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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
Page 4
2009 GHI and the Education Subindex of the 2008 Gender Gap Index, 90 Countries
The relationship between GHI and gender inequality varies across regions
Page 5
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
Page 6
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
Page 7
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)
Page 27
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
Page 28
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?
Page 29
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
Page 30
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
Page 31
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”
Page 32
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
Page 33
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
Page 34
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?
Page 35
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
Page 36
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
Page 37
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
Page 38
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.
Page 39
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.
Page 40
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.
Page 41
Page 42
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
Page 43