The ShEPower Index for Women's Empowerment in India: Development and Validation of an Index Based on National Family Health Survey‐V, 2019–2021

Background The Sustainable Development Goal (SDG) 5 reminds us to have a reliable indicator to track women's empowerment. Our objective was to develop a composite index from the National Health Family Survey‐V India (NFHS‐V) dataset, broadening opportunities for monitoring and research on women's empowerment. We also explored the association between women's empowerment and their adoption of healthier practices and utilization of health care services. Methods We identified items related to women's empowerment from the NFHS‐V dataset and used principal component analysis with varimax rotation to extract the components and confirmatory factor analysis to test the structure. We also explored the association between women's empowerment and adoption of healthier practices after adjusting for age, wealth index and residence. Results 19 items across six domains were selected to form the ShEPower women's empowerment Index: attitude towards domestic violence, freedom of movement, decision making, wife's right to say no to sex, ownership of land/house and social independence. Women with high ShEPower Index were more likely to use modern methods of contraception, regularly consume green leafy vegetables/fruits, sleep under a mosquito net, and were less likely to experience physical or sexual violence at home. Conclusion The ShEPower Index is a valid and reliable 19‐item index to measure women's empowerment. It has the potential to widen the research agenda on women's empowerment and its impact on health outcomes and monitor progress towards achieving SDG 5 targets. Women with high ShEPower score make healthier choices with regards to their diet and health.