While the International Conference on Population & Development (ICPD)  brought about an international consensus on the centrality of (women’s) empowerment and gender equity as desired national goals, the conceptualization and measurement of empowerment in demography and economics have been largely understood in a relational and in a family welfare context where women’s altruistic behaviour (or domestic duty) within the household (e.g. decisions on cooking, household ration, etc.) is tied either to developmental or child health outcomes. As such, the women’s empowerment scholarship is replete with studies that demonstrate pathways through which women achieve certain virtuous development goals related to microcredit programs, poverty alleviation and sustainable development [2–4]. Notwithstanding the policy relevance of these studies, the focus remains on enhancing instrumental gains over individual self-efficacy or as Cornwall  puts it incisively, “empowerment is treated as a destination reached through development’s equivalent of motorways: programmes rolled out over any terrain” (p.342) with no or limited attention to women’s individual realities. By shifting the empirical gaze to woman’s self-efficacy related constructs, the current paper builds on and contributes to the scarce body of scholarship that goes beyond the empowerment-development paradigm.
Given this intellectual and policy background, this study asked if empowerment can be understood in relation to one’s own health and wellbeing. In particular, this study proposed to offer an alternative definition of the household level empowerment measure by including dimensions of self-compassion: a non-judgmental attitude towards one’s own self that includes feelings of awareness, recognition and assertiveness; since research has demonstrated that self-compassion has strong positive association with personal empowerment which in turn generates health gains.
While women’s empowerment is conceptually understood as a “process”  and interrelated terms such as agency, status and autonomy have been variously used in the literature, the lack of adequate data across time makes the measurement of quantifying gains in women’s power and agency problematic. Additionally, scholars note that even if longitudinal data on women’s level of agency/status were available, “the behavioral and normative frontiers that define appropriate indicators for measuring empowerment are constantly evolving” . In this light, Kabeer  suggests that “preconditions” of empowerment which include economic, social and human resources, can create the potential for certain demographic outcomes (or “achievements”) including health behaviors and outcomes. Thus, in Kabeer’s sense, the exercise of power or agency in the presence of resources is the “process” of empowerment making it possible to measure women’s empowerment with cross-sectional data . Subsequently, this paper relied on the India Human Development Survey (2011–2012) to examine how women’s reproductive (captured through antenatal care) health contributes to empowerment at personal and household levels.
Premised on Basu & Koolwal’s  unconventional treatment of women’s empowerment that distinguishes “altruistic (instrumental) versus selfish (self-interest) notions of female autonomy” (p.19), this study developed an empowerment measure rooted in social-psychology (self-compassion) to investigate the health-empowerment debate (discussed in the next sections). The focus on (own) health is crucial as Basu & Koolwal  argue that “when women’s autonomy is put to the service of meeting their own health and other needs, it is quite possible that there is much resistance” (19) and hence to what extent women can take strategic decisions about their own bodies and health may offer a more “durable”  way of understanding women’s expansion of capabilities. The word “resistance” is pertinent here especially in understanding a woman’s ability to pay attention to herself in a context where her needs and aspirations remain subservient to patriarchal loyalties of family and community. For example, demographic scholarship from India has shown that women’s access to education and employment (typical routes through which self-efficacy may be realized) can in fact increase her risk of marital violence arising from a patriarchal anxiety of controlling women’s economic independence and mobility [11,12]. Admittedly, Basu and Koolwal’s plea to focus on woman’s own health assumes substantive significance in the health-empowerment debate. In particular, Basu & Koolwal  utilized the National Family Health Survey-2, 1998–99  data to estimate the effects of household as well as individual characteristics on health outcomes (related to the woman herself and her child/children). The authors’ conceptualization of individual level explanatory factors includes what they call the “self-indulgent” empowerment (variables that capture women’s ability to do things for herself and hence expand her everyday freedoms) as well as those that reflect her capacity to make the best decisions for her family (empowerment as responsibility). Subsequently, these explanatory variables enter their logistic regression models as binary controls where they demonstrate the strongest statistical associations with the (self-indulgent) empowerment variables and women’s own health. It is this finding as well as the creative articulation of the “self” (indulgent or altruistic) that largely motivates the current paper, but it differs in its empirical treatment (described in later sections). Also, the current paper combines pathways of body related constructs, economic freedoms and community participation in its theoretical model, an aspect that has received limited attention in prior studies (including in Basu & Koolwal’s piece). As such, the current paper’s contribution lies in expanding the theoretical development of a survey-based empowerment measure that is uniquely focused on self that simultaneously encompasses robust psychometric qualities.