gender nutrition food security in asia af final

Review of IFPRI’s Work on Gender, Nutrition, and Food security in Asia

Presentation given to the Asia Foundation: July 29, 2010

Women’s status and reductions in child undernutrition

Contributions to reductions in child malnutrition, 1970-95Source: Smith and Haddad 2000

Health environment

19%

National food availability

26%Women's

status12%

Women's education

43%

October 14, 2008

2009 GHI and the Education Subindex of the 2008 Gender Gap Index, 90 Countries

The relationship between GHI and gender inequality varies across regions

In South Asia…

• The strongest correlation with the GHI is with the health and survival subindex

• Four out of 5 countries (except Sri Lanka) rank between 80th and 88th of 90 countries in the health and survival subindex

• Linked with the low status of women:– Maternal malnutrition linked with low birthweight– Micronutrient malnutrition linked with poor prenatal

and postnatal health of mothers

In Sub-Saharan Africa…

• Highest correlation of the GHI with gender inequality is in education

• Less than a quarter of countries in region met MDG goal of gender parity in primary and secondary enrollment rates in 2005

Child nutrition in South Asia

* For age group 6-59 months1. National Family Health Survey, India, 2005-062. Nepal Demographic Health Survey, 20063. Bangladesh Demographic Health Survey, 20044. Pakistan Demographic Health Survey, 20075. Sri Lanka Demographic Health Survey, 2007

Reductions in child underweight from 1988-92 to 2001-2006

Source: Global Hunger Index 2008; Appendix C

Social exclusion and undernutrition in India

NFHS Report; India, 2005-06

Social factors and severe stunting in Nepal

November 25, 2008

The window of most damage…and of opportunity

India, child weight-for-age and height-for-age, by age

-2.5

-2

-1.5

-1

-0.5

0

Age groups (months)

Me

an

Z s

co

res

(w

eig

hte

d)

HAZ

WAZ

Source, NFHS-III 2005-06

Why should we improve early childhood nutrition?

27

8

17

46

0 10 20 30 40 50

Grade attainment(women)

Cognitive abilities

Readingcomprehension

Income/hours worked(men)

%

Source: Hoddinott et al. Lancet, 2008

Improving nutrition in early childhood and adult wage rates

Age when exposed to intervention (months)

p < 0.01p < 0.01

p = 0.41

US

$ /

hour

Source: Hoddinott et al. Lancet 2008

Pathways by which improving early nutrition increases wages

Child development (early childhood)

Heightat 3 y

Height, strength, CV resistance (adulthood)

Schooling1.2 grade (women)

Cognitive skills(adulthood )(0.25 SD)

BRAIN BRAWN

More skilled jobs

Source: Behrman et al. in press

Drivers of maternal and child undernutrition

Social protection and gender policies and interventions

are essential to make a difference!

Black et al., Lancet 2008

SUMMARY:What we know about nutrition in S. Asia

• Overall levels of undernutrition are high and decline has been slow in the past 15 years throughout the region (except Sri Lanka)

• There is variability within the region – geographic, income-based, ethnic/social group-based, gender-based, etc.

• Addressing early childhood nutrition is crucial because of evidence of short term and long term gains

• The links between gender and nutrition are of particular concern but not often acknowledged in policies and programs

Just as gender relations are diverse across regions, Asia itself is quite diverse, and gender relations play out

differently across Asia

South Asia• Girls have less schooling marry and

have children early • Norms of female seclusion limit

women’s ability to work outside the home

• Lack of control over assets and incomes reduce women’s bargaining power within the home

• Boys favored in health- and care –seeking, resulting in mortality differences.

East and Southeast Asia• More gender-egalitarian

allocation of resources, no clear gender differences in nutritional outcomes

• High labor force participation rates outside the home, but…

• Women face work-child care tradeoffs

04/11/23

How do gender inequities in the “window of opportunity” lead to poor nutrition?

Pre-pregnancy and pregnancy• Low education• Early marriage• Early pregnancy• Constraints to use of antenatal

services (mobility, access to resources)

• Poor diets• High workloads (at home and at

work); lack of rest during pregnancy

• Domestic violence

First two years of life• Lack of support from family and

community for infant care and breast feeding

• Resumption of work within and outside home soon after pregnancy

• Constraints to use of health and nutrition services (mobility, access to resources)

• Domestic violence*• Gender-based differences in

infant feeding and care seeking

What can be done about it?

