Why, after so many decades of effort – improvements in agriculture, increases in education levels, advances in technology, great strides in economic growth – are so many of India’s children still going hungry? Half of India’s children are not meeting their basic needs for optimal nutrition.

It is not for lack of will or effort that India’s child malnutrition rate remains so high. Nor is it simply a matter of poverty.

In fact, India’s high incidence of child malnutrition is part of a wider regional anomaly. Fifty percent of children across South Asia continue to suffer from malnutrition, compared to thirty-three percent of children in sub-Saharan Africa. The gap exists despite much higher levels of per capita national income, education and safe water access in South Asia than in sub-Saharan Africa. For more than 20 years, India has even “sustained the greatest effort in history to improve nutritional standards,” according to UNICEF, through its Integrated Child Development Services Programme.

In 1996, India’s preeminent physician-nutritionist of recent times, the late Professor Ramalingaswami, together with Dr. Urban Jonsson and Dr. Jon Rohde, wrote a groundbreaking article on South Asia’s anomalously high malnutrition rates called “The Asian enigma.” At the time, when this article appeared in UNICEF’s Progress of Nations Report, there was insufficient research and no clear consensus on the reasons behind this devastating problem.

After addressing the theories that attempted to explain the Asian Enigma (including South Asia’s higher rates of vegetarianism), Professor Ramalingaswami and his co-authors concluded that the extremely low status of women relative to men in South Asia compared to sub-Saharan Africa accounts for the differences in malnutrition rates between the two regions.

There are obvious links between women’s status and child nutrition. For example, a malnourished mother will give birth to a baby with low birth weight, which is the single most important predictor of child survival. Common practices, such as allowing all the males of the household to eat first, partly explain why 83 percent of women in India suffer from iron deficiency anaemia, as opposed to about 40 percent in sub-Saharan Africa. Not surprisingly therefore, one-third of babies born in India are born with low birth weight, compared to one-sixth in sub-Saharan Africa.

A woman’s control over resources within the household also affects her children. Numerous studies have shown that income or assets controlled by women are more likely to be spent on items that benefit children and themselves, such as food, clothing and health care, than assets controlled by men.

Improving women’s status is widely seen as a strategy for improving family health and nutrition. Yet surprisingly, there has been no comprehensive empirical research linking women’s status and child nutritional status. Millions of dollars are spent each year on programs to protect child nutritional status. It makes sense to put efforts into understanding this central relationship more clearly.

The International Food Policy Research Institute (IFPRI) and the Department of International Health at Emory University sought to address this research deficit in a recent study that picks up the work of the late Professor Ramalingaswami and his distinguished colleagues. Lisa Smith, IFPRI research fellow, and Usha Ramakrishnan, Associate Professor at Emory University, led the research.

The study brought together data from 36 developing countries, spanning over one hundred thousand children under the age of three, and a roughly equal number of women, usually the mothers. Women’s status was defined as “Women’s power relative to men in the households, communities, and nations in which they live.” The research examined women’s status both at the community and household level. Researchers considered several indicators to determine women’s status, such as whether the woman works for cash, the age of the woman at marriage, and the age and educational differences between husband and wife.

The study identified three factors contributing to the nutritional status gap between South Asia and sub-Saharan Africa. The first, making by far the greatest contribution among the three, is women’s status, followed by sanitation and urbanization.

The difference between women’s status in South Asia and sub-Saharan Africa was not found to be that large. Instead, results showed that the negative impact of women’s low status in South Asia on child nutrition was much more severe than in sub-Saharan Africa. In other words, the particular ways in which women in South Asia are disempowered cuts to the heart of their ability to nurture their children.

The study found that in regions where women’s status is lowest, the negative impact of their lower status on child health is proportionately much stronger. The implication for policy is clear: in the interests of improving child nutrition, women’s status should be raised. This need is particularly urgent in South Asia.

The study also concluded that in regions where women’s status is low, programs to improve child nutritional status would have more lasting impact when combined with efforts to improve women’s status.

In areas where efforts to raise women’s status are met with resistance, programs that mitigate the negative effects of power inequalities favoring men can be implemented. For example, the study found that gender inequality at the community level increases rates of child malnutrition because it reduces the use of health services by women and children. Targeting health services to areas where women’s status is known to be low is therefore likely to be an effective strategy.

An extensive empirical study by IFPRI confirms that improving the status of women is crucial to reducing child malnutrition in South Asia. Where efforts to address gender inequality are met with resistance, regional and country-level research will help identify the most effective mitigating strategies. Doing so will give India’s children the best opportunity to develop into tomorrow’s productive young adults, while ignoring these needs can only lead to a future that is much more bleak.

A knowledge-based economy, driven by the ideas and innovations of India’s next generation of young adults, is a bright aspiration. Adequate nutrition is essential to the development of a child’s intellectual capacity, and with strategies that promote women’s status and children’s nutrition, this brighter future is an achievable one.