Social Determinants of Women's Reproductive Health from a Public Health Perspective
DOI:
https://doi.org/10.62872/o.v3i1.490Keywords:
social determinants of health, women's reproductive health, gender equity, health disparities, maternal healthAbstract
Women's reproductive health is fundamentally shaped by complex interplays of social, economic, cultural, and structural factors that extend far beyond biological determinants. This comprehensive review synthesizes current evidence on social determinants affecting reproductive health outcomes across diverse populations. Drawing from systematic reviews, scoping reviews, and empirical studies published between 2021 and 2025, we examine how socioeconomic status, education, gender norms, cultural practices, healthcare access, and structural inequalities influence contraceptive use, antenatal care attendance, maternal mortality, pregnancy complications, and overall reproductive autonomy. The evidence demonstrates that poverty and low educational attainment consistently correlate with unintended pregnancies, inadequate prenatal care, and increased maternal-infant morbidity and mortality. Patriarchal gender norms significantly constrain women's reproductive decision-making autonomy, particularly regarding contraception, birth spacing, and childbirth location. Geographic and financial barriers to quality healthcare services, compounded by provider attitudes and lack of youth-friendly or disability-inclusive services, further exacerbate health inequities. Structural determinants including racial and ethnic discrimination, migrant status, residential segregation, gender-based violence, and weak social support networks profoundly impact reproductive health quality of life. This review underscores the imperative for public health interventions that transcend clinical approaches to address social justice and gender equity as fundamental prerequisites for improving women's reproductive health outcomes globally
References
Abhari, M., Sabetrohani, H., Larijani, S., Ghafori, R., & Nafei, A. (2024). Social determinants of women's reproductive health: A systematic review. Health Scope. https://doi.org/10.5812/healthscope-140449
Alukagberie, M., Elmusharaf, K., Ibrahim, N., & Poix, S. (2023). Factors associated with adolescent pregnancy and public health interventions to address in Nigeria: A scoping review. Reproductive Health, 20. https://doi.org/10.1186/s12978-023-01629-5
Amoadu, M., Ansah, E., Assopiah, P., Acquah, P., Ansah, J., Berchie, E., Hagan, D., & Amoah, E. (2022). Socio-cultural factors influencing adolescent pregnancy in Ghana: A scoping review. BMC Pregnancy and Childbirth, 22. https://doi.org/10.1186/s12884-022-05172-2
Bagherinia, M., Dolatian, M., Mahmoodi, Z., Ozgoli, G., Majd, H., & Haseli, A. (2025). Identifying the social determinants of marginalized women's quality of sexual life based on the WHO approach: Path analysis. Reproductive Health, 22. https://doi.org/10.1186/s12978-025-02050-w
Buser, J., August, E., Rana, G., Gray, R., Tengera, O., Jacobson-Davies, F., Mukeshimana, M., Ntasumbumuyange, D., Kaberuka, G., Bazakare, M., Endale, T., & Smith, Y. (2023). Scoping review of qualitative studies investigating reproductive health knowledge, attitudes, and practices among men and women across Rwanda. PLOS ONE, 18. https://doi.org/10.1371/journal.pone.0283833
Commission on Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva: World Health Organization.
Fernandes, D., Bhat, S., Inamdar, N., & Kamath, V. (2025). A qualitative study of key informants' perceptions of factors influencing women's reproductive autonomy. Sexuality & Culture, 29, 1858-1881. https://doi.org/10.1007/s12119-025-10349-w
Feriani, P., Yunitasari, E., Efendi, F., Krisnana, I., Ernawati, R., Tianingrum, N., & Safaah, N. (2024). A systematic review of determinants influencing family planning and contraceptive use. Iranian Journal of Nursing and Midwifery Research, 29, 596-607. https://doi.org/10.4103/ijnmr.ijnmr_321_23
Girardi, G., Longo, M., & Bremer, A. (2023). Social determinants of health in pregnant individuals from underrepresented, understudied, and underreported populations in the United States. International Journal for Equity in Health, 22. https://doi.org/10.1186/s12939-023-01963-x
Habibi, F., Khani, S., & Ahmadi, M. (2023). Social determinants of reproductive age women's sexual health: A scoping review. Journal of Nursing and Midwifery Sciences. https://doi.org/10.5812/jnms-140898
Ireland, H., Tran, N., & Dawson, A. (2021). The role of social capital in women's sexual and reproductive health and rights in humanitarian settings: A systematic review of qualitative studies. Conflict and Health, 15. https://doi.org/10.1186/s13031-021-00421-1
Jozani, Z., Mahmoodi, Z., Takian, A., & Mirmolaei, S. (2025). Intermediary determinants of health and access to reproductive health services among Afghan migrant women: A scoping review. Iranian Journal of Public Health, 54, 1820-1830. https://doi.org/10.18502/ijph.v54i9.19851
Malin, K., Vance, A., Moser, S., Zemlak, J., Edwards, C., White-Traut, R., Koerner, R., McGrath, J., & McGlothen-Bell, K. (2025). The impact of social determinants of health on infant and maternal health using a reproductive justice lens. BMC Pregnancy and Childbirth, 25. https://doi.org/10.1186/s12884-025-07693-y
Marmot, M., & Wilkinson, R. G. (Eds.). (2006). Social determinants of health (2nd ed.). Oxford: Oxford University Press.
Ninsiima, L., Chiumia, I., & Ndejjo, R. (2021). Factors influencing access to and utilisation of youth-friendly sexual and reproductive health services in sub-Saharan Africa: A systematic review. Reproductive Health, 18. https://doi.org/10.1186/s12978-021-01183-y
Ouahid, H., Mansouri, A., Sebbani, M., Nouari, N., Khachay, F., Cherkaoui, M., Amine, M., & Adarmouch, L. (2023). Gender norms and access to sexual and reproductive health services among women in the Marrakech-Safi region of Morocco: A qualitative study. BMC Pregnancy and Childbirth, 23. https://doi.org/10.1186/s12884-023-05724-0
Ouahid, H., Sebbani, M., Cherkaoui, M., Amine, M., & Adarmouch, L. (2025). The influence of gender norms on women's sexual and reproductive health outcomes: A systematic review. BMC Women's Health, 25. https://doi.org/10.1186/s12905-025-03768-2
Sifora, K., De Wet-Billings, N., Frade-Bekker, S., & Phiri, M. (2025). Individual and community level factors influencing modern contraceptive use among women of reproductive age in South Africa: A multilevel analysis. Contraception and Reproductive Medicine, 10. https://doi.org/10.1186/s40834-025-00392-1
Smarr, M., Avakian, M., Lopez, A., Onyango, B., Amolegbe, S., Boyles, A., Fenton, S., Harmon, Q., Jirles, B., Lasko, D., Moody, R., Schelp, J., Sutherland, V., Thomas, L., Williams, C., & Dixon, D. (2024). Broadening the environmental lens to include social and structural determinants of women's health disparities. Environmental Health Perspectives, 132. https://doi.org/10.1289/ehp12996
Solar, O., & Irwin, A. (2010). A conceptual framework for action on the social determinants of health. Social Determinants of Health Discussion Paper 2 (Policy and Practice). Geneva: World Health Organization.
Starfield, B. (2007). Pathways of influence on equity in health. Social Science & Medicine, 64(7), 1355-1362.
World Health Organization. (2010). Developing sexual health programmes: A framework for action. Geneva: WHO Press.
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