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Maternal work, child feeding, and nutrition in rural Tanzania

Margareta Wandel and Gerd Holmboe-Ottesen

There has been an increasing interest among researchers in the relationship between women's working conditions in developing nations and the nutrition of their children. The concern is that women's participation in production activities may have negative consequences for the nutritional well-being of their children, the assumption being that if they are active in production they have less time to spend on child care and feeding.

Most of the research on this issue has examined women wage earners working outside their homes [1, 2]. but it has been argued that women working in agricultural production on their own farms also may not have enough time for child care. This is particularly a problem for African women who have a heavy workload in agriculture [3]. Some researchers, however. have demonstrated positive effects of women's work on child nutrition [4, 5]. These effects may be even more pronounced when women are working in food production. since household food availability may he affected more directly. Thus. there appear to he opposing effects of women's agricultural work: one is the negative effect of time constraints on child care and feeding; the other is a positive effect on household food availability, which may influence child feeding and nutrition in a positive way.

We examined both of these lines of argument in a study in an area of Tanzania characterized by a net surplus of food and. at the same time, a fairly high frequency of child malnutrition [6]. The study focused on finding reasons for this apparently paradoxical situation. One hypothesis was that women's lack of time for child care and feeding due to a heavy work load was one of the factors contributing to child malnutrition.

A recent paper from this study [6] described the gender division of labour and men's contribution to household food and nutrition. It also described some of the positive effects of women's work on the food situation in the household. This paper examines in more detail the work that women are doing, and especially its possible negative effects on child feeding and nutrition.

The study

Location

The study area is situated in the Rukwa region, in western Tanzania, on a mountainous plateau at an altitude of about 1,200 metres. The annual rainfall varies from 800 to 1,200 mm, occurring mostly from November to April. The majority of the people, who belong to the Fipa tribe, are subsistence farmers and self-sufficient concerning most foods. Maize, finger millet, and beans are the most important crops. In addition, groundnuts, potatoes, various vegetables, fruits, and green leaves are cultivated by most farmers. Many also keep cattle as well as a few pigs and hens. In fact, most farming households produce all the foods necessary for a nutritionally adequate diet.

Research design and field methods

The field study was carried out over one year in 1987-1988. It consisted of two interrelated and overlapping components, seasonal monitoring and in-depth studies.

Seasonal monitoring

Seasonal monitoring (three surveys) of 200 randomly selected households with preschool children took place in two villages. Care was taken to select villages in which infectious diseases due to had water were not a major cause of malnutrition. The three surveys were carried out in April-May, the preharvest season with relatively low workload (survey 1), July-August, the main harvest season with high workload (survey 2), and February-March with highwork load in weeding (survey 3).

These surveys were quantitative, using questionnaires and nutrition survey techniques. The data reported here were collected in the several ways:

First, women's and men's work time in the most common activities was recorded by recall of the previous day.

Respondents were also asked about the number of months that the household did not have maize and beans in stock before the harvest. This was used as an indicator of food shortage versus availability.

Third, mothers were asked about feeding practices in the season in question. "Child meals" were calculated based on the mother's own interpretation of which feeding events could be called a meal. Twenty-four-hour recall of the previous day's intake for weaned children under three years of age was recorded. Child feedings were calculated. including all feeding events. Children's nutrition status was also determined using weight for age as the indicator. Children under five years were weighed on a Salter spring scale. Age was established from birth dates recorded on weighing cards.

Finally, a composite socio-economic index was calculated for each household on the basis of its possession of selected items that were known to be related to the material standard of living in this society. The method was adapted from Smith [7] and employed in earlier surveys by the authors [8].

In-depth studios

In-depth studies were conducted at different seasons in 24 households strategically selected from the larger sample. These were anthropological and included participant observation of mothers and children in the field and at home, especially during food preparation and feeding: structured and unstructured interviews on women's field work, child feeding, and decision making within the household; and group discussions with women of different age groups.

Results

Women's work and men's contribution

Almost all the mothers of the preschool children worked in the field to produce food for household consumption and for sale. Only three mothers in the sample were not engaged in any agricultural work. A few did this work in addition to other types of work. The rest considered farming their main economic activity.

Usually the women began walking to the fields at dawn. The fields were located from 15 minutes, to about 2 hours, walking distance from their houses. Some women returned home around noon, whereas others remained working for up to 10-11 hours. Intensive working periods in the agricultural cycle began with weeding, which lasted for about three months, followed by harvesting, lasting a couple of weeks. However, women did not do field work every day. Even during the peak labour periods, most went to the field about every other day.

