Representation matters? Female legislators and women’s health in Bangladesh

Women’s political representation has increased substantially over recent decades due to concerted efforts, including quotas, to increase female legislative representation in electoral democracies. While studies find that female leadership improves educational outcomes and the provision of public health services, we know little about the impact of women leaders on their female constituents’ health status in less developed countries. In this study, we take advantage of novel geocoded survey data in Bangladesh to employ spatial–temporal methods for investigating whether the presence of women parliamentarians improves prenatal care usage − a key maternal health indicator. Using three different identification approaches, we find evidence, contrary to our expectations, that women’s electoral representation decreases the likelihood of prenatal clinic attendance in electoral districts in Bangladesh. Reflecting on the unusual findings, we explore several factors that may contribute to the maternal health status in woman-led constituencies. Our analysis suggests that women’s electoral representation does not spontaneously improve outcomes for women’s issues. The counterintuitive findings imply that political-institutional and electoral contexts, as well as political culture, may mitigate the impact of women’s political agency on gender-sensitive development outcomes in less developed countries.