This essay explores and reviews the literature from low‐ and middle‐income countries on the pathways of influence between women's empowerment and reproductive outcomes, specially focusing on contraception, and points to some outstanding gaps. We adopt a framework that assesses the influence of contextual factors, notably kinship structures, and marriage systems, on women's empowerment and agency and other transformational factors affecting women's agency and gender roles and wielding direct and indirect influences on empowerment and contraceptive outcomes. The review of around 80 studies highlights that even after other factors are adjusted, women's agency has a strong influence on contraceptive outcomes. Contraceptive use levels are likely influenced by community‐level factors above and beyond individual‐level factors. Transformational factors, especially exogenous factors such as education and family planning programs, have independent and direct effects on contraceptive outcomes, at times even weakening or canceling out the effects of women's agency. Comprehensive contraceptive transition theory must reserve a central place for women's empowerment through agency and gender roles, particularly the ability of women and girls to make independent and free contraceptive choices. Relatedly, progress in contraceptive transition should be assessed according to not only contraceptive prevalence but also women's ability to use their preferred choice of methods for achieving reproductive rights.

中文翻译：

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重新审视妇女赋权和避孕


本文探讨和回顾了低收入和中等收入国家关于妇女赋权和生育结果之间影响途径的文献，特别关注避孕，并指出了一些突出的差距。我们采用了一个框架来评估背景因素（特别是亲属结构和婚姻制度）对女性赋权和能动性的影响，以及影响女性能动性和性别角色的其他转型因素，并对赋权和避孕结果产生直接和间接影响。对大约 80 项研究的回顾强调，即使在调整了其他因素之后，女性的能动性对避孕结果也有很大影响。避孕药具的使用水平可能受社区层面因素的影响，而不是个人层面的因素。转化因素，特别是教育和计划生育计划等外生因素，对避孕结果有独立和直接的影响，有时甚至削弱或抵消妇女能动性的影响。全面的避孕过渡理论必须为通过能动性和性别角色赋予妇女权力保留一个中心位置，特别是妇女和女童做出独立和自由避孕选择的能力。与此相关的是，避孕转变的进展不仅应根据避孕药具的普及率，还应根据妇女使用她们首选的实现生殖权利的方法的能力来评估。