Cultivation was a joint responsibility of men and women. Men were mostly responsible for preparing the soil, and women for weeding. Harvesting could be done by both sexes. The effort that women and men put into the work was governed not only by the need for food for household consumption but also by the need for cash to buy more or less necessary things. Our in-depth data indicated that conflicts often arose within the household relating to these two types of needs, with women tending to be more concerned about the food needs and men most often expressing the need for cash.

The last two decades have seen a gradual shift from the production of millet to maize as the major crop. This switch was accompanied by the introduction of modern techniques of cultivation, including ploughs and fertilizer. This, in turn, led to larger areas being put under cultivation and to surplus production of food. However, the consensus among the informants is that these changes have not enhanced the food available for consumption, since the concomitant increase in the need for cash has resulted in more food being sold. In the main, men make the decision about how much to sell and what to buy with the cash.

With the increase in areas under cultivation, women have more work in weeding, but, at the same time, they have to a certain extent been relieved of the arduous work of preparing the soil. The shift from millet to maize has increased men's participation in agricultural work. They have gradually taken a share even in weeding. Their contribution varies considerably from individual to individual. In households where men do little work in the fields, women spend more time in agricultural work than in households where men make a moderate contribution [6]. However, when men work hard, women do so as well. This phenomenon was explained by the fact that most agricultural tasks are still defined as women's work and as their moral obligation, whereas men are only considered as "helping their wives." Thus, when a man chooses to work hard. his wife is obliged to work by his side.

Child diet and feeding practices

Almost all the children are breast-fed from birth to 9 months of age. By 24 months 50% are totally weaned. Other foods are introduced gradually, beginning at 6 months. The first weaning food is uji, a gruel cooked from maize or millet flour and water. Ugali, the main ingredient of adult meals, is introduced between 9 and 12 months. This is a stiff porridge made of maize or millet flour and water. Small balls of ugali are dipped in a relish sauce, usually made of beans and green leaves, and fed to the children. Potatoes or other vegetables constitute part of the children's diet at certain times of the year. Snack foods, such as corn on the coin, maize stems. and sugar cane or fruits, are given between meals once the children are able to chew.

It is not the custom in this society to eat anything in the morning. However, some mothers prepare uji or snack foods at this time of day for the small children. Most mothers believe that the appropriate number of meals for children under five years old is three per day, and 60% follow this as usual practice. Given this pattern of few meals, snacks are crucial for children of weaning age to meet their nutrient requirements. Therefore, all the feeding events from the 24-hour recall were examined for the subsample of weaned children under three years old. This analysis revealed that 46% received three feedings or fewer per day in the season of low field work. The daily energy intake of the children varied considerably; the mean intake was about 70% of that recommended by the FAO [9].

The malnutrition rate among the children under five, as measured by the number who had weight for age below 75% of the WHO reference standard [10], was estimated to be 20%. There were very small seasonal variations, and there was no difference between boys and girls. Seasonal variations in disease pattern and water quality were very small and did not coincide with changes in nutrition status over the year.

Food availability

An important question to address with regard to child malnutrition is whether households in this community really face food shortage. When the production volume of maize and beans was compared to people's own estimation of their consumption needs, 90%, of the households were found to produce at least as much of these crops as they required for their own consumption. However, since some of the produce was sold to cover cash needs, many households ran out of stocks before the next harvest. This shortage was relieved by the consumption of unripe crops of maize and beans, picked directly from the field. It was estimated that food shortage was a problem only for the 32% of households that did not have maize stocks for three months or more (table 1). Faced with shortage, people have other ways of procuring food, including selling their labour, and bartering or borrowing food from relatives or neighbours. As a safety measure when a hunger period was expected, people would also cultivate potatoes and sweet potatoes. Therefore, none of the households in the sample were completely without food before the harvest.

TABLE 1. Food availability—percentages of households lacking stocks of maize and beans before harvest

In households whose stock of maize runs out less than three months before harvest, food shortage will be buffered by new maize.

However, as seen in table 2, the nutrition of the children was worse in the households where the stocks of maize and beans were exhausted for the longest period. On the other hand, the table also indicates that malnutrition may be a problem even in the households that have enough food. Thus, at least for part of the community, both a surplus of food and malnutrition exist. It is therefore relevant to examine the possible negative effects of women's work in the field on household food and nutrition.

TABLE 2. Relationship between household food availability and children's nutrition status

a. Percentage of WHO reference standard weight for age.
b Percentage of children weighing <75% of WHO reference standard weight for age.
* Difference tested by analysis of variance, controlling for socio-economic score, p = .05.

Women's field work and food and nutrition status

Two opposing effects of women's productive work

Women's and men's field work was analysed in relation to household food stocks to get an indication of the effect of this work on household food availability. The data show an increase in stocks of maize and beans in households where women spend more time in the field (table 3). However, the differences are not significant when the amount of time men spend in the field is controlled in the analysis. When the combined time of both men and women is included, the difference between the means in maize stocks is significant. These results indicate that in this society both men's and women's field work is important for household food availability.

