He Said, She Said, They Said: Couples’ Reports of Women’s Autonomy and Health Care Use in Nepal

Keera Allendorf, University of Wisconsin at Madison

I use data from matched couples in the 2001 Nepal Demographic and Health Survey to explore how incorporating both spouses’ perceptions of household decisionmaking may change our understanding of the determinants of women’s autonomy and its impact on health care. I find that couple agreement on who makes household decisions is far from perfect, but the determinants of autonomy are largely similar according to both spouses’ reports. However, the effects of two important sources of autonomy, women’s education and employment, do differ significantly between spouses. Finally, the association between women’s autonomy and health care use may be underestimated using only women’s reports. When spouses agree that the wife is autonomous, the association between autonomy and health care use is substantially larger.