1. Understanding the Agricultural Nutrition Linkages: Gender dimensions Suneetha Kadiyala International Food Policy Research Institute New Delhi November 14th, 2011

2. The Asian Enigma Why is South Asias child malnutrition rate so much higher than Sub-Saharan Africas, when it does so much better with respect to many of the long- accepted determinants of child nutritional status, such as national income, democracy, food supplies, health services, and education? (Ramalingaswami et al. 1996) 12/3/2011 3. Outline Conceptual framework Determinants of child nutrition Potential interventions (nutrition-specific, nutrition-sensitive) Global and regional undernutrition (burden, trends) Gender and nutrition Agriculture and nutrition pathways Gender dimensions India case study Some findings from India and Bangladesh Policy implications 4. Short and long routes to improving child nutrition Source: World Bank Draft 2011; Adapted from UNICEF 1990 and Ruel 2008 5. Undernutrition in South Asia 12/3/2011 6. Global burden of child stunting (millions, under-fives, 2008) India, 61.21 Bangladesh, 8.79 Ethiopia, 7.5 Kenya, 2.1 Nigeria, 9.57Nepal, 2.08Vietnam, 3.48 Others, 83.27 7. Child Nutrition in South Asia (2005 2007) Source: UNICEF http://www.childinfo.org/undernutrition_nutritional_status.php 1.National Family Health Survey, India, 2005-06 2.Bangladesh Demographic Health Survey, 2007 3.Nepal Demographic Health Survey, 2006 4.Sri Lanka Demographic Health Survey, 2006-07 5.Pakistan National Nutrition Survey 2001-02, Re-analyzed by WHO Nov 2007 43 41 39 21 31 20 17 13 15 14 48 43 49 17 42 0 10 20 30 40 50 60 India Bangladesh Nepal Sri Lanka Pakistan Percentageofunder-fives Underweight Wasting Stunting Source: Menon, Bamezai et al 8. Height-for-age Z-scores by child age and region 12/3/2011 9. Gender and Nutrition 12/3/2011 10. Maternal BMI (weighted) in select South Asian countries 37.98 31.88 25.20 0 10 20 30 40 50 60 70 Percentage Percentage of mothers with mean BMI less than 18.5 India Bangladesh Nepal Source: Authors estimates based on DHS datasets 1.National Family Health Survey, India, 2005-06 2.Bangladesh Demographic Health Survey, 2007 3.Nepal Demographic Health Survey, 2006 19.99 20.99 20.36 19.4 19.6 19.8 20 20.2 20.4 20.6 20.8 21 21.2 MeanBMI Mean maternal BMI India Bangladesh Nepal Source: Menon, Bamezai et al 11. 2009 GHI and the Education Sub-index of the 2008 Gender Gap Index, 90 Countries Page 12 12. In South Asia The strongest correlation with the GHI is with the health and survival sub-index Four out of 5 countries (except Sri Lanka) rank between 80th and 88th of 90 countries in the health and survival sub-index Linked with the low status of women: Maternal malnutrition linked with low birth weight Micronutrient malnutrition linked with poor prenatal and postnatal health of mothers 13. Womens status and reductions in child undernutrition Contributions to reductions in child malnutrition, 1970-95 Source: Smith and Haddad 2000 14. Agriculture-Nutrition Pathways 12/3/2011 15. Why Agriculture for nutrition in South Asia? Agriculture sector engages over 50% of the total labor force in South Asia Agriculture generates over 50% of rural income Agriculture is fundamental to a more inclusive and sustainable structural transformation The potential for agriculture to influence nutrition outcomes at scale is large 16. Conceptualizing the pathways between agriculture and nutrition Agriculture is a key driver of poverty reduction But... Pathways to nutrition are diverse and interconnected 1. Agriculture as a source of food 2. Agriculture as a source of income 3. Agricultural policy and food prices 4. Expenditure patterns: how income derived from agriculture is actually spent Gender dimensions 5. Womens status and intrahousehold decisions and resource allocation 6. Womens ability to manage young child care 7. Womens own nutritional status 17. Female share of agricultural labor force Source: FAO , 2011 South Asia averages masked by India. In Bangladesh the proportion is over 50% Proportion of women engaged in agriculture in rural areas is much higher83% in India 18. Proportion of labor in all activities by women Source: FAO , 2011 19. Share of male and female agriculture land holders Source: FAO , 2011 The gender gap is evident in many assets, inputs & services Closing the gender gap can increase yields by 20-30% 20. Emerging Findings from India 12/3/2011 21. Estimated elasticities between undernutrition and some welfare indicators Independent variable Weight Dependent Variable Stunting Low BMI, (Women) Asset Index None 0.09 -0.45# GDP per cap growth None 0.08 -0.63 Agr. GDP/worker Ag. initial share in total employment -0.20# -0.44* Non-Agr. GDP/worker -0.14# -0.29* Source: Headey, Chiu and Kadiyala 2011 *significant differences from zero at the 10% level, # indicates marginal insignificance at the 10% level 22. Impact of employment in agriculture on maternal and child nutrition Occupation choice on mother's BMI Mother's BMI Not working -0.08 Clerical -0.31 Sales 0.33* Services -0.35*** Manual -0.54*** Agriculture -0.62*** Professional (reference category) Mother's BMI on children's nutrition Child's HAZ Child's WAZ Mother's BMI 0.030*** 0.060*** *,**,*** indicate significance at the 10%, 5% and 1% levels respectively Source: Headey et al; Menon et al . 23. Property share, mobility and decision-making among currently married women Predictedprobability (highlymobile-independentdecisionmaking) Source: Swaminathan, Lahoti and Suchitra Data: Karnataka Household Asset Survey (KHAS), 2010-11 24. Womens empowerment and dietary diversity Non- agriculture household Agriculture household Womens education none (omitted) Womens education primary 0.14* -0.00 Womens education secondary 0.09 0.11* Womens decision making power 0.04*** 0.06*** N 7106 4829 Controlling for income, location, child characteristics, health behaviors etc. Data: IHDS-2; Bhagowalia et al. 25. Quisumbing and Kumar (2010) Some findings from Bangladesh 12/3/2011 26. Long-term impact of agriculture technologies Panel data set based on 957 households:1996/7 & 2006/7 3 technologies/implementation modalities evaluated: improved vegetables for homestead production, disseminated through womens groups fishpond technology through womens groups fish pond technology targeted to individuals Fishponds increased aggregate nutrient availability with mixed results in child and womens nutrition status Vegetable gardens improved nutrient intake and status Did emphasis on vegetables, and targeting to women, improve nutrition, even if income gains were minimal in the vegetables sites? 27. Impact of agricultural technology on mens and womens assets in Bangladesh Womens assets increased more by programs that targeted technologies through womens groups Even when comparing identical technologies Nevertheless, the bulk of the households assets are controlled by men Intrahousehold impacts may be quite different from household- level impacts at the household level, the individual fishpond program appears to be the big success but looking at improvements in individual (womens and childrens) nutritional status, group-based programs were more effective 28. Policy Implications 12/3/2011 29. Womens Empowerment: A key entry point for agriculture to improve nutrition outcomes Ensuring land and property rights for women the Groups efforts (e.g. womens cooperatives) should be used for improving convergence of health ,nutrition, agriculture and other social sector initiatives at scale SHGs could focus on micronutrient fortification, low cost nutrient dense supplementary foods, community mobilization Maternity entitlements, high quality child care facilities Correcting the gender bias in the functioning of institutions and support systems Closing the gender gap in wages, access to inputs, services etc.