• What does analytical research tell us?• What does impact evaluation research tell us?• Learn from IFPRI’s new work program on gender and

assets: (1) analytical methods and (2) impact evaluation• I will briefly present results from both tracks of the

research program, focusing on Bangladesh

04/11/23

RESULTS FROM ANALYTICAL RESEARCH

04/11/23

Domestic violence and malnutritionin Bangladesh

Analysis using nationally representative data set (BDHS 2007) and IFPRI panel (1996/7-2006/7) shows:

• Attitudes tolerating domestic violence are associated with chronic child malnutrition (BDHS)

• Experience of domestic violence associated in lower rates of improvement in stunting and women’s own nutritional status (IFPRI panel)

• Sons of mothers who experience domestic violence do better relative to their sisters (IFPRI panel)

04/11/23

Women’s work and child nutrition in Vietnam and the Philippines

• Philippines: women’s participation in nonfarm employment reduces short-run malnutrition (wasting), but has no impact on stunting

• Vietnam: women’s work is a constraint to continuation of breastfeeding

04/11/23

Impact of shocks on men’s and women’s assets, Bangladesh

Most commonly reported shocks, 1996-2006, Bangladesh

Estimating asset growth regressions shows that:

• Illness shocks reduce women’s assets• Dowry and wedding expenses reduce husbands’ assets• Since health shocks are the most prevalent shocks, lack of

health insurance threatens women’s asset accumulation• Implications for health insurance and social policy

RESULTS FROM IMPACT EVALUATIONS

04/11/23

Evaluating long-term impact of agricultural technology in Bangladesh

(Kumar and Quisumbing 2010)

• Panel data set based on 957 households surveyed in 1996/7 and 2006/7 in study sites examining impact of new agricultural technologies in rural Bangladesh

• 3 technologies/implementation modalities:1. improved vegetables for homestead production, disseminated through women’s

groups (Saturia)2. fishpond technology through women’s groups (Jessore)3. fish pond technology targeted to individuals (Mymensingh)

Big picture story at the household level (Kumar and Quisumbing 2009)

• Biggest gains to early adoption are in the individual fishpond sites, significant positive impacts on hh-level consumption, assets, calorie availability

• Short-term positive impact of early adoption in vegetables site dissipated in long run; technology is divisible and easy to adopt

• Short-term positive impact of group fishponds also dissipated over long run; income gains have to be shared by many families

• However, the story is quite different when we look at indicators of nutritional status, as well as individually owned assets

Impacts on nutrient intake and nutritional status(Kumar and Quisumbing 2010)

• In individual fishpond sites, aggregate nutrient availability increased; percentage of hh members consuming below RDA decreased; stunting decreased; BUT: children’s and women’s BMIs have decreased.

• In group fishpond sites, later adopters did better in terms of nutrient intake, but early adopters realized improvements in long-run nutritional status of children. However, ZBMI and percentage of kids with ZBMI<-2 increased

• In the homestead vegetables sites, despite reduction in hh food consumption (from expenditure data), there were improvements in nutritional status: increase in vit A and iron for men; reduction in proportion of hh members below iron and vit A RDAs; improvement in stunting rates (girls), women’s BMI and hemoglobin

• Did emphasis on vegetables, and targeting to women, improve nutrition even if income gains were minimal in the vegetables sites?

Impact of agricultural technology on men’s and women’s assets in Bangladesh

(Kumar and Quisumbing 2010)

• How have the agricultural technology programs contributed to: (1) asset growth of men and women; (2) reduction of the gender asset gap?

• We use matching methods to examine impact of the agricultural technology program over time on household and individual level outcomes, men’s and women’s assets on average, and men’s and women’s assets within the same household.

