Association between women's autonomy and their health outcomes in India: evidence from NFHS-5

Purpose This study explores the association between women's autonomy and their health outcomes in India, focusing on anaemia and body mass index among currently married women aged 15–49 years using nationally representative data from the National Family Health Survey (NFHS-5). Design/methodology/approach The study first constructs an index of women's autonomy based on indicators of economic decision-making, financial and social access, sexual autonomy and mobility. The analytical sample is restricted to currently married women to ensure measurement consistency across all survey modules, particularly spousal education and sexual autonomy. The study uses survey-weighted logistic and multinomial logistic regression models that account for the complex sampling design of NFHS-5 by incorporating sampling weights and clustering standard errors at the primary sampling unit (PSU) level. State fixed effects are included to control for unobserved state-level heterogeneity. The analysis assesses how variations in autonomy relate to women's health outcomes after controlling for socioeconomic, educational and household characteristics. Findings The results indicate that higher levels of autonomy are associated with a significantly lower likelihood of anaemia among women. At the same time, greater autonomy is associated with lower chances of being underweight but higher chances of being overweight, pointing to a dual burden of malnutrition shaped by social and behavioural factors. Originality/value While existing research in the Indian context has largely examined women's autonomy in relation to healthcare access and service utilisation, this study extends the population health literature by providing direct evidence on how autonomy is linked to women's health and nutritional outcomes. The findings suggest the importance of gendered social determinants in shaping health inequalities and suggest that policies aimed at enhancing women's autonomy may have health effects.