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Dissertation

Reproductive Health Capability:Towards a tool to measure inequity in reproductive health. A case study of Colombia

01 Jan 2021-
TL;DR: In this paper, a conceptual framework called Reproductive Health Capability is developed to measure reproductive health inequity in Colombia, and a valid and reliable empirical index that captures reproductive health capability for women in Colombia is assessed.
Abstract: Despite global improvements in typical reproductive health indicators, inequities in reproductive health are widening within and between sub-populations. To address reproductive health inequity, a theory of justice is required. Reproductive Justice, the most recent development of the reproductive health discourse, provides encouraging insight into the real, intersectional, and socially unjust reproductive oppressions experienced by vulnerable and minority populations. However, Reproductive Justice has limitations - notably it cannot operate as a complete moral theory. It has been argued for an application of Sen's Capability Approach to reproductive health; the theory provides a more realistic assessment of women's reproductive health because it assesses their actual ability to realise valued outcomes. This research supports the application of the capability approach to reproductive health and Reproductive Justice. To measure reproductive health inequity, a conceptual framework entitled: Reproductive Health Capability is developed. Unlike previous work on capability and reproductive health, this project identifies the relevant capabilities a woman requires to be in good reproductive health, as guided by Reproductive Justice and capability literature. These capabilities are universal, instrumental, and intrinsic to reproductive health; a deficit in these capabilities is grounds for injustice. Using data collected from Colombia's 2015 DHS survey, exploratory data analysis is undertaken to translate these capabilities into an empirical multidimensional measure. From this, the potential for the DHS to be re-purposed to measure health justice is assessed. Using this empirical measure, reproductive health capability for women in Colombia is assessed. This project finds a valid and reliable empirical index that captures Reproductive Health Capability for women in Colombia. It finds a novel index of health agency and supports the development of agencyfocused health interventions. Empirical analysis also finds women living in rural and Pacific and Amazon/Orinoco regions, who are indigenous and Afro-Colombian, and with little education have limited capability to reproductive health.
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Journal ArticleDOI
TL;DR: This paper explored the race and gender dimensions of violence against women of color and found that the experiences of women of colour are often the product of intersecting patterns of racism and sexism, and how these experiences tend not to be represented within the discourse of either feminism or antiracism.
Abstract: Over the last two decades, women have organized against the almost routine violence that shapes their lives. Drawing from the strength of shared experience, women have recognized that the political demands of millions speak more powerfully than the pleas of a few isolated voices. This politicization in turn has transformed the way we understand violence against women. For example, battering and rape, once seen as private (family matters) and aberrational (errant sexual aggression), are now largely recognized as part of a broad-scale system of domination that affects women as a class. This process of recognizing as social and systemic what was formerly perceived as isolated and individual has also characterized the identity politics of people of color and gays and lesbians, among others. For all these groups, identity-based politics has been a source of strength, community, and intellectual development. The embrace of identity politics, however, has been in tension with dominant conceptions of social justice. Race, gender, and other identity categories are most often treated in mainstream liberal discourse as vestiges of bias or domination-that is, as intrinsically negative frameworks in which social power works to exclude or marginalize those who are different. According to this understanding, our liberatory objective should be to empty such categories of any social significance. Yet implicit in certain strands of feminist and racial liberation movements, for example, is the view that the social power in delineating difference need not be the power of domination; it can instead be the source of political empowerment and social reconstruction. The problem with identity politics is not that it fails to transcend difference, as some critics charge, but rather the opposite- that it frequently conflates or ignores intra group differences. In the context of violence against women, this elision of difference is problematic, fundamentally because the violence that many women experience is often shaped by other dimensions of their identities, such as race and class. Moreover, ignoring differences within groups frequently contributes to tension among groups, another problem of identity politics that frustrates efforts to politicize violence against women. Feminist efforts to politicize experiences of women and antiracist efforts to politicize experiences of people of color' have frequently proceeded as though the issues and experiences they each detail occur on mutually exclusive terrains. Al-though racism and sexism readily intersect in the lives of real people, they seldom do in feminist and antiracist practices. And so, when the practices expound identity as "woman" or "person of color" as an either/or proposition, they relegate the identity of women of color to a location that resists telling. My objective here is to advance the telling of that location by exploring the race and gender dimensions of violence against women of color. Contemporary feminist and antiracist discourses have failed to consider the intersections of racism and patriarchy. Focusing on two dimensions of male violence against women-battering and rape-I consider how the experiences of women of color are frequently the product of intersecting patterns of racism and sexism, and how these experiences tend not to be represented within the discourse of either feminism or antiracism... Language: en

15,236 citations

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TL;DR: The historical development of a from other indexes of internal consistency (split-half reliability and Kuder-Richardson 20) and four myths associated with a are discussed, including that it is a fixed property of the scale and that higher values are always preferred over lower ones.
Abstract: Cronbach's a is the most widely used index of the reliability of a scale. However, its use and interpretation can be subject to a number of errors. This article discusses the historical development of a from other indexes of internal consistency (split-half reliability and Kuder-Richardson 20) and discusses four myths associated with a: (a) that it is a fixed property of the scale, (b) that it measures only the internal consistency of the scale, (c) that higher values are always preferred over lower ones, and (d) that it is restricted to the range of 0 to 1. It provides some recommendations for acceptable values of a in different situations.

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TL;DR: The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group, which is essential to wellbeing and to overcoming other effects of social disadvantage.
Abstract: Study objective: To propose a definition of health equity to guide operationalisation and measurement, and to discuss the practical importance of clarity in defining this concept. Design: Conceptual discussion. Setting, Patients/Participants, and Main results: not applicable. Conclusions: For the purposes of measurement and operationalisation, equity in health is the absence of systematic disparities in health (or in the major social determinants of health) between groups with different levels of underlying social advantage/disadvantage that is, wealth, power, or prestige. Inequities in health systematically put groups of people who are already socially disadvantaged (for example, by virtue of being poor, female, and/or members of a disenfranchised racial, ethnic, or religious group) at further disadvantage with respect to their health; health is essential to wellbeing and to overcoming other effects of social disadvantage. Equity is an ethical principle; it also is consonant with and closely related to human rights principles. The proposed definition of equity supports operationalisation of the right to the highest attainable standard of health as indicated by the health status of the most socially advantaged group. Assessing health equity requires comparing health and its social determinants between more and less advantaged social groups. These comparisons are essential to assess whether national and international policies are leading toward or away from greater social justice in health.

1,423 citations