INDIA’s bachelor leader, Narendra Modi, struggles with the opposite sex. Last year he tried to be seen to revere his mother by rushing to her side after his big election victory. But then he failed to invite her to his grand inauguration. He has talked, admirably, about the need to respect women. But he defines “our mothers, daughters and sisters” by their relationships with men and as treasures to protect. It does not help his reputation that, until he was running for the prime ministership, he refused to acknowledge that he has an estranged wife, whom he was forced to marry as a teenager and has not lived with since.

For a man usually so eloquent, Mr Modi occasionally lands his sandalled foot in his mouth: on June 7th he made an especially crass comment during an otherwise successful visit to Bangladesh, praising his host, Sheikh Hasina, the prime minister, for being tough on terrorism “despite being a woman”. Critics back home accused Mr Modi of having retrograde views, typical of those who revere the country as “Mother India” but who treat women atrociously. Yet such attitudes are widely shared, not just in India but across South Asia. The whole region fails to grant women equal respect or opportunities.

That may seem odd, given how prominent a role women play in South Asian politics. China, Japan, Russia and many other countries have failed to produce a female prime minister or president. South Asia has had several. If Hillary Clinton is elected next year to lead the world’s most powerful democracy, it will be a full half-century after Indira Gandhi first led the world’s largest one. Sri Lanka’s Sirimavo Bandaranaike pipped her to become the world’s first female head of government, in 1960. In that country, uniquely, both a mother and her daughter have held the highest political office. In the late 1990s Chandrika Kumaratunga even served as president at the same time as her ageing mother, Mrs Bandaranaike, completed a third, mostly ceremonial, term as prime minister.

Women prosper at the top of South Asian democracies partly because they are propelled by dynasties that long formed the core of political parties. In Bangladesh the two battling begums have ensured that no other politician gets a look-in. Sheikh Hasina lets no one forget she is the daughter of the country’s murdered founder, Sheikh Mujibur Rahman. Her fierce rival Khaleda Zia, the opposition leader, joined politics after the murder of her husband, also an early president. Pakistan’s only female prime minister, the late Benazir Bhutto, entered politics after the execution of her father, Zulfikar Bhutto, a populist prime minister. In India some talk seriously of Priyanka Gandhi as a future leader of the Congress Party—mostly because her mother, Sonia Gandhi, has done the job, as well as her lookalike granny, Indira.

But if South Asia is one of the best places on Earth for elite women who aspire to a political career, it is one of the worst places to be an ordinary woman. The occasional chauvinism faced by females at the top pales beside the burdens heaped on those at the bottom. South Asian women fare terribly in a “Mothers’ Index” put together in May by Save the Children, a British charity. It ranks 179 countries according to the well-being of their women, using indicators such as maternal mortality, the survival of young children and women’s involvement in politics. Subcontinental nations come out the worst in Asia. Women in India and Pakistan (ranked 140th and 149th) have a quality of life only a little brighter than those in Afghanistan (152nd) and far behind those in China (61st), who are far more likely to survive childbirth, or see their offspring spend a long time in school.

Not everything is gloomy. Over the past 25 years, thanks to economic growth and official health schemes, some things have improved dramatically for South Asians. Take the blight of child weddings. In the mid-20th century the average Indian woman was married at 15 and endured early, frequent and often debilitating pregnancies. Now Indian women are more likely to tie the knot after getting an education, marrying on average at 21.

Another measure is the 289,000 women, globally, who died in childbirth in 2013. South Asia accounted for a quarter of them. But here too, improvements are striking. The rate of such deaths in the region has plummeted from 550 for every 100,000 live births in 1990 to 190 now. Poorer countries in South Asia—Nepal, Afghanistan and Bangladesh—have made notable gains by providing free maternal and child care, and recruiting more female health workers.

Let money do the talking

Yet South Asia will need to spend a lot more on women in order to see further improvements. The region devotes barely 1% of GDP to public health (China spends 3.1%). This puts a heavy burden on those who give birth and take most responsibility for child care. In part this is because of lingering poverty: World Health Organisation figures from 2012 show that combined public and private funds for health care, per person, came to a little over $50 per year in South Asia. Africa spent nearly double that; in East Asian countries it was ten times more. In North America spending on health, per person, was $8,500 a year.

The resources spent on women in South Asia are shared more unevenly than in most places. Among the richest quintile in Delhi (it is a similar story in Dhaka and elsewhere), women can enjoy maternal and other care close to first-world standards. By contrast the poorest quintile in the same cities, especially in slums, endure conditions as bad—or worse—than in far poorer villages: in Delhi only 19% of such women have someone skilled present when they give birth. Barely half of their children have had a measles jab and nearly three-fifths are stunted. Reducing such inequality would be one way to make existing resources go further in South Asia. But that is likely to happen no quicker than changing old-fashioned attitudes to women.