The relationship between women\u27s autonomy and infant and child survival: Evidence from five Asian countries

Abstract

I evaluate the hypothesis that higher autonomy of mothers is related to lower infant and child mortality in 47 communities across five south and southeast Asian countries: India, Pakistan, Malaysia, Philippines and Thailand. I also consider the idea that the lower autonomy of Muslim compared to non-Muslim women is related to experience of higher infant and child death for the former group. The main method is a proportional hazards model that includes a correction for clustering of mortality risks within families. I find that women\u27s autonomy is not a consistent or strong correlate of infant and child survival and any observed association between autonomy and mortality is often heavily contingent on country and communities within country. In Malaysia and Philippines, the mother\u27s discretion over family income is related to lower post neonatal and child death. But in Pakistan, north India, and Thailand several dimensions of women\u27s autonomy such as freedom of movement, discretion over material resources, and decision making over children\u27s illness have weak associations with child survival once the socioeconomic status of the mother and her family or region of residence are considered. In India, these features of women\u27s position are positively related to child survival only in the more gender egalitarian southern area of Tamil Nadu. In all five countries measures of women\u27s autonomy are relatively useless for understanding variation in neonatal mortality. Examination of Muslim and non-Muslim differences in mortality and women\u27s autonomy shows that Muslims usually have higher death rates in the southeast Asian settings of Philippines, Malaysia and Thailand. But they do not have consistently lower autonomy compared to non-Muslims. At the community and individual level, the relation between Muslim and non-Muslim differences in mortality and autonomy is weak. Socioeconomic status usually fails in explaining the religious differences in mortality, in part due to the indeterminate relation between religion and household wealth in these settings