Health and the Political Agency of Women

This paper investigates whether improvements in women’s political representation are associated with higher child survival, and whether any improvements are greater for girls. It also differentiates the caste of both the child and the political leader. We use within-district variation in electoral outcomes for 286 districts across 31 years and within-mother variation in survival outcomes for 0.75 million children. To control for omitted preferences that may drive a positive correlation between female leadership and child health, we instrument female representation with female representation in elections in which the woman wins over a man by a small margin. We find that a one standard deviation increase in female political representation results in a 1.1% reduction in neonatal mortality, the average incidence of which is 6.3%. We find no effects on post-neonatal (or under-5) mortality and no significant difference in the effect for boys and girls. With a view to illuminating pathways, we investigate a range of indicators of investment in child health. We find that female political representation is associated with more antenatal care visits and with higher probabilities of breastfeeding in the first 24 hours following birth, giving birth in a government [and not private] facility rather than at home, and full immunization by the age of one. Improvements in post-natal investments are larger for boys. Other than for breastfeeding, outcomes for low caste mothers and children are more responsive to female leadership and especially low caste female leadership.