Agnes Quisumbing (Senior Research Fellow, IFPRI) recently participated in the 5th annual Leverhulme Centre for Integrative Research on Agriculture and Health (LCIRAH) conference, which focused this year on “agri-health research.” Returning from the conference, Agnes reflects on how far we’ve come in terms of recognizing gendered linkages within agriculture-nutrition research and where there are opportunities to close knowledge gaps, especially with new datasets and increased attention to the role of men.
Last month I had the privilege of giving the opening keynote at the 5th annual LCIRAH conference. The conference theme – “Agri-health research: What have we learned and where to next”—inspired me to look back to the 1995 World Conference on Women in Beijing, how gender was conceptualized at that time, and what gender research has done to improve our understanding of the pathways linking agriculture, health and nutrition. You can view my presentation here.
In 1995, there was very little empirical evidence on gender and food security. Also, most people thought that gender meant “women”. An IFPRI Food Policy Report, “Women: The Key to Food Security,” prepared for the Beijing Conference highlighted women’s roles as food producers, income earners, and caregivers. While the Food Policy Report presented new empirical evidence on each of these areas, they were treated as silos, not fully recognizing the linkages among the three. And men were conspicuously absent from any discussion of gender and food security! If women were holding up half the sky, where were the men?
As researchers working on gender and nutrition, we often have blinders. We often think only of women and nutrition, not recognizing that women live in households and communities where men are important partners, caregivers, and decisionmakers. The current thinking in agriculture-nutrition-health research has certainly evolved, with pathways linking agriculture and nutrition recognized as clearly gendered, although women-specific roles remain important in three of those pathways (Ruel and Alderman 2013; Kadiyala et al 2014). There is also growing attention placed on women’s empowerment—and, in measures such as the gender parity gap sub-index of the WEAI, women’s empowerment is measured relative to men’s. Yet, there is still insufficient attention to men’s roles in nutrition. At the LCIRAH Conference, the four papers presented in the morning session represent how the next wave of gender research is looking forward. Although this was an all-female panel (men: you are welcome to get involved in gender research!), I was glad to find out that there were male co-authors on a number of the papers.
- Kenda Cunningham talked about ongoing work examining the link between women’s empowerment and child nutrition in Nepal, where 41% of children under 5 years of age are stunted – a serious public health problem. It is well known that women’s disempowerment and low social status contribute to persistent child under-nutrition in South Asia, given the maternal role as primary caregiver. In previous work, Kenda and her colleagues found a positive significant association between several dimensions of women's empowerment in agriculture — autonomy in production decisions, satisfaction with time available for leisure, and access to and decision-making on credit — and child (under 2 years of age) length-for-age z-scores (LAZ).
In her current paper, she tested whether two care practices — child feeding and household water, sanitation, and hygiene (WASH) facilities and behaviors — mediate these associations for children 6 to 24 months of age. She found that in the context of rural Nepal, women's empowerment in agriculture is a contributor to child LAZ, and infant and young child feeding practices along with water, sanitation, and hygiene are also key contributors. Thus, addressing under-nutrition in Nepal, particularly during the most vulnerable growth-faltering period of the first two years, will likely require nutrition programs and policies that prioritize women's empowerment within agricultural households, along with traditional approaches such as IYCF behavior change programs—a combination of nutrition-specific and nutrition-sensitive approaches.
- Monica Jain’s presentation was featured in a previous GNIE blogpost. Observing that complementary child feeding practices are poor in Bangladesh and have improved minimally over time, Monica and Manfred Zeller hypothesized that mothers lack time to prepare age-appropriate food and feed it to their children with the required frequency. Testing this hypothesis using a unique panel data on time use of women and food intake of children (based on 24 hour recall) in Bangladesh collected in 1996-97 in three different agricultural seasons, she found that, even if the majority of women reduce their cooking time in the peak agricultural seasons, exclusive child care time remains roughly constant at about two hours, regardless of income, education or agricultural season. However, there is gender discrimination in child care time in favor of boys.
