Spouses’ Agreement on Women’s Autonomy in Rural Bangladesh and Its Influence on Health Outcomes

Chinyelum Morah, Johns Hopkins Bloomberg School of Public Health

The study explored spousal agreement on women’s decision-making power in four areas (household resources, freedom of mobility, childcare, and family planning) and its relationship to four health outcomes (antenatal care, treatment of sick children by trained health professionals, vitamin A receipt, and unwanted/mistimed pregnancies). The sample consisted of 512 rural Bangladeshi couples selected by stratified random sampling. Levels of agreement ranged from 59% (mobility) to 88% (childcare). Relative to wives, husbands underestimated wives’ say in decisions regarding household resources and mobility, and overestimated say in childcare and family planning. Husbands ascribed less importance to microcredit participation and wives’ paid employment as determinants of autonomy. A significant negative association was found between women’s autonomy and antenatal care. When couples agreed, the relationship between autonomy and healthcare outcomes was similar to reports from wives’ surveys. Among divergent couples, wives’ reports were closer to those of convergent couples than were husbands’.