Defense Date


Graduation Date

Summer 8-13-2022


One-year Embargo

Submission Type


Degree Name





School of Nursing

Committee Chair

Dr. L. Kathleen Sekula

Committee Member

Dr. Rick Zoucha

Committee Member

Dr. Sridhar Venkatapuram


Reproductive freedom, sexual and reproductive health, capabilities, women's health, mixed methods


Introduction: Reproductive freedom is a social determinant of health (SDOH) that reduces health disparities and increases health equity. Through the National Health Insurance Plan, Israeli women can access a range of contraceptive methods. Scant data on Israeli women limits development of policies and interventions to meet international benchmarks for reproductive freedom. The purpose of this dissertation study is to synthesize current international multidisciplinary literature using the capability approach for reproductive freedom, explore determinants of reproductive freedom among Israeli women ages 18-50 using Nussbaum's capability approach, and make recommendations for nursing research, practice, and theory.

Methodology: Using Whittemore and Knafl’s framework, and integrative literature was conducted in December 2019. A subsequent convergent social justice mixed-methods study was conducted in 2020-2021.

Results: The integrative review resulted in 14 Studies originating from 5 disciplines. No nursing or biomedical articles were found. Extracted themes included: history of capability approach, methodologies, operationalization, and application in different economic environments. Results of the quantitative analysis confirmed the qualitative results. Overall, participants reported high capability for women’s health. Significant determinants of reproductive freedom included geographical location, language, educational level, and religion.

Discussion: Until now, lack of data presented a major barrier to understanding social, cultural, political, and economic determinants of reproductive freedom. The results of these studies suggest that more research is needed in rural areas of Israel and among vulnerable populations. Identifying gaps and barriers to accessing services may help create policies that increase women’s freedom to make sexual and reproductive health choices.