Women's decision making and child health: Familal and social hierachies

Ever since the advent of Women in Development literature in the 1970s, many researchers have argued that women’s empowerment is closely linked to positive outcomes for families and societies (Presser and Sen, 2000). Nowhere has this argument been more important than in the literature on child health (Mason, 1986). While intuitively plausible, the empirical work on this topic has been limited. Two major factors account for this paucity in the literature: 1) conceptually, as we begin to use an increasingly ophisticated and nuanced conceptualization of empowerment, the way in which different dimensions of empowerment relate to each other has become increasingly problematic; and 2) data for empirical research on this topic have been limited at best. In an attempt to address some of these deficiencies, this paper draws from two parallel developments. First, the theoretical literature has grown increasingly sophisticated in its understanding of women’s empowerment—particularly distinguishing between the roles of families and communities. Second, in the past ten years, comparable cross-national studies in a large number of developing countries have been performed. These studies, known as Demographic and Health Surveys (DHS), contain large samples and make it possible to carry out an empirical examination of some of these arguments. Drawing on these two developments, this paper examines the impact of women’s ability to make independent decisions on children’s health outcomes—particularly vaccination status, nutritional status, and child mortality in 12 developing countrie