Empowering women and addressing gender-based discrimination are key elements of the development agenda of the Nepal government and integral to achieving the Millennium Development Goals (MDGs). Spousal violence is one of the forms of gender-based violence prevalent in Nepal. The objective of this study is to understand women’s empowerment and spousal violence in relation to health outcomes of women and their children. The study analyzed data on 3,084 currently married women age 15-49 from the 2011 Nepal Demographic and Health Survey (NDHS). A composite Women’s Empowerment Index (WEI) was developed that included five variables: i) household decision-making, ii) ownership of land or house, iii) membership in community group, iv) proportion earning cash, and v) women’s education. The WEI classified women into three empowerment levels, whereby 17, 48, and 35 percent of married women were in high, moderate, and low empowerment levels, respectively. Variations in women’s empowerment were distinct by age, caste / ethnicity, and wealth quintile. The WEI is used to analyze spousal violence separately and jointly in relation to health outcomes. Twenty eight percent of women reported having experienced spousal physical and/or sexual violence at least once during their lifetime. In the bivariate analysis, women’s empowerment was inversely associated with greater odds of having experienced spousal violence. After controlling for age, wealth, caste / ethnicity, and ecological zone, however, women's empowerment was not significantly related to the odds of spousal violence. This finding may suggest the extent to which violence is a multi-faceted problem affected by a wide variety of contextual and situational factors. Utilization of four or more antenatal care visits, the recommended international standard, was significantly greater for highly empowered women, even after controlling for spousal violence and socio-demographic characteristics. Less empowered women and women who had experienced spousal violence were also more likely to have anemic children. Children of women who had experienced spousal violence had lower odds of being immunized, even after adjusting for related factors. These findings suggest that women’s empowerment and spousal violence appear to have important implications for the health of women and their children. It is recommended that a holistic approach to improving the health of women and children in Nepal incorporate multi-sectoral programming to promote women’s empowerment and reduce gender-based violence. - See more at: http://www.popline.org/node/579081#sthash.1cqy7uDh.dpuf