The Women’s and Girls’ Empowerment in Sexual and Reproductive Health (WGE-SRH) project aimed to 1) develop a comprehensive WGE-SRH framework, building on existing literature and grounding our process in the voices of women from different geographies and cultural settings in sub-Saharan Africa, and 2) develop a quantitative WGE-SRH index reflecting the proposed framework. The resulting multidimensional WGE-SRH index captures a process including women’s sexual and reproductive autonomy (existence of choice) and women’s sexual and reproductive self-efficacy, decision-making, and negotiation (exercise of choice). The WGE-SRH index was developed and tested across three sub-Saharan African country settings (Ethiopia, Nigeria, and Uganda).