Unmasking power as foundational to research on sexual and reproductive health and rights

Abstract

Relations of power are intrinsic to the social determinants of sexual and reproductive health (SRH); they influence the content, quality and outcomes of SRH care; and they shape the negotiation and realisation of sexual and reproductive health and rights (SRHR) more broadly. Power dynamics pervade how SRHR is understood, studied and acted on, in ways that are distinct from other health issues.1 For example, the deeply held personal beliefs about women’s sexuality and childbearing, cultural mores regarding adolescent sexuality and state goals related to fertility all mark SRHR as a sphere with distinct and deeply contested power dynamics. Unmasking power as a central element in SRHR research is therefore crucial to developing a research agenda that can produce knowledge to transform hierarchies of power and advance SRHR.2 For example, key studies on violence against women and HIV that included explicit measures of power broke new ground by assessing how multilevel programmes impacted power relations and SRH outcomes, thus elucidating the importance of power relations, the factors that shape power relations and how these relations can be changed.3–5 In this Commentary, we summarise key ways power has been understood, defined and operationalised in SRHR research. We propose areas where further theoretical and empirical work and improved research processes could better interrogate power, yielding insights that can help transform policies, programmes and services.