Developing an Original Theory of Reproductive Autonomy and Its Demographic Outcomes in Sub-Saharan Africa

Reproductive autonomy, the capacity of women to make free and informed decisions about reproduction without coercion, is a foundational concept in both human rights and demographic theory, yet its theoretical operationalisation and measurement for sub-Saharan African demographic contexts, including Nigeria, remains insufficiently developed. This study developed an original theoretical and measurement framework for reproductive autonomy and its demographic outcomes in sub-Saharan African contexts, with empirical grounding in Nigeria's six geopolitical zones. A theory-building methodology employing systematic review, qualitative research, and quantitative model development was used. Systematic review of 67 reproductive autonomy publications from 2018 to 2024 confirmed that existing operationalisations conflated autonomy with decision-making authority, inadequately theorised the role of social norms as autonomy constraints independent of individual attitudes, and rarely decomposed autonomy into its procedural and substantive dimensions. Qualitative research with 48 women across the six geopolitical zones generated Nigeria-specific autonomy constructs including fear-free contraceptive access, partner communication quality, and religious norm internalisation versus external coercion. The original Reproductive Autonomy Theory for Sub-Saharan Africa proposes a three-layer model: structural autonomy (economic and social enabling conditions), relational autonomy (dyadic negotiation quality), and normative autonomy (freedom from coercive social norms). Each layer includes culturally adapted measurement items validated in the Nigerian context. Expert review by 20 reproductive health and demographic theory specialists confirmed the framework's original theoretical and measurement contributions.

Keywords: reproductive autonomy, sub-Saharan Africa, demographic outcomes, fertility decision-making, original theory