Do They Really Have a Say? Female Representation, Central State Reach, and Maternal and Infant Mortality in a Cross-National Panel Analysis

Extensive research has examined whether greater female representation in legislatures leads to policy outcomes that improve women’s conditions in society. A crucial outcome in this context is the reduction in maternal and infant mortality. Building on theories about the conditions linking descriptive to substantive representation, this study argues that central state reach, i.e., the extent to which the central state can translate parliamentary decisions into policy, is a critical yet overlooked moderator of this relationship. We conceptualize central state reach along two dimensions: horizontal reach, defined as parliament’s authority over other state actors such as the government and the bureaucracy; and vertical reach, defined as parliament’s authority over subnational governments. The horizontal dimension is captured through public administration systems, which reflect norms about the state’s role vis-à-vis society and the balance between rule adherence and goal achievement. The vertical dimension is measured as the degree of decentralization. We hypothesize that in countries with English common law traditions, where the state follows a contractarian logic and plays a more limited role in service provision, female representation will have weaker effects on health outcomes. Conversely, in interventionist legal systems (e.g., civil law), where the state is more deeply embedded in society, women’s parliamentary presence should exert stronger influence. Furthermore, we expect that decentralization reduces the impact of national-level female representation, as policymaking and service delivery shift away from the center. In more centralized contexts, by contrast, female representation in parliament should translate into greater substantive representation, producing stronger improvements in maternal and infant health. Applying two-way fixed effects model to a sample of 164 countries from 1991 to 2020, we find that the negative association between the share of women in parliaments and mortality rates is weaker in common law countries compared to civil law ones. When we look at vertical concentration of power, instead, we find that such negative association weakens as decentralization increases only for longer-term mortality indicators (infant, child mortality) and that the moderating role of decentralization might operate non-linearly.