Published on Let's Talk Development

It takes two: Women's empowerment and couple concordance in South Asia

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South Asian, Sri Lankan couple Holding hands in the evening South Asian, Sri Lankan couple Holding hands in the evening

Many South-Asian soap operas and movies portray strong women who take decisions independently in a positive light. However, at home, these same female characters often have to endure clashing with their extended families over their roles. Just as in the entertainment industry, academic research recognizes the relevance of cultural values for development policy (Donald et al., 2016). Increasingly, more research in economics considers the influence of power relations inside the household and in the broader society on the decision processes and choices of women, their wellbeing, and gender inequality. This renewed attention to agency, empowerment, and culture is partially due to the recognition that fast-rising incomes in recent years have not brought improvements in gender disparities in South Asia.

A new working paper (Bussolo et al., 2021) looks at how husbands’ recognition of women’s decision-making power matters for household health outcomes. Relaxing financial constraints alone is not sufficient to improve women’s empowerment (Banerjee et al. 2015), as empowerment depends also on the agency to set and act upon goals, and finally on actual outcomes and achievements (Kabeer, 1999). We focus on the agency dimension.  

Classifying forms of women’s agency through household decision-making

Using Demographic and Health Survey data on more than 80 thousand married couples from six South-Asian countries, we discern different forms of agency by considering how decisions are taken within the household. To classify types of agency, we use matched responses from couples to the question: “Who has the last say on large household purchases?” Following Annan et al. (2020), three categories of decision making are considered: i) husband and wife both report that the wife participates in decisions, and they agree on her decision-making role; ii) the wife reports that she participates in decisions but the husband does not, that is, she takes more decision-making power than the husband accords her; and iii) the husband reports that the wife participates in decisions but the wife reports she does not, that is, the husband gives her a decision-making role she does not claim herself. A residual category contains all the responses in which she is accorded no role by either spouse. 

Almost half of all couples disagree on how decision-making occurs (sum of off-diagonal elements in the table below). The most common matched response is for husbands and wives to agree that decisions are joint (in orange), while wives taking power (in blue) and husbands giving power (in green) each comprise less than a quarter of the responses.

Husband-wife responses (percent shares)

Women’s agency in claiming their own roles is positively correlated with other standard empowerment indicators. 

These different forms of agency are correlated with resources such as education and outcomes such as household health, at varying intensities. For example, being employed, older, married for longer, having smaller education differences with their spouses and higher household wealth are all positively and significantly associated with women taking decisions alone and with women making decisions with their husbands. Women with husbands engaged in agriculture and living in rural households are less likely to take decisions alone or jointly. Working women are less likely to be given power by their husbands and a large difference in ages and education level between spouses increases the probability of a husband giving power. Women who have no agency are typically younger, less educated, unemployed and are married fewer years as compared to women who participate in household decision-making.

Women’s agency is positively associated with better reproductive health outcomes. 

Compared to women who do not have a decision-making role, women’s agency – linked to decision making, either by the wife taking power or by consensual agreement – is associated with lower probabilities of being underweight and higher probabilities of having terminated a pregnancy, using prenatal help, using assistance during delivery, having at least the recommended number of antenatal visits, and of both the wife and husband reporting modern contraceptive use. 

The probability of reporting use of modern contraception is 2.3 and 2.7 percentage points higher among couples,  for wife and husband, who jointly agree that the woman participates as compared to couples who do not accord the wife any decision-making role. For couples where the woman takes power, that same differential is 1.2 percentage points for both wife and husband. This is a large increase if compared to the unconditional probability of using modern contraceptives, which is 46% for women and 21% for men.

We find evidence that spousal agreement may support child health.

We find that the likelihood of girls being vaccinated is 3.7 percentage points higher for couples with spousal agreement than for couples in which women have no decision-making role. This is equivalent to an 8 percent increase in vaccination when compared to the 23 percent average rate. Agency in the form of spousal agreement and decreased stunting in boys are also correlated. With respect to the unconditional mean of about a quarter (almost 1 in four boys are stunted in South Asia), the reduction associated with this type of women’s agency is of 2.4 percentage points or, equivalently, 10%.

Spousal agreement agency is strongly associated with less domestic violence. 

Couple's agreement is most beneficial with regard to domestic violence. For instance, women in partnerships where there is agreement are 6 percentage points less likely to experience emotional violence, less severe violence, and intimate partner violence in the past 12 months than women who do not participate in decision-making. This is also the case when the comparison is with respect to women who take power. 

Policy Implications

Our work supports the theoretical framework of empowerment: women’s agency is a key facilitator of household well-being outcomes. We highlight that women’s agency is not a uniform condition or capacity, and its complexity must be acknowledged. Specifically, for programs targeting women, the views and behaviors of partners (and potentially other family members) matter. 

Women’s empowerment programming aimed to address health outcomes and domestic violence continually call for more engagement of men. Our work supports this by showing the importance of couple concordance for household health. In South Asia, we find that approximately half of the couples disagree on who within the household usually makes decisions. Given that we find agreement/disagreement to be informative on well-being outcomes, we provide a key message for programming and policy: we can’t ignore couple communication in our work.


Maurizio Bussolo

Lead Economist, Chief Economist Office for South Asia

Anaise Williams

Consultant, South Asia Gender Innovation Lab

Nayantara Sarma

Consultant, South Asia Chief Economist's Office, World Bank

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