Women's and Girls' Empowerment-Sexual and Reproductive Health Index (WGE-SRH)

The Women's and Girl's Empowerment in Sexual and Reproductive Health (WGE-SRH) Index is a 22-item measure that assesses existence and exercise of choice related to sex, contraceptive use, and pregnancy.


Geographies Tested: Ethiopia,Nigeria,Uganda

Populations Included: Female

Age Range: Adolescents, Adults


Existence of Choice

Sex by choice
1. If I refuse sex with my husbandpartner, he may physically hurt me*
2. If I refuse sex with my husbandpartner, he may force me to have sex*
3. If I show my husbandpartner that I want to have sex, he may consider me promiscuous*
4. If I refuse sex with my husbandpartner, he may stop supporting me*

Contraception by choice
5. If I use family planning, my husbandpartner may seek another sexual partner*
6. If I use family planning, I may have trouble getting pregnant the next time I want to*
7. There could bewill be conflict in my relationshipmarriage if I use family planning*
8. If I use family planning, my children may not be born normal*
9. If I use family planning, my body may experience side effects that will disrupt my relations with my husbandpartner*

Pregnancy by choice
10. If I space or limit my pregnancies, I will improve my relationship with my husband
11. If I rest between pregnancies, I can take better care of my family

Exercise of Choice

Sex by choice
12. I am confident I can tell my husbandpartner when I want to have sex
13. I am able to decide when to have sex
14. If I do not want to have sex, I can tell my husband
15. If I do not want to have sex, I am capable of avoiding it with my husband

Contraception by choice
16. I would feelfeel confident discussing family planning with my husbandpartner
17. I can decide to switch from one family planning method to another if I want to
18. I feel confident telling my provider what is important for me when selecting a family planning method
19. If I want to use contraception, I can tell my husbandpartner

Pregnancy by choice
20. I could decide when I wanted to startstop having children
21. I cancould decide when to start having have another child
22. I can negotiate with my husbandpartner when to stop having children

Response Options:
Strongly disagree - 1
Disagree - 2
Neither agree nor disagree - 3
Agree - 4
Strongly agree - 5

*Items are reverse scored

Scoring Procedures

To construct the index, summary scores for each domain and outcome by averaging scores for relevant items are computed. Three outcome-specific empowerment scores (sexual empowerment, contraceptive empowerment and pregnancy empowerment) can be computed by adding the relevant summary scores for the existence of choice and exercise of choice domains. Finally, to examine the contribution of empowerment across the three SRH dimensions, a multidimensional SRH additive index comprising all items included in the three empowerment subscales can be computed. Although all indicators are continuous variables with possible values ranging from 1 to 10, in some analyses (e.g., logistic regressions) the scores can be divided into tertiles for ease of interpretation and application.

Original Citation

Moreau, C., Karp, C., Wood, S. N., Galadanci, H., Kibira, S. P. S., Makumbi, F., Omoluabi, E., Shiferaw, S., Seme, A., & Tsui, A. (2020). Reconceptualizing women's and girls' empowerment: A cross-cultural index for measuring progress toward improved sexual and reproductive health. International Perspectives on Sexual and Reproductive Health, 46, 187-198.

Psychometric Score

Ease of Use Score

Scoring breakdown

Formative Research

Qualitative Research

Existing Literature/Theoretical Framework

Field Expert Input

Cognitive Interviews / Pilot Testing








Criterion (gold-standard)



Ease of Use


Scoring Clarity


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