerment. Royal Tropical Institute (KIT)
World Population Prospects 2019 Revision. (2019). Total population by age groups, India 2015. Accessed 15 May 2019.
Acknowledgements
We thank Trace Kershaw, PhD, for providing comments on the manuscript. We also thank colleagues at the Population Council, including K.G. Santhya, who was involved in the initial design, implementation, and analysis of the Understanding the Lives of Adolescents and Young Adults Study, which this analysis was based on.
Funding
Katharine McCarthy received dissertation support from the CUNY Graduate School of Public Health & Health Policy Dean’s Dissertation award (95757–00-01).
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Katharine J. McCarthy: formal analysis, writing original draft, writing — review and editing, visualization. Katarazyna Wyka: conceptualization, methodology, writing — review and editing, supervision. Diana Romero: writing — review and editing, supervision. Heidi E. Jones: conceptualization, writing — review and editing, supervision.
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McCarthy, K.J., Romero, D., Wyka, K. et al. A Multidimensional Profile of Adolescent Agency in Uttar Pradesh, India, and Implications for Reproductive Choice. Sex Res Soc Policy 20, 287–299 (2023). https://doi.org/10.1007/s13178-022-00711-0
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DOI: https://doi.org/10.1007/s13178-022-00711-0