- Maria Christina Jolejole-Foreman and her coauthor Guenther Fink added to the growing literature on in utero exposure to hunger and child health outcomes. They linked data from Zambia's post-harvest surveys (PHS), which track food reserves at the household level over time, to child health outcomes captured in the Demographic Health Survey (DHS), to examine the extent to which food reserves among small-scale farms affect maternal nutrition and birth outcomes. They found that the impact on children's physical growth measures occurs predominantly when the mother is exposed to food scarcity in early gestation. While the chance of survival decreases when mothers were exposed to food scarcity during the second trimester, exposure to scarcity during the first trimester yielded the opposite result. A plausible reason is selection: those fetuses who survive the first trimester, even if the mother is really malnourished, may be healthier to begin with and are more likely to survive.
- Finally, Happy Magoha and her coauthors made everyone who likes peanuts rather nervous: her study was on exposure to aflatoxin and fumonisin among breastfeeding infants in Tanzania. The study built on recent findings showing that dietary exposure to mycotoxins has profound effects on growth of children. Infants breastfeeding from mothers consuming mycotoxin-contaminated foods may be exposed to aflatoxin M1 (a metabolite of aflatoxin B1) and fumonisin excreted in breast milk, which can impair their growth.
This study examined the exposure to aflatoxin and fumonisin through breast-feeding in infants under six months of age and their associated effects. A disturbing result from their study is the high degree of mycotoxin contamination of breast milk, at levels exceeding provisional maximum tolerable daily levels. They also found inverse associations between mycotoxin exposure levels and weight-for-age z-scores (WAZ) and height-for-age z-scores (HAZ) (aflatoxin) and WAZ and weight-for-height z-scores (WHZ) (fumonisin). The authors called for measures to reduce mycotoxin contamination in food, and the prevention of exposure of lactating women to unsafe food, both for themselves and their nursing infants.
It is exciting to see new research investigate both the biological and social roles of women in nutrition with empirical evidence. This research is critical to add nuance to the linkages between agriculture, nutrition, and gender. The aflatoxin study and maternal exposure to food insecurity highlight new and specific ways in which maternal nutrition affects child health and nutrition outcomes. These studies, along with the time use study, emphasize how much timing matters. Through gestation to early childhood, development is rapid and a child’s needs change quickly; risks are high but vary at different stages. Monica’s study reminds us that a child’s demand for her mother’s time is very different at 6 months of age versus 2 years of age. Similarly, Maria Christina shows us that the trimester during which women face food insecurity matters.
The studies in Nepal, Bangladesh, and Tanzania demonstrate the value of datasets that link gender relations (e.g. sex-disaggregated time use and decision-making power data), nutrition and health indicators, and rural livelihoods information. Such datasets are still rare but critical for testing linkages and understanding how contextual conditions like poverty, seasonality, timing, and other factors mediate the pathways (the LSMS-ISA and Feed the Future baselines are two examples of large-scale survey initiatives to combine these topics). Though the agriculture-nutrition pathways have yet to explicitly posit how men can contribute to nutrition (in contrast to research on agricultural production, which tends to undervalue women’s efforts), “linked” datasets like these can already be examined to produce new hypotheses so we learn how to engage men in support of maternal and child nutrition.
Many other oral and poster presentations throughout the LCIRAH conference addressed the significance of gender in agriculture and nutrition research, including some by A4NH researchers Hazel Malapit and Nancy Johnson. The agriculture-nutrition community has a framework for asking how agriculture might affect nutrition through gender, but though we have moved from pillars to pathways, perhaps for the next 20 years, it will be our task to generate evidence about the mechanisms and contextual factors that influence the outcome and strength of these pathways. Women are still the key to food security, but we know that there are many kinds of doors to unlock to get to full nutrition security, and many other actors – including men, relatives, the community – help them open the door.
This post is part of a blog, the Gender-Nutrition Idea Exchange, maintained by the CRP on Agriculture for Nutrition and Health.