Political gender quotas have become the institutional solution for most governments hoping to increase women's descriptive and substantive representation in national and local government, despite the lack of consensus over whether quotas have a consistent positive effect on the lives of women. We argue that the different forms in which quotas are implemented result in diverse effects in the substantive representation of women's issues. Using women's health to illustrate the substantive effect of women's political participation through quotas, we utilize multilevel models to find that quotas are effective at placing women into legislative office and that this descriptive representation is associated with positive conditions for women's health. However, the strength of the relationship depends on the type of quota implemented. Countries implementing candidate quotas exhibit more consistent but weaker relationships between representation and women's health outcomes than in countries with reserved seat quotas. These results affirm the quota's objective to place women in political office but suggest that the policy effectiveness of the individual female legislators may depend on the quota system in place.
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