Women's work time in the field was compared to the number of times children were fed during the day.

TABLE 3. Relationship between time allocated to field work and household food availability

Only the period of heaviest held work is included.
* Analysis of variance, controlling for socio-economic score, p = 04.

A significant (p < .05) positive relationship was found, even when the socio-economic score was controlled for (table 4). Furthermore, comparing data from the seasonal surveys, we find that women spent less time cooking and children were fed less often in the seasons of hard field work (table 5). Thus, there appear to be some negative effects of women's work on child feeding practices, especially when the workload is high.

TABLE 4. Relationship between mothers' field work and average number of child feedings per day

Data based on averages from three surveys.
* Analysis of variance, controlling for Socio-economic score, p = .02.

TABLE 5. Seasonal variations in cooking and child feeding patterns

* Difference between survey 1 and surveys 2 and 3 significant below the .05 level (paired t test).

The relationship between the numbers and types of feedings and children's nutrition status is shown in table 6. It was not significant. However. the number of feedings taken together with types and quality of foods given was significantly and positively related to children's nutrition status.

TABLE 6. Relationship between feeding pattern (number of feedings per day and type of food) and nutrition status

Only children who, were not breast-fed were included in the analysis.
a. Percentage of WHO reference standard.
b. Percentage of children weighing <75% of the WHO reference standard.
c. 1-4 feedings, with 1 meal or less consisting of ugali and beans, fish, or meat—the rest being uji, corn on the cob, fruit, or vegetables,
d. 4-5 feedings, with 2 meals or more consisting of ugali and beans, fish, or meat
* Difference between groups significant below the 0.5 level (Student's t test).

Analysis of the direct relationship between the time mothers spent working in the field and child nutrition status gave no conclusive support to the notion that women's work has negative consequences for the child (table 7). A negative relationship was suggested, but the difference is not significant at the .05 level when the socioeconomic score is controlled for.

TABLE 7. Relationship between mothers' field work and children's nutrition status

Data based on averages from three surveys.
The differences are not significant at the .05 level (analysis of variance statistics. controlling for socio-economic score. p = 27).

To understand the implications of these findings, it is necessary to consider some of the intermediary factors and mechanisms that come into play in determining the impact of women's work in the field on nutrition. The crucial issue is the extent to which such work prevents proper care and feeding of children. The most important questions are what happens with child care and feeding when the mother is in the field, and how does it differ from the care they receive when the mother stays at home?

Child care and mothers' field work

Women very often bring their small children along to the field. This is always true for children who are breast-fed and can be carried on the back. Weaned children may sometimes be left in the care of relatives, neighbours, or older siblings. When the mother leaves the child in care of older siblings, she often prepares food in advance to ensure that the child will be fed something while she is away.

When the children are brought to the field, women have traditionally carried uji to feed them. However, at the time of the study, many women no longer followed this practice. Sometimes they brought foods such as corn on the cob, which is difficult for young children to eat, but as many as 53% of the mothers stated that they were not in the habit of bringing any food to the field. Data from the in-depth study indicated that many women did not think it was necessary if they only worked for half a day. This view was confirmed in the group discussions with women of different age groups. The time constraint was not the reason many women did not bring food to the field; rather, according to the younger women, it was the shorter length of field work time.

Quantitative data seem to point in the same direction. It was more common to bring food when the fields were located far away from home than when they were close. It should be recalled that it was not the custom in this society to eat anything in the morning. Furthermore, food preparation after returning home could be a lengthy process since the meal often included beans. which require a long cooking time. Therefore, the first meal might not he served until early in the afternoon on working days.

Women had ways of compensating for children's loss of feedings on days they worked. They could give the breast more often, and some women fed their children before going to the field. Other provided something for the children to eat before they began preparations for the main meal. It was therefore important to assess whether the abandonment of the practice of bringing food to the field really resulted in fewer feedings and hence a deterioration of the children's nutrition status.

Analysis of the quantitative data shows that the children of the mothers who brought food to the field received significantly more feedings per day than those of mothers who did not bring food. However, the mothers who brought food were not less likely to have malnourished children. This may be explained by the fact that the items brought to the field (uji, corn on the cob) have low nutritive value due to low energy density, or were unsuited for children of weaning age for other reasons. The fact that there was no significant relationship between the number of feedings and nutrition status but that the number of feedings taken together with the types and quality of foods given was positively related to the children's nutrition status supports this interpretation.

Discussion and conclusions

The finding that the amount of mothers' field work did not seem to have any profound or conclusive relationship to children's nutrition status may be explained by several factors that could buffer or compensate for the potentially negative impact of such work.