• Three comparisons:1. NGO members with technology vs. NGO members without technology2. Early adopters vs. late adopters3. NGO members vs. non-NGO members• We look at changes in husband’s assets relative to changes in wife’s assets

within the same household, focusing on exclusively owned assets

Suggestive conclusions from Bangladesh study

• Implementation modalities matter: women’s assets increased more by programs that targeted technologies through women’s groups

• Even when comparing an identical technology (polyculture fish technology), we find women’s assets increased more, relative to men’s, when women were targeted

• Nevertheless, the bulk of the household’s assets are controlled by men• Intrahousehold impacts may be quite different from household-level

impacts; looking at the household level, the individual fishpond program appears to be the big success, but looking at improvements in individual (women’s and children’s) nutritional status, group-based programs were more effective

• This reinforces the need to look within the household when evaluating impacts of programs and policies

Evaluation of food and cash transfers targeted to women (Ahmed et al. 2010)

Four transfer programs are studied:

1. Income-Generating Vulnerable Group Development (IGVGD): “Only food”

2. Food Security Vulnerable Group Development (FSVGD): “Food-cash combination”

3. Food for Asset-creation (FFA) component of the Integrated Food Security (IFS) program: “Food-cash combination”

4. Rural Maintenance Program (RMP): “Only cash”

Monthly Value of Transfers Per Beneficiary(6-month average)

407 404

837

695

0

100

200

300

400

500

600

700

800

900

1000

IGVGD(food)

FSVGD(food+cash)

FFA(food+cash)

RMP (cash)

Taka

per

ben

efic

iary

per

mon

th

Composition of Transfer Value by Commodity Type

0

100

200

300

400

500

600

700

800

900

IGVGD FSVGD FFA RMP

Tak

a pe

r be

nefi

ciar

y pe

r m

onth

Wheat Atta Rice Cash

Impact on women’s empowerment outcomes (method: propensity score matching)

• Participating in either FFA or RMP has positive outcomes on many indicators of women’s empowerment

• RMP tends to have a large, positive impact on many outcomes

• FFA has a negative marginal impact relative to RMP for married women, but a positive impact on some outcomes for widows

• But how cost-effective are the programs?

Cost of increasing participation in food decisionmaking by 1% (taka)

38.045

11.983

0

5

10

15

20

25

30

35

40

FFA RMP

FFA

RMP

Impact on decisions on food: cost-effectiveness

• RMP is more cost-effective in increasing women’s participation in decision making on food expenditures

• It costs three times more for FFA to increase women’s participation in food decision making compared to RMP

Cost of increasing percentage of women taking NGO loans by 1% (taka)

6

45

12

20

0

5

10

15

20

25

30

35

40

45

50

IGVGD FSVGD FFA RMP

Impact on taking NGO loans: Cost-effectiveness

• IGVGD is the most cost effective in terms of the taka cost of increasing the percentage taking NGO loans by 1 percent: only 6 taka, compared to 12 for FFA, 20 for RMP, and 45 for FSVGD

• But this also reflects differences in program priorities. As mentioned earlier, taking NGO loans appears to be less of a priority for FSVGD.

Concluding remarks from cash-food evaluation

• The large positive impacts of FFA and RMP compared to the other two programs are probably due to the size of transfers, which are about twice those given in IGVGD and FSVGD

• Nevertheless, given differences in costs between programs, RMP is more cost-effective in increasing women’s participation in decision making over food, whereas IGVGD is more cost-effective in graduating poor women to the microfinance system

• Differences in cost-effectiveness performance will have to be weighed vis-à-vis program objectives

• Compared to a “food only” program, there seem to be some advantages to having cash

• However, compared to a “cash only” program, the advantages of having food are received only by widows. Married women who participate in public works programs do better with cash.

Concluding remarks from cash-food evaluation, cont’d

• Why does receiving food not appear to strengthen women’s bargaining power within the household? Seems to go against conventional wisdom

• Some explanations:– The main food based program had much lower

transfers than the cash-based program– The economy has become more diversified, and

cash is important– Receiving cash allows women to expand their area

of decisionmaking beyond their traditional roles as food providers and caregivers

• For widows and those who are divorced or separated, however, having direct control of some food may be important.

Caveats--1Six blind men (or women) and the elephant

Caveats--2

• Gender-related outcomes are very nuanced• Statistical and econometric analysis can only tell you so much• Gender relations change, and what may be an indicator of

empowerment before may no longer be relevant over time• Improvement of gender-related outcomes needs to be viewed

in the context of overall program objectives• Learn from both evaluations and feedback from beneficiaries

and program officials to improve design and implementation

gender nutrition food security in asia af final

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