A Multidimensional Profile of Adolescent Agency in Uttar Pradesh, India, and Implications for Reproductive Choice

Introduction: Agency is a salient individual resource in attaining reproductive choice, yet it remains insufficiently characterized among adolescents. Methods: This study characterizes agency profiles among a state-representative sample of adolescents ages 15 to 19 in Uttar Pradesh, India, by sex and marital status using latent class analysis from a 2015–2016 cross-sectional survey. We identify agency profiles most at risk for loss of reproductive autonomy and explore predictors of agency group membership. Results: Distinct three-class profiles were identified for girls and boys. Among girls, the classes were as follows: high agency (41.0% married, 16.9% unmarried), motivational autonomy, low actualization (71.9% married, 22.1% unmarried), and low agency (11.1% married, 36.9% unmarried). Among boys, the classes were as follows: high agency (51.5%), gender-conforming actors (42.1%), and moderate agency (6.2%). Greater education and household wealth increased odds of membership to belong to the highest agency class; experience of physical violence increased odds of low agency class membership. Findings were not consistent among married girls. High agency married girls were most at risk of violence, to have unmet family planning need, unwanted/mistimed pregnancy, or a birth, relative to those in lower agency classes. Conclusions: Findings suggest that in some settings, high agency girls, are at greater risk for loss of reproductive choice, particularly in the context of marriage. Policy Implications: Segmented adolescent programming paired with activities to address unequal gender dynamics and provide conflict resolution information in marriage is needed. These strategies can optimize interventions which seek to empower adolescents as a mechanism to improve reproductive health and well-being.