The most important factor is that women's agricultural work is important for the food availability in the household, which in turn has a positive influence on children's nutrition status. Food availability can be assumed to be an important precondition for adequate feeding of the child in a society where children do not have priority in the distribution of food within the household.

Concerning the relationship to women's time, several points emerge. Even in the peak labour season women usually only work in the field every other day. This implies that in a time of food surplus, children's low intake on working days may be compensated for by higher intake on days when the mother stays at home.

When women do not take their children to the field, they try to secure proper care and feeding for the youngsters. Even when they have to resort to the older siblings for care-taking, they provide some food for the children to eat.

The reduced energy intake in the field may, to some extent, be compensated for by increased intake be fore and after the stay in the field. There may also be a greater frequency of breast-feeding.

These compensatory mechanisms point to the conclusion that women's time constraint is not a very important factor in explaining the variation in children's nutrition status in this society. This conclusion is also in line with the women's own interpretation of the situation.

What seems to be more important is the quality of diet fed to young children. Most women tried to give their small children a diet that they thought was appropriate—three daily meals of mainly uji and ugali made out of maize flour. They did not always succeed, because of low food availability or long working days. Except for that, they did not see any reason to change. However, according to UNICEF. Tanzania [11], three daily meals on this diet is not sufficient to cover the energy needs of children under five years old.

Some of the underlying causes for the inadequate child feeding are related to the mismatch between the traditional practices and the changes that have occurred in the course of "development." The increased emphasis on maize production at the expense of millet has had direct consequences for children's diet. Ugali and uji, which traditionally were made of millet, are now made from maize, a change that has negatively affected the nutritional value of the meals in terms both of energy density and of nutrient content. Furthermore, the practice of always trying to secure enough food for household consumption has gradually been abandoned in favour of maximizing cash income. This may have a bearing on child feeding and nutrition.

The nutrition education given in schools and health clinics has not managed to counteract the effect of these problems. Women did not find the education useful, because it did not fit with their perception of health and disease and did not pay attention to their circumstances.

Even though women's time constraints are not important in explaining the variation in child malnutrition at present, they may be crucial when attempts are made to remedy the problem. The norm of feeding children three meals a day was well matched with women's working, so that many women managed to fulfil this even on working days. In group discussions it was revealed that a large number of women saw this as the absolute maximum they could manage in addition to other responsibilities, because of both field work and other types of work. Therefore, advice that encourages more numerous or more time-consuming preparations would not be easily accepted. Furthermore, if "development" implies more field work for women, it may result in deterioration of the food and nutritional status of the children.

As a step toward addressing these difficult problems, we suggest initiating dialogues with both men and women on issues such as the following:

• child feeding practices—energy-dense weaning foods and meal frequencies, taking into account women's field work;
• excessive selling of food—men's responsibility for food availability in the household;
• the division of labour—men's responsibility to par take in field work.

Acknowledgement

We express our gratitude to Dr. Ophelia Mascarenhas of the University of Dar es Salaam for her contribution in planning the research project.

References

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2. Carloni A. The impact of maternal employment and income on the nutritional status of children in rural areas of developing countries. Report prepared for the UN Administrative Committee on Coordination. Subcommittee on Nutrition. Rome, 1984.
3. FAO. Women in food production, food handling and nutrition. Food and Nutrition Paper no. 8. Rome: Food and Agriculture Organization. 1979.
4. Kumar S. Composition of economic constraints in child nutrition: impact of maternal incomes and employment in low-income households. Doctoral dissertation, Cornell University, Ithaca, NY, USA, 1977.
5. Tripp R. Farmers and traders: some economic determinants of nutritional status in northern Ghana. Food Nutr 1982;8(1):3-11.
6. Holmboe-Ottesen G. Wandel M. Men's contribution to the food and nutritional situation in the Tanzanian household. Ecol Food Nutr 1991;26(1):83-96.
7. Smith DM. Where the grass is greener: living in an unequal world. Harmondsworth, UK. and New York: Penguin, 1979.
8. Holmboe-Ottesen G, Wandel M, Oshaug A. Nutritional evaluation of an agricultural development project in southern Sri Lanka. Food Nutr Bull 1989;11(3):47-56.
9. FAO/WHO/UNU Expert Consultation. Energy and protein requirements. Technical Report Series, no. 724. Geneva: World Health Organization, 1985.
10. WHO. Measurement of nutritional impact: a guideline for the measurement of nutritional impact of supplementary feeding programs aimed at vulnerable groups. Geneva: World Health Organization, 1979.
11. UNICEF/Government of Tanzania. Analysis of the situation of children and women: priorities for child survival and development. Dar es Salaam. Tanzania: UNICEF. 1985.

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